title: Prevalence and genotype distribution of Pneumocystis jirovecii in Cuban infants and toddlers with whooping cough.
abstract: This study describes the prevalence and genotype distribution of Pneumocystis jirovecii obtained from nasopharyngeal (NP) swabs from immunocompetent Cuban infants and toddlers with whooping cough (WC). A total of 163 NP swabs from 163 young Cuban children with WC who were admitted to the respiratory care units at two pediatric centers were studied. The prevalence of the organism was determined by a quantitative PCR (qPCR) assay targeting the P. jirovecii mitochondrial large subunit (mtLSU) rRNA gene. Genotypes were identified by direct sequencing of mtLSU ribosomal DNA (rDNA) and restriction fragment length polymorphism (RFLP) analysis of the dihydropteroate synthase (DHPS) gene amplicons. qPCR detected P. jirovecii DNA in 48/163 (29.4%) samples. mtLSU rDNA sequence analysis revealed the presence of three different genotypes in the population. Genotype 2 was most common (48%), followed in prevalence by genotypes 1 (23%) and 3 (19%); mixed-genotype infections were seen in 10% of the cases. RFLP analysis of DHPS PCR products revealed four genotypes, 18% of which were associated with resistance to sulfa drugs. Only contact with coughers (prevalence ratio [PR], 3.51 [95% confidence interval {CI}, 1.79 to 6.87]; P = 0.000) and exposure to tobacco smoke (PR, 1.82 [95% CI, 1.14 to 2.92]; P = 0.009) were statistically associated with being colonized by P. jirovecii. The prevalence of P. jirovecii in infants and toddlers with WC and the genotyping results provide evidence that this population represents a potential reservoir and transmission source of P. jirovecii.
authors.affiliation: Department of Bacteriology and Mycology, Institute of Tropical Medicine Pedro Kourí, Havana, Cuba.
authors.forename: Ernesto X
authors.initials: EX
authors.lastname: Monroy-Vaca
authors.forename: Yaxsier
authors.initials: Y
authors.lastname: de Armas
authors.forename: María T
authors.initials: MT
authors.lastname: Illnait-Zaragozí
authors.forename: Gilda
authors.initials: G
authors.lastname: Toraño
authors.forename: Raúl
authors.initials: R
authors.lastname: Diaz
authors.forename: Dania
authors.initials: D
authors.lastname: Vega
authors.forename: Ileana
authors.initials: I
authors.lastname: Alvarez-Lam
authors.forename: Enrique J
authors.initials: EJ
authors.lastname: Calderón
authors.forename: Christen R
authors.initials: CR
authors.lastname: Stensvold
mesh_terms: D002648:Child; D002675:Child, Preschool; D003462:Cuba / Q000453:epidemiology; D004271:DNA, Fungal / Q000737:chemistry / Q000235:genetics; D005260:Female; D005838:Genotype; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008969:Molecular Sequence Data; D009305:Nasopharynx / Q000382:microbiology; D016720:Pneumocystis Infections / Q000453:epidemiology* / Q000382:microbiology*; D045363:Pneumocystis carinii / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification*; D012150:Polymorphism, Restriction Fragment Length; D015995:Prevalence; D060888:Real-Time Polymerase Chain Reaction; D017422:Sequence Analysis, DNA; D014917:Whooping Cough / Q000150:complications* / Q000382:microbiology
chemical_list: D004271:DNA, Fungal