Investigation of outbreaks of Pneumocystis jirovecii pneumonia in two Scottish renal units.
Pneumocystis jirovecii is recognized as an opportunistic pathogen. In recent years, human-to-human transmission of P. jirovecii has been demonstrated. However, outbreaks of P. jirovecii infections are not well defined because the epidemiological setting that facilitates transmission is not fully understood. This article describes two outbreaks of P. jirovecii pneumonia (PCP) in renal transplant patients in the West of Scotland. In total, 25 patients in two geographically contiguous locations were affected. Allele B was identified as the dominant type, along with allele A3. It was not possible to determine the exact reason for clustering of cases, although the outpatient clinic setting featured in one of the outbreaks. The outbreaks ceased with the use of trimethoprim-sulphamethoxazole prophylaxis; the target populations that received prophylaxis were different in the two outbreaks. Infection control teams should be alert to the possibility of outbreaks of PCP.
Incident Management Team, Western Infirmary, Glasgow, UK; Incident Management Team, University Hospital Crosshouse, Kilmarnock, UK. Electronic address: Teresa.Inkster@nhs.net.
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Inkster
Incident Management Team, Western Infirmary, Glasgow, UK.
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Dodd
Department of Virology, Glasgow Royal Infirmary, Glasgow, UK.
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Gunson
Incident Management Team, Western Infirmary, Glasgow, UK; Health Protection Scotland eField Epidemiology Service, Public Health England, UK.
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Imrie
Incident Management Team, University Hospital Crosshouse, Kilmarnock, UK.
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Spalding
Incident Management Team, Western Infirmary, Glasgow, UK.
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Packer
Incident Management Team, Western Infirmary, Glasgow, UK.
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Deighan
Incident Management Team, Western Infirmary, Glasgow, UK.
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Daly
Incident Management Team, Western Infirmary, Glasgow, UK.
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Coia
Incident Management Team, University Hospital Crosshouse, Kilmarnock, UK.
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Imtiaz
Incident Management Team, University Hospital Crosshouse, Kilmarnock, UK.
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McGuffie
Incident Management Team, University Hospital Crosshouse, Kilmarnock, UK.
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Wilson
Incident Management Team, University Hospital Crosshouse, Kilmarnock, UK.
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D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use; D018890:Chemoprevention / Q000379:methods; D016000:Cluster Analysis; D004196:Disease Outbreaks; D005260:Female; D005838:Genotype; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D045363:Pneumocystis carinii / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D011020:Pneumonia, Pneumocystis / Q000453:epidemiology*; D012606:Scotland / Q000453:epidemiology; D066027:Transplant Recipients; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use
D000935:Antifungal Agents; D015662:Trimethoprim, Sulfamethoxazole Drug Combination
Outbreak; P. jirovecii pneumonia (PCP); Pneumocystis jirovecii; Renal transplant