Outbreak-Causing Fungi: Pneumocystis jirovecii

Mycopathologia. 2020 Oct;185(5):783-800. doi: 10.1007/s11046-019-00408-w. Epub 2019 Nov 28.

Abstract

Pneumocystis jirovecii pneumonia (PCP) is an important cause of morbidity in immunocompromised patients, with a higher mortality in non-HIV than in HIV patients. P. jirovecii is one of the rare transmissible pathogenic fungi and the only one that depends fully on the host to survive and proliferate. Transmissibility among humans is one of the main specificities of P. jirovecii. Hence, the description of multiple outbreaks raises questions regarding preventive care management of the disease, especially in the non-HIV population. Indeed, chemoprophylaxis is well codified in HIV patients but there is a trend for modifications of the recommendations in the non-HIV population. In this review, we aim to discuss the mode of transmission of P. jirovecii, identify published outbreaks of PCP and describe molecular tools available to study these outbreaks. Finally, we discuss public health and infection control implications of PCP outbreaks in hospital setting for in- and outpatients.

Keywords: Infection control; Invasive fungal disease; Molecular typing; Outbreaks; Pneumocystis; Renal transplant recipient.

Publication types

  • Review

MeSH terms

  • Chemoprevention
  • Cross Infection / drug therapy
  • Cross Infection / transmission
  • Disease Outbreaks / prevention & control
  • HIV Infections / complications
  • Humans
  • Immunocompromised Host
  • Infection Control
  • Mycological Typing Techniques
  • Pneumocystis carinii* / genetics
  • Pneumocystis carinii* / isolation & purification
  • Pneumocystis carinii* / pathogenicity
  • Pneumocystis carinii* / physiology
  • Pneumonia, Pneumocystis / drug therapy
  • Pneumonia, Pneumocystis / transmission*
  • Public Health
  • Trimethoprim, Sulfamethoxazole Drug Combination / pharmacology

Substances

  • Trimethoprim, Sulfamethoxazole Drug Combination