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Published on: February 23, 2014
Nosocomial Pneumocystis jirovecii infections
G Nevez1, M Chabé, M Rabodonirina
1Laboratoire de Parasitologie et Mycologie, Hôpital Augustin Morvan, CHU, Brest, France. gilles.nevez@chu-brest.fr
Abstract:
Airborne transmission of Pneumocystis sp. from host to host has been demonstrated in rodent models and several observations suggest that interindividual transmission occurs in humans. Moreover, it is accepted that the Pneumocystis organisms infecting each mammalian species are host specific and that the hypothesis of an animal reservoir for Pneumocystis jirovecii (P. jirovecii), the human-specific Pneumocystis species, can be excluded. An exosaprophytic form of the fungus cannot be strictly ruled out. However, these data point toward the potential for the specific host to serve as its own reservoir and for Pneumocystis infection in humans as an anthroponosis with humans as a reservoir for P. jirovecii. This review highlights the main data on host-to-host transmission of Pneumocystis in rodent models and in humans by the airborne route and provides a rationale for considering the occurrence of nosocomial infections and measures for their prevention
Insights
Airborne transmission of Pneumocystis fungi occurs between hosts. Humans may act as reservoirs for Pneumocystis jirovecii, suggesting anthroponosis and the need for infection control.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Epidemiology
Background:
- Pneumocystis species transmission is established in animal models.
- Human-to-human transmission of Pneumocystis is suggested by observations.
- Pneumocystis organisms are generally host-specific, excluding animal reservoirs for human-infecting species.
Purpose of the Study:
- To review evidence for airborne transmission of Pneumocystis.
- To discuss the implications of human-specific Pneumocystis jirovecii reservoirs.
- To provide a rationale for preventing nosocomial Pneumocystis infections.
Main Methods:
- Review of existing literature on Pneumocystis transmission.
- Analysis of data from rodent models and human observations.
- Synthesis of evidence supporting airborne and anthroponotic transmission.
Main Results:
- Airborne transmission of Pneumocystis is demonstrated in rodent models.
- Human-to-human airborne transmission is a plausible route for Pneumocystis.
- Pneumocystis jirovecii likely infects humans from human reservoirs (anthroponosis).
Conclusions:
- Humans serve as the reservoir for Pneumocystis jirovecii.
- Airborne transmission facilitates Pneumocystis spread between humans.
- Prevention strategies should focus on nosocomial infection control.
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