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Multilocus sequence typing of Pneumocystis jirovecii from clinical samples: how many and which loci should be used?

Céline Maitte1, Marion Leterrier, Patrice Le Pape

  • 1Laboratoire de Parasitologie-Mycologie, CHU de Nantes, Nantes, France.

Journal of Clinical Microbiology
|June 21, 2013
PubMed

Insights

A simplified multilocus sequence typing (MLST) scheme using three genetic markers (mt26S, CYB, and SOD) effectively identifies Pneumocystis jirovecii pneumonia (PCP) clusters. This method offers high discriminatory power for investigating PCP outbreaks in immunocompromised patients.

Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Molecular Epidemiology

Background:

  • Pneumocystis jirovecii pneumonia (PCP) is a significant opportunistic infection in immunocompromised individuals.
  • Nosocomial outbreaks of PCP, particularly in kidney transplant recipients, necessitate robust epidemiological investigation tools.
  • Multilocus sequence typing (MLST) is the gold standard for PCP outbreak investigations, but a consensus scheme is lacking.

Purpose of the Study:

  • To evaluate the discriminatory power of eight distinct genetic loci for molecular typing of Pneumocystis jirovecii.
  • To identify an optimal and simplified MLST scheme for investigating PCP outbreaks.

Main Methods:

  • Retrospective analysis of respiratory samples from 33 PCP-positive patients admitted between 2006 and 2011.
  • Molecular typing using eight previously described loci: ITS1, CYB, mt26S, 26S, SOD, β-TUB, DHPS, and DHFR.
  • Calculation of discriminatory power using the Hunter (H) index for each locus and combined schemes.

Main Results:

  • The discriminatory power of individual loci varied significantly.
  • An eight-locus MLST scheme demonstrated high discriminatory power (H-index = 0.996).
  • A simplified three-locus scheme (mt26S, CYB, SOD) achieved substantial discriminatory power (H-index = 0.987), suitable for preliminary investigations.

Conclusions:

  • The selection of loci is critical for the discriminatory power of MLST in Pneumocystis jirovecii typing.
  • A three-locus MLST scheme (mt26S, CYB, SOD) is a viable and effective alternative for preliminary epidemiological investigations of PCP clusters.
  • This simplified approach can aid in the timely identification and management of PCP outbreaks.

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