The shift from pulmonary colonization to Pneumocystis pneumonia
Solène Le Gal1,2, Pierre Bonnet1,2, Antoine Huguenin3
1Université de Brest, Université d'Angers, GEIHP, Brest, France.
Medical Mycology
|December 28, 2020
Summary
Pulmonary colonization with Pneumocystis jirovecii may precede Pneumocystis Pneumonia (PcP). Genotyping suggests colonization can be distinct from, or an incubation phase of, PcP, warranting individualized clinical consideration.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Pulmonology
Background:
- Pulmonary colonization with Pneumocystis jirovecii is recognized.
- The clinical significance and progression of colonization to Pneumocystis Pneumonia (PcP) require further elucidation.
Purpose of the Study:
- To investigate the relationship between P. jirovecii colonization and subsequent PcP development using genotyping.
- To determine if pulmonary colonization represents an incubation period or a distinct state from active PcP.
Main Methods:
- Retrospective analysis of pulmonary specimens from five patients with initial colonization and subsequent PcP.
- P. jirovecii genotyping was performed on paired specimens.
Main Results:
- Genotype matches were observed in three of five patients.
- A partial match was seen in one patient, and a mismatch in another.
- These findings indicate variability in the relationship between colonization and PcP.
Conclusions:
- Pulmonary colonization by P. jirovecii may represent either a distinct entity or the incubation phase of PcP.
- Clinicians should consider PcP treatment or prophylaxis for colonized patients on a case-by-case basis.
- Rethinking the management of P. jirovecii colonization is recommended.
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