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Transmission of Pneumocystis carinii from patients to hospital staff
B Lundgren1, K Elvin, L P Rothman
1Department of Clinical Microbiology, Hvidovre Hospital, Compenhagen, Denmark.
Background:
An extrahuman reservoir of human pathogenic Pneumocystis carinii remains unknown. Host to host transmission has been described in animal studies and in cluster cases among immunodeficient patients. P carinii DNA has recently been detected in air filters from inpatient and outpatient rooms in departments of infectious diseases managing patients with P carinii pneumonia (PCP), suggesting the airborne route of transmission. Exposure of staff to P carinii may occur in hospital departments treating patients with PCP.
Methods:
Exposure to P carinii was detected by serological responses to human P carinii by ELISA, Western blotting, and indirect immunofluorescence in 64 hospital staff with and 79 staff without exposure to patients with PCP from Denmark and Sweden. DNA amplification of oropharyngeal washings was performed on 20 Danish staff with and 20 staff without exposure to patients with PCP.
Results:
There was no significant difference in the frequency or level of antibodies to P carinii between staff exposed and those unexposed to patients with PCP. None of the hospital staff had detectable P carinii DNA in oropharyngeal washings.
Conclusions:
There is no difference in antibodies and no detectable P carinii DNA in oropharyngeal washings, which suggests that immunocompetent staff treating patients with PCP are not a potentially infectious source of P carinii for immunocompromised patients.
Insights
Immunocompetent hospital staff exposed to Pneumocystis pneumonia (PCP) patients showed no increased antibodies or detectable DNA, suggesting they are not infectious sources. This research addresses airborne transmission concerns for Pneumocystis carinii.
Area of Science:
- Infectious Diseases
- Immunology
- Microbiology
Background:
- The extrahuman reservoir of Pneumocystis carinii, a human pathogen, is unknown.
- Airborne transmission of P. carinii is suggested by its detection in hospital air filters.
- Healthcare workers in infectious disease departments may be exposed to P. carinii.
Purpose of the Study:
- To investigate potential P. carinii exposure and transmission among hospital staff treating patients with P. carinii pneumonia (PCP).
- To determine if immunocompetent staff pose an infectious risk to immunocompromised patients.
Main Methods:
- Serological responses (ELISA, Western blotting, immunofluorescence) to P. carinii were measured in 64 exposed and 79 unexposed hospital staff.
- DNA amplification of P. carinii was performed on oropharyngeal washings from 20 exposed and 20 unexposed Danish staff.
Main Results:
- No significant difference in antibody frequency or levels to P. carinii was found between exposed and unexposed staff.
- P. carinii DNA was not detected in the oropharyngeal washings of any hospital staff studied.
Conclusions:
- Immunocompetent staff treating patients with PCP do not exhibit increased P. carinii antibodies or detectable DNA.
- Findings suggest that these staff members are unlikely to be a source of P. carinii transmission to immunocompromised patients.