Outbreak-Causing Fungi: Pneumocystis jirovecii

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.

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AA and SD contributed to the conception and design of the review. AA, SD and MGM drafted the manuscript. AA, SD, MGM and SB critically revised the entire manuscript, agreed to be fully accountable for ensuring the integrity and accuracy of the work and approved the final submission.

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Correspondence to Alexandre Alanio.

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Dellière, S., Gits-Muselli, M., Bretagne, S. et al. Outbreak-Causing Fungi: Pneumocystis jirovecii. Mycopathologia 185, 783–800 (2020). https://doi.org/10.1007/s11046-019-00408-w

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Keywords

  • Pneumocystis
  • Outbreaks
  • Renal transplant recipient
  • Invasive fungal disease
  • Molecular typing
  • Infection control