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Pneumocystis primary infection in infancy: Additional French data and review of the literature

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dc.contributor.author Nevez, Gilles
dc.contributor.author Guillaud-Saumur, Thibaud
dc.contributor.author Cros, Pierrick
dc.contributor.author Papon, Nicolas
dc.contributor.author Vallet, Sophie
dc.contributor.author Quinio, Dorothée
dc.contributor.author Minoui-Tran, Adissa
dc.contributor.author Pilorgé, Léa
dc.contributor.author de Parscau, Loïc
dc.contributor.author Sizun, Jacques
dc.contributor.author Ochoa Woodell, Theresa Jean
dc.contributor.author Bustamante Rufino, Ana Beatriz
dc.contributor.author Ponce, Carolina
dc.contributor.author Vargas, Sergio L.
dc.contributor.author Le Gal, Solène
dc.date.accessioned 2019-07-04T17:00:20Z
dc.date.available 2019-07-04T17:00:20Z
dc.date.issued 2019
dc.identifier.uri https://hdl.handle.net/20.500.12866/6881
dc.description.abstract Data on features of Pneumocystis primary infection in infancy are still fragmented. To study Pneumocystis primary infection, 192 infants who were monitored for acute pulmonary disease or fever over a 40-month period were retrospectively investigated. P. jirovecii detection on archival nasopharyngeal aspirates was performed using a qPCR assay. Factors associated with P. jirovecii were assessed using univariate and multivariate analyses. P. jirovecii genotypes in infants and a control group of adults contemporaneously diagnosed with Pneumocystis pneumonia were identified using unilocus, bilocus, and multilocus sequence typing (MLST). P. jirovecii was detected in 35 infants (18.2%). The univariate analysis pointed out four factors: viral infection (P = .035, OR [IC 95], 2.2 [1.1-4.7]), lower respiratory tract infection (P = .032, OR [IC 95], 2.5 [1.1-5.9]), absence of hospital discharge after birth (P = .003, OR (IC 95), 0.1 (0.02-0.5]), and the 63-189-day group (P < .001, OR [IC 95], 42.2 [5.4-332]). The multivariate analysis confirmed these two latter factors (P = .02, OR [IC 95], 0.1 [0.02-0.72]; P = .005, OR [IC 95], 11.5 [2.1-63.5]). Thus, P. jirovecii acquisition mostly takes place in the community. A comparison of these data with those of previously published studies showed that median and interquartile range of positive-infant ages were close to those observed in Chile, Denmark, and Peru, highlighting similar characteristics. Common unilocus or bilocus genotypes were identified in infants and adults, whereas no MLST genotypes were shared. Therefore, a common reservoir made up of infected infants and adults is still hypothetical. Finally, primary infection is a worldwide phenomenon occurring at the same time in childhood regardless of geographical location, rather than an incidental event. en_US
dc.language.iso eng
dc.publisher Oxford University Press
dc.relation.ispartofseries Medical Mycology
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject genotypes en_US
dc.subject infants en_US
dc.subject MLST en_US
dc.subject Pneumocystis jirovecii en_US
dc.subject primary infection en_US
dc.title Pneumocystis primary infection in infancy: Additional French data and review of the literature en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1093/mmy/myz040
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.03.08
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#4.03.00
dc.relation.issn 1460-2709


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