Laurence Pougnet

Pneumocystis jirovecii in the air surrounding patients with Pneumocystis pulmonary colonization

In this study, Pneumocystis jirovecii was detected and characterized in the air surrounding patients with Pneumocystis pulmonary colonization. Air samples were collected in the rooms of 10 colonized patients using Coriolis® μ air sampler at 1m and 5m from the patients head. P. jirovecii DNA was amplified and genotyped in pulmonary and air samples at the mitochondrial large subunit ribosomal RNA gene. P. jirovecii DNA was detected in 5 of the 10 air samples collected at 1m and in 5 of the 10 other air samples collected at 5m. P. jirovecii genotyping was successful in 4 pairs or triplets of air and pulmonary samples. Full genotype matches were observed in 3 of the 4 pairs or triplets of air and pulmonary samples. These results provide original data supporting P. jirovecii exhalation from colonized patients and emphasize the risk of P. jirovecii nosocomial transmission from this patient population.

A misleading false-negative result of Pneumocystis real-time PCR assay due to a rare punctual mutation: A French multicenter study

Abstract This article describes a previously unreported mutation at position 210 (C210T) of the mitochondrial large subunit ribosomal RNA (mtLSUrRNA) gene of Pneumocystis jirovecii, which led to a false‐negative result of a real‐time polymerase chain reaction (PCR) assay. Since the aforementioned real‐time PCR assay is widely used in France, a French multicenter study was conducted to estimate the mutation frequency and its potential impact on the routine diagnosis of Pneumocystis pneumonia (PCP). Through analysis of data obtained from eight centers, the mutation frequency was estimated at 0.28%. This low frequency should not call into question the routine use of this PCR assay. Nonetheless, the occurrence of the false‐negative PCR result provides arguments for maintaining microscopic techniques combined to PCR assays to achieve PCP diagnosis.

Pneumocystis jirovecii and Cystic Fibrosis in Brittany, France

Pneumocystis jirovecii is a transmissible fungus with a high pulmonary tropism. The prevalence of P. jirovecii in patients with cystic fibrosis (CF) has been estimated in Germany at 7.4%, in Spain at 21.5% and in Brazil at 38.2%. Data on the prevalence of P. jirovecii in CF patients in France remain scarce, particularly in Brittany, where the prevalence of CF is high (from 1/1600 to 1/4500). Our objectives were to determine the prevalence of colonization of the airways by P. jirovecii in Brittany in CF patients monitored at the “Centre de Ressources et de Compétences de la Mucoviscidose (CRCM)” of Rennes compared to that previously observed at the CRCM of Roscoff–Brest. Sputa from 86 patients (178 specimens) followed in Rennes were analyzed retrospectively. The detection of P. jirovecii was performed using real-time PCR targeting the gene encoding the mitochondrial large subunit of ribosomal RNA. Pneumocystis jirovecii DNA was detected in 3/86 patients (3.5%) monitored at Rennes, whereas it had previously been detected in 1/76 patients (1.3%) monitored at Roscoff–Brest, thus showing an overall prevalence of 2.5% in Brittany. These results obtained from two Breton centers taken together show that P. jirovecii prevalence in patients with CF in Brittany is lower than those observed in Germany, Spain, Brazil or in other regions of France. This study is a preliminary step in determining the risk factors for P. jirovecii acquisition, its epidemiological and clinical significance in CF patients through a prospective multicenter study.

Health effects of hyperbaric exposure on chamber attendants: a literature review

BACKGROUND Inside attendants working in hyperbaric chambers are exposed to risks related to the hyperbaric environment, handling and care. The aim of this study is to review the literature focusing on the impact of this activity on health. MATERIALS AND METHODS This is a literature review using the Medline database. RESULTS Eight articles studied decompression illness (DCI). The incidence of DCI ranged from 0 to 37 per 100,000 sessions in hyperbaric chambers (SHC). The incidence of injuries ranged from 0 to 412 per 100,000 SHC. The most prevalent cause of accidental death was fire: 77 deaths (patients and attendants) between 1923 and 1996. Dysbaric osteonecrosis has been reported in one study only. CONCLUSIONS Inside attendants face risks in the chamber, even if serious health effects seems rare compared to the total number of SHC.

Pneumocystis jirovecii Exhalation in the Course of Pneumocystis Pneumonia Treatment

Kathleen A. Quan, RN, MSN; Jennifer Yim, RN, BSN; Doug Merrill, MD, MBA, MA, FASA; Usme Khusbu, MS; Keith Madey, MAFIS, BBA; Linda Dickey, RN, MPH; Amish A. Dangodara, MD; Scott E. Rudkin, MD, MBA; Margaret O’Brien, RN, BSN; Daniel Thompson, MAFIS; Nimisha Parekh, MD, MPH, FACG, AGAF; C. Gregory Albers, MD, FACG; William C. Wilson, MD; Lauri Thrupp, MD; Cassiana E. Bittencourt, MD; Susan S. Huang, MD, MPH; Shruti K. Gohil, MD, MPH