Helweg-Larsen J, Tsolaki A G, Miller R F, Lundgren B, Wakefield A E
Department of Haematology, Rigshospitalet, Copenhagen, Denmark.
QJM. 1998 Dec;91(12):813-20. doi: 10.1093/qjmed/91.12.813.
Genotyping at the internal transcribed spacer (ITS) regions of the nuclear rRNA operon was performed on isolates of P. carinii sp. f. hominis from three clusters of P. carinii pneumonia among eight patients with haematological malignancies and six with HIV infection. Nine different ITS sequence types of P. carinii sp. f. hominis were identified in the samples from the patients with haematological malignancies, suggesting that this cluster of cases of P. carinii pneumonia was unlikely to have resulted from nosocomial transmission. A common ITS sequence type was observed in two of the patients with haematological malignancies who shared a hospital room, and also in two of the patients with HIV infection who had prolonged close contact on the ward. In contrast, different ITS sequence types were detected in samples from an HIV-infected homosexual couple who shared the same household. These data suggest that person-to-person transmission of P. carinii sp. f. hominis may occur from infected to susceptible immunosuppressed patients with close contact within hospital environments. However direct transmission between patients did not account for the majority of cases within the clusters, suggesting that person-to-person transmission of P. carinii sp. f. hominis infection may be a relatively infrequent event and does not constitute the major route of transmission in man.
对来自8例血液系统恶性肿瘤患者和6例HIV感染患者的3组卡氏肺孢子虫肺炎病例中分离出的卡氏肺孢子虫人型变种，进行了核糖体RNA操纵子内部转录间隔区（ITS）的基因分型。在血液系统恶性肿瘤患者的样本中鉴定出9种不同的卡氏肺孢子虫人型变种ITS序列类型，这表明该组卡氏肺孢子虫肺炎病例不太可能是医院内传播所致。在共用一间病房的2例血液系统恶性肿瘤患者中，以及在病房内有长期密切接触的2例HIV感染患者中，观察到一种常见的ITS序列类型。相比之下，在来自同一家庭的一对HIV感染同性恋伴侣的样本中检测到不同的ITS序列类型。这些数据表明，卡氏肺孢子虫人型变种可能在医院环境中通过密切接触在受感染的免疫抑制患者与易感患者之间发生人际传播。然而，患者之间的直接传播并不占这些病例组中的大多数，这表明卡氏肺孢子虫人型变种感染的人际传播可能是相对罕见的事件，并非人类主要的传播途径。
