Lundgren B, Elvin K, Rothman L P, Ljungström I, Lidman C, Lundgren J D
Department of Clinical Microbiology, Hvidovre Hospital, Compenhagen, Denmark.
Thorax. 1997 May;52(5):422-4. doi: 10.1136/thx.52.5.422.
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.
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.
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.
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.
人类致病卡氏肺孢子虫的非人宿主尚不清楚。在动物研究以及免疫缺陷患者的聚集性病例中已描述了人际传播情况。最近在收治卡氏肺孢子虫肺炎（PCP）患者的传染病科室的住院和门诊房间的空气过滤器中检测到卡氏肺孢子虫DNA，提示存在空气传播途径。在治疗PCP患者的医院科室中，工作人员可能会接触到卡氏肺孢子虫。
采用ELISA、蛋白质印迹法和间接免疫荧光法检测丹麦和瑞典64名接触过PCP患者的医院工作人员以及79名未接触过PCP患者的工作人员对人卡氏肺孢子虫的血清学反应，以检测其对卡氏肺孢子虫的接触情况。对20名接触过PCP患者的丹麦工作人员和20名未接触过PCP患者的工作人员的口咽冲洗液进行DNA扩增。
接触过PCP患者的工作人员与未接触过PCP患者的工作人员在卡氏肺孢子虫抗体频率或水平上无显著差异。医院工作人员的口咽冲洗液中均未检测到可检测到的卡氏肺孢子虫DNA。
抗体无差异，口咽冲洗液中未检测到可检测到的卡氏肺孢子虫DNA，这表明治疗PCP患者有免疫能力的工作人员不是免疫功能低下患者潜在的卡氏肺孢子虫传染源。
