Pneumocystis jiroveci in Portuguese immunocompromised patients: Association of specific ITS genotypes with treatment failure, bad clinical outcome and childhood

Olga Matos, Chao Hung Lee, Shaoling Jin, Baozheng Li, Marina C. Costa, Luzia Gonçalves, Francisco Antunes

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21 Scopus citations


We analyzed the genetic variation among isolates of Pneumocystis jiroveci from Portuguese immunocompromised patients with PCP at the internal transcribed spacer (ITS) regions of the nuclear rRNA operon and at the dihydropteroate synthase (DHPS) gene. Pulmonary secretions from 42 patients with PCP corresponding to 43 episodes were studied. Demographic, immunological, and clinical data were obtained from all patients. By combining the two regions ITS1 and ITS2, we found 17 different ITS types of P. jiroveci, two of them were new types (Pb and Pe). The four most prevalent ITS types were Eg (23.3%), Eb and Ne (11.6% each), and Bi (9.3%). A single type was detected in 95.3% of the samples and 4.7% had mixed infections with three different ITS types. DHPS mutants were present in 17 (46%), and the wildtype was present in 20 (54%) of 37 isolates. No association was found between ITS and DHPS types and between DHPS types and therapy or response to anti-PCP treatment. Type Ne presented an association with negative response to anti-PCP treatment (P<0.001) and with death before 120 days after PCP diagnosis (P=0.025). Type Eb was significantly more common in children than in adults (P=0.001). Our data suggest an association of specific ITS genotypes with treatment failure, bad clinical outcome and childhood.

Original languageEnglish (US)
Pages (from-to)281-285
Number of pages5
JournalInfection, Genetics and Evolution
Issue number4
StatePublished - Nov 1 2003



  • DHPS gene
  • Genotyping
  • ITS regions
  • Pneumocystis jiroveci pneumonia
  • Portuguese immunocompromised patients

ASJC Scopus subject areas

  • Ecology, Evolution, Behavior and Systematics
  • Genetics
  • Microbiology
  • Infectious Diseases

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