Pneumocystis Detected in 16% of Clinicians
SAN FRANCISCO — A year-long pilot study found Pneumocystis carinii DNA in initial oropharyngeal wash results of 10 of 104 health care workers, and 7 more converted from negative to positive tests on subsequent gargle tests.
Among a control group of 61 other staff (administrative, financial, and janitorial staff) who reported having no direct patient-care responsibilities, none tested positive for P. carinii, Dr. Laurence Huang said at a meeting on HIV management sponsored by the University of California, San Francisco.
The implications are not clear. “Is finding Pneumocystis DNA in a gargle representative of dead or alive organisms? Are we colonized, or carriers? Are we infectious to our patients?” asked Dr. Huang, professor of medicine at the university.
He and his associates tested oropharyngeal wash specimens monthly and serum specimens quarterly and asked subjects to complete a questionnaire. The 17 health care workers (doctors, nurses, and a respiratory therapist) with P. carinii DNA in gargle results accumulated 28 positive gargle tests. Two of the health care workers each had five tests that were positive for P. carinii.
Unlike the control group, all of the health care workers with P. carinii reported on questionnaires that they had been exposed to patients with HIV and/or P. carinii pneumonia, with the most recent exposure ranging from 1 hour ago to more than a month ago.
The findings support a previous study by Dr. Huang and his associates that found significantly higher Pneumocystis antibody levels in the blood of 103 clinicians, compared with 23 nonclinical staff (Emerg. Infect. Dis. 2009;15:1590–7).
Previous studies have suggested that P. carinii pneumonia can be transmitted between people in hospitals and clinics, he added. People without P. carinii pneumonia shown to be colonized with P. carinii include some infants and children, pregnant women, people with lung disease, people with HIV, and HIV-negative immunocompromised patients.
Disclosures: Dr. Huang reported having no relevant conflicts of interest.
