We conducted a pilot study of patients with cystic fibrosis (CF) to assess intra-family transmission of P. jirovecii and compare it with data on other prevalent pathogens such as P. aeruginosa and S. pneumoniae, in which respiratory transmission has already been documented. Oral swab samples from 10 patients with CF and 15 household members were collected at baseline and 2 weeks later. P. aeruginosa and S. pneumoniae were assessed using standardized culture methods and PCR, and P. jirovecii was assessed using real and nested PCR, genotyping the positive samples by direct sequencing. P. aeruginosa cultures were positive for 7/10 (70%) of patients with CF at baseline and was identified by PCR in 8/10 (80%) of cases at baseline and 2 weeks later. S. pneumoniae cultures were negative for all patients, but the microorganism was identified by PCR in two cases. P. jirovecii was detected by real time and nested PCR in 5/10 (50%) of the patients at the two time points. In the household members, P. aeruginosa and P. jirovecii were identified in 7/15 (46.7%), and S. pneumoniae was identified in 8/15 (53,3%). The concordance of positive or negative pairs of patients with CF and their household members was 33.3% (5/15) for P. aeruginosa, 46.7% (7/15) for S. pneumonia and 93.3% (14/15) for P. jirovecii. The concordance for P. jirovecii genotypes among five pairs with available genotype was 100%. This study suggests for the first time the possible transmission of Pneumocystis in the home of patients with CF, indicating that patients and their household members are reservoirs and possible sources of infection. Lay Summary This study suggests for the first time the possible transmission of Pneumocystis in the family environment of patients with cystic fibrosis, indicating that patients and their household members are reservoirs and possible sources of this infection.

中文翻译：

---

囊性纤维化患者及其家庭成员中的耶氏肺孢子菌

我们对囊性纤维化 (CF) 患者进行了一项初步研究，以评估 P. jirovecii 的家庭内传播，并将其与其他流行病原体（如铜绿假单胞菌和肺炎链球菌）的数据进行比较，其中已经记录了呼吸道传播. 在基线和 2 周后收集了 10 名 CF 患者和 15 名家庭成员的口腔拭子样本。使用标准化培养方法和 PCR 评估铜绿假单胞菌和肺炎链球菌，使用真实和巢式 PCR 评估 P. jirovecii，通过直接测序对阳性样本进行基因分型。基线时 7/10 (70%) 的 CF 患者铜绿假单胞菌培养呈阳性，并且在基线和 2 周后的 8/10 (80%) 病例中通过 PCR 鉴定。所有患者的肺炎链球菌培养结果均为阴性，但在两种情况下通过PCR鉴定了微生物。在两个时间点，5/10 (50%) 的患者通过实时和巢式 PCR 检测到 P. jirovecii。在家庭成员中，铜绿假单胞菌和耶氏假单胞菌在 7/15 (46.7%) 中被发现，而肺炎链球菌在 8/15 (53.3%) 中被发现。CF 患者及其家庭成员阳性或阴性配对的一致性为：铜绿假单胞菌为 33.3%（5/15），肺炎链球菌为 46.7%（7/15），肺炎链球菌为 93.3%（14/15）。伊罗维西。具有可用基因型的五对之间的 P. jirovecii 基因型的一致性为 100%。该研究首次提示肺孢子菌可能在 CF 患者家中传播，表明患者及其家庭成员是宿主和可能的感染源。