Pneumocystis primary infection in non-immunosuppressed infants in Lima, Peru

Objectives: To provide original data on Pneumocystis primary infection in non-immunosuppressed infants from Peru. Methods: A cross sectional study was performed. Infants less than seven months old, without any underlying medical conditions attending the "well baby" outpatient clinic at one hospital in Lima, Peru were prospec-tively enrolled during a 15-month period from November 2016 to February 2018. All had a nasopharyngeal aspirate (NPA) for detection of P. jirovecii DNA using a PCR assay, regardless of respiratory symptoms. P. jiro-vecii DNA detection was considered to represent pulmonary colonization contemporaneous with Pneumocys-tis primary infection. Associations between infants' clinical and demographic characteristics and results of P. jirovecii DNA detection were analyzed. Results: P. jirovecii DNA was detected in 45 of 146 infants (30.8%) and detection was not associated with con-current respiratory symptoms in 40 of 45 infants. Infants with P. jirovecii had a lower mean age when com-pared to infants not colonized (p <0.05). The highest frequency of P. jirovecii was observed in 2-3-month-old infants (p < 0.01) and in the cooler winter and spring seasons (p <0.01). Multivariable analysis showed that infants living in a home with <= 1 bedroom were more likely to be colonized; Odds Ratio =3.03 (95%CI 1.31 - 7.00; p = 0.01). Conclusion: Pneumocystis primary infection in this single site in Lima, Peru, was most frequently observed in 2 - 3-month-old infants, in winter and spring seasons, and with higher detection rates being associated with household conditions favoring close inter-individual contacts and potential transmission of P. jirovecii. (c) 2021 SFMM. Published by Elsevier Masson SAS. All rights reserved.