Chlamydia pneumoniae infection in patients after kidney transplantation treated with spiramycin.
BACKGROUND
Previous research has pointed to a role of Chlamydia pneumoniae infection in the development of chronic renal allograft dysfunction, chronic liver rejection, and vasculopathy in the transplanted heart. The aim of this study was to evaluate the presence of C. pneumoniae prior to and after kidney transplantation as well as to determine the role of spiramycin therapy among kidney transplant recipients.


METHODS
The study group consisted of 50 patients (25 pairs) who received kidney transplants from cadaveric donors. One of the 2 kidneys from a donor was transplanted to a patient randomized to spiramycin (2 x 3 million U/d orally for 3 months; group S) and the other to a patient assigned as control (group C). Markers of infection were assessed on day 1 posttransplantation and 3 months later (average, 94 days). All 50 patients were examined for the presence of bacterial DNA in peripheral blood leukocytes using real-time polymerase chain reaction (PCR) and for titers of serum anti C. pneumoniae immunoglobulin (IgG) and IgA antibodies using microimmunofluorescence (MIF). C. pneumoniae infection was diagnosed by the presence of C. pneumoniae DNA in peripheral blood leukocytes or positive antibodies of both classes.


RESULTS
C. pneumoniae infection was initially diagnosed in 14 patients among group S and 8 patients among group C (P = not significant [ns]) and after 3 months in 12 and 9 patients, respectively (P = ns). Conversion from positive to negative C. pneumoniae status occured in 7 patients among group S and 1 patient among group C (P = .04). Conversion from negative to positive C. pneumoniae status occured in 5 patients from group S and 2 patients from group C (P = ns).


CONCLUSIONS
These results suggest a possible role for spiramycin treatment of C pneumoniae infection in kidney allograft recipients. C. pneumoniae infection diagnosis and treatment should be considered to be routine for every patient awaiting transplantation.
Fesolowicz
S
S
Medical University of Warsaw, Warsaw, Poland.
Kwiatkowski
A
A
Wszola
M
M
Podsiadly
E
E
Ostrowski
K
K
Durlik
M
M
Paczek
L
L
Tylewska-Wierzbanowska
S
S
Rowinski
W
W
Chmura
A
A
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002102:Cadaver; D002690:Chlamydia Infections / Q000188:drug therapy*; D016993:Chlamydophila pneumoniae; D003404:Creatinine / Q000097:blood; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D011183:Postoperative Complications / Q000188:drug therapy / Q000382:microbiology; D015572:Spiramycin / Q000627:therapeutic use*; D014019:Tissue Donors
D000900:Anti-Bacterial Agents; D015572:Spiramycin; D003404:Creatinine