Pneumocystis jirovecii pneumonia in renal transplant recipients occurring after discontinuation of prophylaxis: a case–control study.
A case-control study was conducted to identify risk factors for Pneumocystis jirovecii pneumonia (PCP) in renal transplant recipients. Eleven cases of PCP were matched with 22 controls. Cases occurred a median of 18 months after transplantation, and none of the recipients was receiving prophylaxis. Univariate analysis showed that graft rejection, duration of steroid use, use of mammalian target of rapamycin (mTOR) inhibitors and lymphocytopenia at the time of prophylaxis discontinuation were risk factors for PCP. In the multivariate model, only graft rejection (OR 8.66, p 0.017) remained significantly associated with PCP. In patients with a history of graft rejection, PCP prophylaxis should be maintained, especially among those with lymphocytopenia.
De Castro
N
N
Department of Infectious Diseases, Saint-Louis Hospital, Assistance-Publique Hôpitaux de Paris, University of Paris Diderot, Paris, France. nathalie.de-castro@sls.aphp.fr
Xu
F
F
Porcher
R
R
Pavie
J
J
Molina
J-M
JM
Peraldi
M-N
MN
D000328:Adult; D000368:Aged; D000935:Antifungal Agents / Q000627:therapeutic use*; D016022:Case-Control Studies; D018890:Chemoprevention / Q000379:methods*; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D045363:Pneumocystis carinii / Q000302:isolation & purification*; D011020:Pneumonia, Pneumocystis / Q000453:epidemiology*; D012307:Risk Factors; D014180:Transplantation
D000935:Antifungal Agents