title: Pneumocystis jirovecii colonization among renal transplant recipients.
abstract: OBJECTIVE
  Renal transplant recipients are at risk of developing Pneumocystis pneumonia (PcP), especially in the first 2 years after transplantation, with a mortality rate of up to 50%. No data are available on pulmonary colonization with Pneumocystis jirovecii in renal transplant recipients. The aim of this study was to determine the prevalence of pulmonary colonization with Pneumocystis jirovecii in renal transplant recipients and to find related risk factors.
  
  
  METHODS
  We investigated the induced sputa of 70 renal transplant recipients for the presence of Pneumocystis jirovecii using nested polymerase chain reaction.
  
  
  RESULTS
  Thirteen of 70 patients (18.6%) were colonized with Pneumocystis jirovecii. There was no significant correlation between colonization and immunosuppressive medication or regimens. However, colonized subjects had undergone transplantation longer ago than non-colonized subjects. 30.8% of those whose transplantation had taken place more than 8 years previously were colonized, in contrast to 11.4% of those whose transplantation had taken place less than 8 years ago (P = 0.059; odds ratio = 3.467, 95% confidence interval = 0.99-12.09).
  
  
  CONCLUSIONS
  Most cases of Pneumocystis colonization were detected in those patients where renal transplantion had taken place more than 2 years previously. As most PcP cases occur within the first 2 years of transplantation, colonization does not seem to play a role in the development of acute PcP in this period. Though Pneumocystis pneumonia is likely to be a newly acquired infection in the first 2 years after transplantation, colonized patients remain a potential source of transmission of Pneumocystis jirovecii.
authors.affiliation: Division of Tropical Medicine and Infectious Diseases, Department of Medicine, University of Rostock, Rostock, Germany. Carlos.Fritzsche@med.uni-rostock.de
authors.forename: Carlos
authors.initials: C
authors.lastname: Fritzsche
authors.forename: Diana
authors.initials: D
authors.lastname: Riebold
authors.forename: Andreas
authors.initials: A
authors.lastname: Fuehrer
authors.forename: Andrea
authors.initials: A
authors.lastname: Mitzner
authors.forename: Sebastian
authors.initials: S
authors.lastname: Klammt
authors.forename: Brigitte
authors.initials: B
authors.lastname: Mueller-Hilke
authors.forename: Emil C
authors.initials: EC
authors.lastname: Reisinger
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000009:adverse effects*; D008168:Lung / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D045363:Pneumocystis carinii / Q000302:isolation & purification*; D012307:Risk Factors; D013997:Time Factors
chemical_list: D007166:Immunosuppressive Agents