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Lifelong Prophylaxis With Trimethoprim-Sulfamethoxazole for Prevention of Outbreak of Pneumocystis jirovecii Pneumonia in Kidney Transplant Recipients.
- Source :
-
Transplantation direct [Transplant Direct] 2017 Apr 05; Vol. 3 (5), pp. e151. Date of Electronic Publication: 2017 Apr 05 (Print Publication: 2017). - Publication Year :
- 2017
-
Abstract
- Background: Outbreaks of Pneumocystis jirovecii pneumonia (PCP) in kidney transplant recipients are frequently reported worldwide. However, the general guidelines propose only short-term prophylaxis with trimethoprim-sulfamethoxazole after kidney transplantation. We experienced 3 PCP outbreaks in the last 10 years despite providing the recommended prophylaxis. The purpose of this study was to find a prophylaxis regimen that could successfully prevent future PCP outbreaks in immunosuppressed kidney transplant recipients.<br />Methods: Occurrence of PCP at our hospital since 2004 was reviewed. A total of 48 cases were diagnosed from July 2004 through December 2014. Genotypes of P. jirovecii were determined in these cases.<br />Results: Three PCP outbreaks by 3 different genotypes of P. jirovecii in each outbreak occurred with 2-year intervals in last 10 years. Molecular analysis showed that each intraoutbreak was caused by identical P. jirovecii , whereas interoutbreaks were caused by different genotypes. Although short-term prophylaxis was provided to all kidney recipients after each outbreak after identification of a single PCP case, additional outbreaks were not prevented because the universal prophylaxis had already been completed when new case of PCP emerged.<br />Conclusions: The contagious nature of P. jirovecii allows easy development of outbreaks of PCP in immunosuppressed kidney transplant recipients. Although the universal short-term prophylaxis is effective in controlling ongoing outbreak, lifelong prophylaxis of kidney transplant recipients should be considered to prevent new outbreaks.<br />Competing Interests: The authors declare no conflicts of interest.
Details
- Language :
- English
- ISSN :
- 2373-8731
- Volume :
- 3
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Transplantation direct
- Publication Type :
- Academic Journal
- Accession number :
- 28573186
- Full Text :
- https://doi.org/10.1097/TXD.0000000000000665