The Journal of infection · 2026
Pneumocystis jirovecii pneumonia in solid organ transplant recipients: a prospective observational cohort study.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Alanio Alexandre, Boukris-Sitbon Karine, Obadia Thomas, Desnos-Ollivier Marie, Garcia-Hermoso Dea, Letscher-Bru Valérie, Desoubeaux Guillaume, Guemas Emilie, Durieux Marie-Fleur, Morio Florent, Robert-Gangneux Florence, Bonhomme Julie, Lanternier Fanny, Lortholary Olivier, French RESSIF Study Group
Аннотация
BACKGROUND: Pneumocystis pneumonia (PCP) is a well-known infectious complication of organ transplantation requiring prophylaxis at least within the first 6 month to 1 year post transplantation.
RESEARCH QUESTION: Few data exist comparing the characteristics of Pneumocystis pneumonia associated with kidney, heart, liver or lung transplant recipients.
STUDY DESIGN & METHOD: We here conducted a cross-sectional study nested within the surveillance of our national reference center for invasive mycoses to analyze the prospectively declared cases of PCP occurring in solid organ transplant recipients over a period of 11 years.
RESULTS: We found that the median occurrence of PCP post-transplantation varies from the organ recipients with PCP occurring earlier in liver recipients and later in other organs reaching a median of 3.9 years in kidney recipients. We also found a clear increase the proportion of positive mycological criteria in PCP cases occurring within 2 years post-transplantation. Age and ICU hospitalization were major variables associated with 3 month-mortality with liver and lung recipient having a better outcome than renal transplant patients upon adjustment including age. A trend toward the role of additional risk factors (such as HIV, Cancer of hematological malignancy) in the outcome of PCP was also observed.
INTERPRETATION: Altogether, this study described on a large patient cohort, some key mycological and clinical information associated with PCP in solid organ transplant patients. The characteristics of PCP in kidney and heart recipients seems similar.
RESEARCH QUESTION: Few data exist comparing the characteristics of Pneumocystis pneumonia associated with kidney, heart, liver or lung transplant recipients.
STUDY DESIGN & METHOD: We here conducted a cross-sectional study nested within the surveillance of our national reference center for invasive mycoses to analyze the prospectively declared cases of PCP occurring in solid organ transplant recipients over a period of 11 years.
RESULTS: We found that the median occurrence of PCP post-transplantation varies from the organ recipients with PCP occurring earlier in liver recipients and later in other organs reaching a median of 3.9 years in kidney recipients. We also found a clear increase the proportion of positive mycological criteria in PCP cases occurring within 2 years post-transplantation. Age and ICU hospitalization were major variables associated with 3 month-mortality with liver and lung recipient having a better outcome than renal transplant patients upon adjustment including age. A trend toward the role of additional risk factors (such as HIV, Cancer of hematological malignancy) in the outcome of PCP was also observed.
INTERPRETATION: Altogether, this study described on a large patient cohort, some key mycological and clinical information associated with PCP in solid organ transplant patients. The characteristics of PCP in kidney and heart recipients seems similar.