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P neumocystis jirovecii pneumonia in kidney transplantation
Author(s) -
Goto N.,
Oka S.
Publication year - 2011
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/j.1399-3062.2011.00691.x
Subject(s) - medicine , transplantation , pneumocystis jirovecii , kidney transplantation , pneumonia , intensive care medicine , outbreak , isolation (microbiology) , trimethoprim , pediatrics , antibiotics , virology , bioinformatics , microbiology and biotechnology , biology
P neumocystis jirovecii pneumonia ( PCP ) remains an important cause of morbidity and mortality in immunocompromised renal transplant recipients. In recent years, PCP outbreaks in renal transplant centers have been reported in many countries. Person‐to‐person transmission between PCP patients and other recipients lacking prophylaxis is one of the possible sources of infection. To prevent infection, effective prophylaxis in susceptible patients is recommended. Trimethoprim‐sulfamethoxazole ( TMP ‐ SMX ) is the most effective drug for PCP prophylaxis, but its recommended duration of use after transplantation varies among the different guidelines. The E uropean R enal A ssociation recommends a prophylaxis period of 4 months after transplantation, the A merican S ociety of T ransplantation ( AST ) 6–12 months, and the K idney D isease I mproving G lobal O utcomes guidelines 3–6 months. Lifelong prophylaxis with TMP ‐ SMX is not recommended in renal transplant recipients; however, in many cases, PCP has occurred after the recommended prophylaxis periods after transplantation. In this minireview, we discuss the risk factors including environmental‐nosocomial exposure; state‐of‐the‐art diagnosis, treatment, prophylaxis and isolation; and references to the AST 2009 guidelines with the aim of integrating our experience with PCP outbreaks into recent reports, and we discuss how renal transplant recipients can be protected from PCP .