P neumocystis jirovecii colonization among renal transplant recipients

Aim 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 P neumocystis jirovecii in renal transplant recipients. The aim of this study was to determine the prevalence of pulmonary colonization with P neumocystis 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 P neumocystis jirovecii using nested polymerase chain reaction. Results Thirteen of 70 patients (18.6%) were colonized with P neumocystis 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). Conclusion Most cases of P neumocystis 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 P neumocystis 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 P neumocystis jirovecii .