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01.12.2014 | original article | Ausgabe 23-24/2014

Wiener klinische Wochenschrift 23-24/2014

Pneumocystis pneumonia (PCP) and Pneumocystis jirovecii carriage in renal transplantation patients: a single-centre experience

Zeitschrift:
Wiener klinische Wochenschrift > Ausgabe 23-24/2014
Autoren:
MD Matthias Maruschke, PhD Diana Riebold, PhD Martha Charlotte Holtfreter, PhD Martina Sombetzki, MD Steffen Mitzner, MD Micha Loebermann, MD Emil Christian Reisinger, MD Oliver W. Hakenberg

Summary

Background

The Pneumocystis pneumonia is an increasing problem in transplanted patients: up to 25 % suffer from Pneumocystis pneumonia, occurring during the first 6 months after transplantation.

Methods

From 2001 to 2009, we investigated 21 patients with pneumonia after renal transplantation for the presence of Pneumocystis jirovecii. The laboratory diagnosis was established by Grocott and Giemsa staining methods and Pneumocystis-specific mitochondrial transcribed large subunit nested polymerase chain reaction (PCR). The PCR was also used for the differentiation of Pneumocystis pneumonia from Pneumocystis carriage.

Results

Of 21 patients, 7 had a Pneumocystis pneumonia, 6 were Pneumocystis carriers and 8 patients were negative. Four out of seven Pneumocystis pneumonia patients and two out of six patients with Pneumocystis carriage had a delayed graft function. An acute cytomegalovirus infection after transplantation was not detectable in the patients with Pneumocystis pneumonia, but in three patients with Pneumocystis carriage.

Conclusions

Pneumocystis pneumonia was present in 33.3 % of transplanted patients with suspected pneumonia. An association between acute rejection or co-infections and Pneumocystis pneumonia or carriage in patients after renal transplantation cannot be excluded. In three out of seven Pneumocystis pneumonia patients, an overlapping of hospitalisation times and an onset of Pneumocystis pneumonia 6 months after transplantation was found. Thus, person-to-person transmission seems probable in these cases.

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