Identification of Predictive Markers and Outcomes of Late-onset Pneumocystis jirovecii Pneumonia in Kidney Transplant Recipients
| Autor: | Benjamin Taton, Isabelle Accoceberry, Xavier Iriart, Julie Belliere, Jonathan Visentin, Eléna Charpentier, Arnaud Del Bello, Pierre Merville, Laure Burguet, Marco Gregori, Lionel Couzi, Laurence Delhaes, Stéphane Poirot-Mazères, Nassim Kamar, Hannah Kaminski |
|---|---|
| Přispěvatelé: | Immunology from Concept and Experiments to Translation (ImmunoConcept), Centre National de la Recherche Scientifique (CNRS)-Université de Bordeaux (UB), CHU de Bordeaux Pellegrin [Bordeaux], Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées, CHU Toulouse [Toulouse], Institut de Mathématiques de Bordeaux (IMB), Université Bordeaux Segalen - Bordeaux 2-Université Sciences et Technologies - Bordeaux 1-Université de Bordeaux (UB)-Institut Polytechnique de Bordeaux (Bordeaux INP)-Centre National de la Recherche Scientifique (CNRS), Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS) |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
0301 basic medicine
Microbiology (medical) medicine.medical_specialty Opportunistic infection medicine.drug_class Lymphocyte 030106 microbiology kidney transplantation Pneumocystis carinii Pneumocystis pneumonia corticosteroid boluses 03 medical and health sciences 0302 clinical medicine [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases Internal medicine medicine Humans 030212 general & internal medicine Kidney transplantation Retrospective Studies Predictive marker business.industry Pneumonia Pneumocystis lymphopenia medicine.disease Transplant Recipients 3. Good health Transplantation Pneumonia Infectious Diseases medicine.anatomical_structure Case-Control Studies Corticosteroid business |
| Zdroj: | Clinical Infectious Diseases Clinical Infectious Diseases, Oxford University Press (OUP), 2021, 73 (7), pp.e1456-e1463. ⟨10.1093/cid/ciaa1611⟩ |
| ISSN: | 1058-4838 1537-6591 |
| DOI: | 10.1093/cid/ciaa1611⟩ |
| Popis: | BackgroundIn the era of prophylaxis, Pneumocystis pneumonia (PCP) has become a late-onset opportunistic infection requiring indications for prolonged prophylaxis to be defined. The primary objective of our study was therefore to evaluate risk factors associated with late-onset PCP. The secondary objective was to assess the impact of this infection on graft and patient survival.MethodsWe conducted a French case-control study in Bordeaux and Toulouse center by matching 1 case to 1–2 controls from the same center based on the transplant date and the type of induction treatment.ResultsSeventy cases and 134 controls were included. PCP occurred at a median of 3 years after transplantation. The total lymphocyte count and CD4+ and CD8+ T-lymphocyte values were lower in the cases than in their matched controls on the day of infection and annually up to 4 years earlier. The covariables independently associated with PCP were the total lymphocyte count 1 year before Pneumocystis, mTOR inhibitors used as maintenance immunosuppressive drugs, and the administration of corticosteroid boluses used in acute rejection. A total lymphocyte count threshold ConclusionsPneumocystis pneumonia has dramatic consequences in kidney transplant recipients; a targeted prophylaxis based on simple criteria, such as chronic lymphopenia and/or history of corticosteroid boluses, could be useful to avoid life-threatening complications. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|