Epidemiology and risk factors associated with Pneumocystis jirovecii pneumonia in kidney transplant recipients after 6-month trimethoprim-sulfamethoxazole prophylaxis: A case-control study
DC Field | Value | Language |
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dc.contributor.author | Park, Se Yoon | - |
dc.contributor.author | Jung, Joo Hee | - |
dc.contributor.author | Kwon, Hyunwook | - |
dc.contributor.author | Shin, Sung | - |
dc.contributor.author | Kim, Young Hoon | - |
dc.contributor.author | Chong, Yong-Phil | - |
dc.contributor.author | Lee, Sang-Oh | - |
dc.contributor.author | Choi, Sang-Ho | - |
dc.contributor.author | Kim, Yang Soo | - |
dc.contributor.author | Woo, Jun Hee | - |
dc.contributor.author | Kim, Sung-Han | - |
dc.contributor.author | Han, Duck Jong | - |
dc.date.accessioned | 2021-08-11T08:37:09Z | - |
dc.date.available | 2021-08-11T08:37:09Z | - |
dc.date.issued | 2020-04 | - |
dc.identifier.issn | 1398-2273 | - |
dc.identifier.issn | 1399-3062 | - |
dc.identifier.uri | https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/2983 | - |
dc.description.abstract | Background Pneumocystis jirovecii pneumonia (PCP) is an important cause of morbidity and mortality in kidney transplant recipients (KTRs), and prophylaxis with trimethoprim-sulfamethoxazole (TMP-SMX) is recommended. The aim of this study was to investigate incidence and risk factors for PCP in KTRs after 6-month TMP-SMX prophylaxis. Methods We conducted a case-control study of patients with PCP who received 6-month PCP prophylaxis with TMP-SMX after kidney transplantation (KT). In cases of rejection, PCP prophylaxis was provided for six additional months after anti-rejection therapy. Cytomegalovirus (CMV) infection was not considered an indication for PCP prophylaxis due to concerns of nephrotoxicity associated with TMP-SMX. Results Among 3941 kidney or pancreas-kidney transplant recipients, 67 (1.7%) developed PCP after discontinuing TMP-SMX. A total of 47 patients with KT PCP and 94 controls were included. Duration of PCP prophylaxis was similar between cases and controls (median 6 months, P = .53). In multivariate analysis, rejection (OR 3.9; 95% CI 1.4-11.1) and CMV infection (OR 2.4; 95% CI 1.0-5.8) were independently associated with PCP development after TMP-SMX. Rejection or CMV infection was observed in 70% of patients with PCP. Time to PCP development after rejection (median [IQR] 6 [5-19] months) was slightly shorter than after CMV infection (median [IQR] 9 [5-12] months; P = .18). Conclusion Post-prophylaxis PCP occurred in <2% of KTRs, and about two-thirds of these experienced rejection or CMV infection. These data suggest that at least 6 to 9-month additional chemoprophylaxis may be needed to prevent PCP in KTRs with transplant rejection or CMV infection. | - |
dc.language | 영어 | - |
dc.language.iso | ENG | - |
dc.publisher | Blackwell Publishing Inc. | - |
dc.title | Epidemiology and risk factors associated with Pneumocystis jirovecii pneumonia in kidney transplant recipients after 6-month trimethoprim-sulfamethoxazole prophylaxis: A case-control study | - |
dc.type | Article | - |
dc.publisher.location | 미국 | - |
dc.identifier.doi | 10.1111/tid.13245 | - |
dc.identifier.scopusid | 2-s2.0-85078672095 | - |
dc.identifier.wosid | 000508998600001 | - |
dc.identifier.bibliographicCitation | Transplant Infectious Disease, v.22, no.2 | - |
dc.citation.title | Transplant Infectious Disease | - |
dc.citation.volume | 22 | - |
dc.citation.number | 2 | - |
dc.type.docType | Article | - |
dc.description.isOpenAccess | N | - |
dc.description.journalRegisteredClass | scie | - |
dc.description.journalRegisteredClass | scopus | - |
dc.relation.journalResearchArea | Immunology | - |
dc.relation.journalResearchArea | Infectious Diseases | - |
dc.relation.journalResearchArea | Transplantation | - |
dc.relation.journalWebOfScienceCategory | Immunology | - |
dc.relation.journalWebOfScienceCategory | Infectious Diseases | - |
dc.relation.journalWebOfScienceCategory | Transplantation | - |
dc.subject.keywordPlus | CYTOMEGALOVIRUS DISEASE | - |
dc.subject.keywordPlus | PREEMPTIVE THERAPY | - |
dc.subject.keywordPlus | INFECTION | - |
dc.subject.keywordPlus | ERA | - |
dc.subject.keywordAuthor | cytomegalovirus | - |
dc.subject.keywordAuthor | Pneumocystis jirovecii pneumonia | - |
dc.subject.keywordAuthor | rejection | - |
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