Pneumocystis jirovecii pneumonia in liver transplant recipients in an era of routine prophylaxis
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Pneumocystis jirovecii pneumonia in liver transplant recipients in an era of routine prophylaxis. / Andreasen, Philip B.; Rezahosseini, Omid; Møller, Dina L.; Wareham, Neval E.; Thomsen, Magda T.; Houmami, Ranya; Knudsen, Andreas D.; Knudsen, Jenny; Kurtzhals, Jørgen A.L.; Rostved, Andreas A.; Pedersen, Christian R.; Rasmussen, Allan; Nielsen, Susanne D.
I: Immunity, Inflammation and Disease, Bind 10, Nr. 1, 2022, s. 93-100.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Pneumocystis jirovecii pneumonia in liver transplant recipients in an era of routine prophylaxis
AU - Andreasen, Philip B.
AU - Rezahosseini, Omid
AU - Møller, Dina L.
AU - Wareham, Neval E.
AU - Thomsen, Magda T.
AU - Houmami, Ranya
AU - Knudsen, Andreas D.
AU - Knudsen, Jenny
AU - Kurtzhals, Jørgen A.L.
AU - Rostved, Andreas A.
AU - Pedersen, Christian R.
AU - Rasmussen, Allan
AU - Nielsen, Susanne D.
N1 - Publisher Copyright: © 2021 The Authors. Immunity, Inflammation and Disease published by John Wiley & Sons Ltd.
PY - 2022
Y1 - 2022
N2 - Background: Pneumocystis jirovecii pneumonia (PCP) is an opportunistic infection in organ transplant recipients that may be prevented by antibiotic prophylaxis. We aimed to investigate the incidence rate (IR) of PCP and the related hospitalization and mortality rates in liver transplant recipients in an era of routine prophylaxis. Methods: We included all adult liver transplant recipients transplanted at Rigshospitalet between January 1, 2011 and October 1, 2019. Microbiology data were obtained from the Danish Microbiology Database (MiBa), a national database containing all data from all Departments of Clinical Microbiology in Denmark receiving samples from both hospitals and general practices. According to local guidelines, PCP prophylaxis was initiated 1 week posttransplantation and discontinued after 6 months or sooner in patients experiencing side effects. Results: We included 343 liver transplant recipients with 1153 person-years of follow-up (PYFU), of which 269 (78%) received PCP prophylaxis during the first 6 months posttransplantation. Seven (2%) recipients were diagnosed with PCP during follow-up. In the first 6 months posttransplantation and in 269 transplant recipients who received prophylaxis there were zero PCP events while the IR was 32 (95% confidence interval [CI] 2.9–148) per 1000 PYFU in 74 recipient who did not receive prophylaxis. During 7th to 12th month posttransplantation the IR was 20 (95% CI: 5.5–53) per 1000 PYFU. All seven (100%) recipients diagnosed with PCP were hospitalized, however none died. Conclusions: PCP was not detected in liver transplant recipients while on prophylaxis. Though, it worth mentioning that two out of the seven PCP patients received high-dose prednisolone before the PCP event. All liver transplant recipients with PCP were hospitalized, but none died. Randomized clinical trials to determine the optimal duration of prophylaxis are warranted.
AB - Background: Pneumocystis jirovecii pneumonia (PCP) is an opportunistic infection in organ transplant recipients that may be prevented by antibiotic prophylaxis. We aimed to investigate the incidence rate (IR) of PCP and the related hospitalization and mortality rates in liver transplant recipients in an era of routine prophylaxis. Methods: We included all adult liver transplant recipients transplanted at Rigshospitalet between January 1, 2011 and October 1, 2019. Microbiology data were obtained from the Danish Microbiology Database (MiBa), a national database containing all data from all Departments of Clinical Microbiology in Denmark receiving samples from both hospitals and general practices. According to local guidelines, PCP prophylaxis was initiated 1 week posttransplantation and discontinued after 6 months or sooner in patients experiencing side effects. Results: We included 343 liver transplant recipients with 1153 person-years of follow-up (PYFU), of which 269 (78%) received PCP prophylaxis during the first 6 months posttransplantation. Seven (2%) recipients were diagnosed with PCP during follow-up. In the first 6 months posttransplantation and in 269 transplant recipients who received prophylaxis there were zero PCP events while the IR was 32 (95% confidence interval [CI] 2.9–148) per 1000 PYFU in 74 recipient who did not receive prophylaxis. During 7th to 12th month posttransplantation the IR was 20 (95% CI: 5.5–53) per 1000 PYFU. All seven (100%) recipients diagnosed with PCP were hospitalized, however none died. Conclusions: PCP was not detected in liver transplant recipients while on prophylaxis. Though, it worth mentioning that two out of the seven PCP patients received high-dose prednisolone before the PCP event. All liver transplant recipients with PCP were hospitalized, but none died. Randomized clinical trials to determine the optimal duration of prophylaxis are warranted.
KW - incidence
KW - liver transplantation
KW - Pneumocystis jirovecii pneumonia
KW - prophylaxis
KW - trimethoprim sulfamethoxazole
U2 - 10.1002/iid3.546
DO - 10.1002/iid3.546
M3 - Journal article
C2 - 34713963
AN - SCOPUS:85118213589
VL - 10
SP - 93
EP - 100
JO - Immunity, inflammation and disease
JF - Immunity, inflammation and disease
SN - 2050-4527
IS - 1
ER -
ID: 320003013