A Pneumocystis jirovecii pneumonia outbreak in a single kidney-transplant center: role of cytomegalovirus co-infection.

Détails

ID Serval
serval:BIB_5B282AC3529B
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
A Pneumocystis jirovecii pneumonia outbreak in a single kidney-transplant center: role of cytomegalovirus co-infection.
Périodique
European Journal of Clinical Microbiology and Infectious Diseases
Auteur(s)
Pliquett R.U., Asbe-Vollkopf A., Hauser P.M., Presti L.L., Hunfeld K.P., Berger A., Scheuermann E.H., Jung O., Geiger H., Hauser I.A.
ISSN
1435-4373 (Electronic)
ISSN-L
0934-9723
Statut éditorial
Publié
Date de publication
2012
Volume
31
Numéro
9
Pages
2429-2437
Langue
anglais
Notes
Publication types: Journal ArticlePublication Status: ppublish. Authors' contributions H.G., E.H.S., R.U.P., and I.A.H. conceived the study. R.U.P. and A.A.-V. collected the data and performed the analysis. R.U.P., A.A.-V., and I.A.H. interpreted the data. O.J., K.P.H., and A.B. contributed to the collection of data. P.M.H. and L.L.P. contributed to the analysis and gave critical input to the interpretation of data. I.A.H., P.M.H., and R.U.P. drafted the manuscript.
Résumé
Pneumocystis jirovecii pneumonia (PCP) and cytomegalovirus (CMV) infection represent possible complications of medical immunosuppression. Between 2005 and 2010, non-human immunodeficiency virus (HIV) PCP patients admitted to a nephrology unit were analyzed for outcome, CMV comorbidity, and patient-to-patient contacts prior to PCP. In contrast to 2002-2004 (no cases) and 2008-2010 (10 cases), a PCP outbreak of 29 kidney-transplant recipients and one patient with anti-glomerular basement membrane disease occurred between 2005 and 2007. None of the patients were on PCP chemoprophylaxis. In four PCP patients, the genotyping data of bronchoalveolar lavage specimen showed an identical Pneumocystis strain. PCP cases had a higher incidence of CMV infection (12 of 30 PCP patients) and CMV disease (four patients) when compared to matched PCP-free controls (p < 0.05). Cotrimoxazole and, if applicable, ganciclovir were started 2.0 ± 4.0 days following admission, and immunosuppressive medication was reduced. In-hospital mortality was 10% and the three-year mortality was 20%. CMV co-infection did not affect mortality. CMV co-infection more frequently occurred during a cluster outbreak of non-HIV PCP in comparison to PCP-free controls. Here, CMV awareness and specific therapy of both CMV infection and PCP led to a comparatively favorable patient outcome. The role of patient isolation should be further investigated in incident non-HIV PCP.
Pubmed
Web of science
Création de la notice
20/09/2012 19:07
Dernière modification de la notice
20/08/2019 15:14
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