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Identification of Predictive Markers and Outcomes of Late-onset Pneumocystis jirovecii Pneumonia in Kidney Transplant Recipients

hal.structure.identifierImmunology from Concept and Experiments to Translation = Immunologie Conceptuelle, Expérimentale et Translationnelle [ImmunoConcept]
hal.structure.identifierCHU de Bordeaux Pellegrin [Bordeaux]
dc.contributor.authorKAMINSKI, Hannah
hal.structure.identifierUniversité Toulouse III - Paul Sabatier [UT3]
hal.structure.identifierCentre Hospitalier Universitaire de Toulouse [CHU Toulouse]
dc.contributor.authorBELLIERE, Julie
hal.structure.identifierCHU de Bordeaux Pellegrin [Bordeaux]
dc.contributor.authorBURGUET, Laure
hal.structure.identifierCentre Hospitalier Universitaire de Toulouse [CHU Toulouse]
dc.contributor.authorDEL BELLO, Arnaud
hal.structure.identifierCHU de Bordeaux Pellegrin [Bordeaux]
hal.structure.identifierInstitut de Mathématiques de Bordeaux [IMB]
dc.contributor.authorTATON, Benjamin
hal.structure.identifierCHU de Bordeaux Pellegrin [Bordeaux]
dc.contributor.authorPOIROT-MAZÈRES, Stéphane
hal.structure.identifierCHU de Bordeaux Pellegrin [Bordeaux]
dc.contributor.authorACCOCEBERRY, Isabelle
hal.structure.identifierCHU de Bordeaux Pellegrin [Bordeaux]
dc.contributor.authorDELHAES, Laurence
hal.structure.identifierImmunology from Concept and Experiments to Translation = Immunologie Conceptuelle, Expérimentale et Translationnelle [ImmunoConcept]
hal.structure.identifierCHU de Bordeaux Pellegrin [Bordeaux]
dc.contributor.authorVISENTIN, Jonathan
hal.structure.identifierCHU de Bordeaux Pellegrin [Bordeaux]
dc.contributor.authorGREGORI, Marco
hal.structure.identifierCentre Hospitalier Universitaire de Toulouse [CHU Toulouse]
hal.structure.identifierInstitut Toulousain des Maladies Infectieuses et Inflammatoires [Infinity]
dc.contributor.authorIRIART, Xavier
hal.structure.identifierCentre Hospitalier Universitaire de Toulouse [CHU Toulouse]
hal.structure.identifierInstitut Toulousain des Maladies Infectieuses et Inflammatoires [Infinity]
dc.contributor.authorCHARPENTIER, Elena
hal.structure.identifierImmunology from Concept and Experiments to Translation = Immunologie Conceptuelle, Expérimentale et Translationnelle [ImmunoConcept]
hal.structure.identifierCHU de Bordeaux Pellegrin [Bordeaux]
dc.contributor.authorCOUZI, Lionel
hal.structure.identifierInstitut Toulousain des Maladies Infectieuses et Inflammatoires [Infinity]
hal.structure.identifierCentre Hospitalier Universitaire de Toulouse [CHU Toulouse]
dc.contributor.authorKAMAR, Nassim
hal.structure.identifierImmunology from Concept and Experiments to Translation = Immunologie Conceptuelle, Expérimentale et Translationnelle [ImmunoConcept]
hal.structure.identifierCHU de Bordeaux Pellegrin [Bordeaux]
dc.contributor.authorMERVILLE, Pierre
dc.date.accessioned2024-04-04T02:45:05Z
dc.date.available2024-04-04T02:45:05Z
dc.date.issued2021-10-01
dc.identifier.issn1058-4838
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/191438
dc.description.abstractEnBackground: In 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.Methods: We 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. Results:Seventy 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 <1000/µL offered the best predictive value for infection occurrence. PCP was associated with high incidence of graft loss and patient death (30% and 17% respectively, 3 years after PCP).Conclusions: Pneumocystis 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.
dc.language.isoen
dc.publisherOxford University Press (OUP)
dc.subject.enPneumocystis pneumonia
dc.subject.encorticosteroid boluses
dc.subject.enkidney transplantation
dc.subject.enlymphopenia
dc.title.enIdentification of Predictive Markers and Outcomes of Late-onset Pneumocystis jirovecii Pneumonia in Kidney Transplant Recipients
dc.typeArticle de revue
dc.identifier.doi10.1093/cid/ciaa1611
dc.subject.halSciences du Vivant [q-bio]/Médecine humaine et pathologie/Maladies infectieuses
bordeaux.journalClinical Infectious Diseases
bordeaux.pagee1456-e1463
bordeaux.volume73
bordeaux.hal.laboratoriesInstitut de Mathématiques de Bordeaux (IMB) - UMR 5251*
bordeaux.issue7
bordeaux.institutionUniversité de Bordeaux
bordeaux.institutionBordeaux INP
bordeaux.institutionCNRS
bordeaux.peerReviewedoui
hal.identifierhal-03380342
hal.version1
hal.popularnon
hal.audienceInternationale
hal.origin.linkhttps://hal.archives-ouvertes.fr//hal-03380342v1
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