Abstract
The charts for seven renal transplant recipients who developedPneumocystis carinii pneumonia were reviewed. They included six men and one woman transplanted a mean of 150 days before the diagnosis of this infection. Six presented at least one episode of acute graft rejection. Cytomegalovirus pneumonia was diagnosed in six of the patients. All patients were treated with cotrimoxazole. Global mortality was 43 %. In additional to the classic hypothesis of latentPneumocystis carinii reactivation in immunocompromised hosts, this and previous reports of outbreaks strongly suggest either a person-to-person transmission or acquisition from the environment. Molecular typing of isolates could be of value in identifying the source of such outbreaks. Chemoprophylaxis should be more systematically administered to renal transplant patients, co-trimoxazole being the drug of choice.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Chave JP, David S, Wauters JP, Van Melle G, Franciolo P: Transmission ofPneumocystis carinii from AIDS patients to other immunosuppressed patients: a cluster ofPneumocystis carinii pneumonia in renaltransplant recipients. AIDS 1991, 5: 927–932.
Glotz D, Kazatchkine M, Vincent F, Haddad H, Duboust A, Druet P, Bariety J: Pneumocystoses dans un centre de transplantation rénale proche d'une unité de soins de malades sidéens. Presse Médicale 1992, 231: 2154.
Bartlett MS, Smith JW:Pneumocystis carinii: an opportunist in immunocompromised patients. Clinical Microbiological Reviews 1991, 4: 137–149.
Peglow SL, Smulian AG, Linke MJ, Pogue CL, Nurre S, Crisler J, Phair J, Gold JWM, Armstrong D, Walzer PD: Serologic responses toPneumocystis carinii antigens in health and disease. Journal of Infectious Diseases 1990, 161: 296–306.
Hardy AM, Wajszezuk CP, Suffredini AF, Makala TR, Ho M:Pneumocystis carinii pneumonia in renal transplant recipients treated with cyclosporine and steroids. Journal of Infectious Diseases 1984, 149: 143–147.
Wakefield AE, Pixley FJ, Banerji S, Sinclair K, Miller RF, Moxon ER, Hopkin JM: Detection ofPneumocystis carinii with DNA amplification. Lancet 1990, 336: 451–453.
Millard PR, Heyret AR: Observations favouringPneumocystis carinii pneumonia as a primary infection: a monoclonal antibody study on paraffin sections. Journal of Pathology 1986, 154: 365–370.
Singer C, Armstrong D, Rose PP, Schottenfeld D:Pneumocystis carinii pneumonia: a cluster of eleven cases. Annals of Internal Medicine 1975, 82: 772–777.
Jacobs JL, Libby DM, Winters RA, Gelmont DM, Freid ED, Hartman BJ, Laurence J: A cluster ofPneumocystis carinii pneumonia in adults without predisposing illnesses. New England Journal of Medicine 1991, 109: 246–250.
Lee CH, Lu JJ, Bartlett MS, Durkin MM, Liu TM, Wang J, Jiang B, Smith JW: Nucleotide sequence variations inPneumocystis carinii strains that infect humans. Journal of Clinical Microbiology 1993, 31: 754–757.
Santiago-Delpin EA, Mora E, Gonzalez ZA, Morales-Otero LA, Bermudez R: Factors in an outbreak ofPneumocystis carinii in a transplant unit. Transplant Proceedings 1988, 20: 462–465.
Bensousan TH, Garo B, Islam S, Bourbigot B, Cledes J, Garre M: Possible transfer ofPneumocystis carinii between kidney-transplant recipients. Lancet 1990, 336: 1066–1067.
Walzer P:Pneumocystis carinii — new clinical spectrum? New England Journal of Medicine 1991, 324: 263–265.
Schluger N, Godwin T, Sepkowitz K, Armstrong D, Bernard E, Rifkin M, Cerami A, Bucala R: Application of DNA amplification to pneumocystosis: presence of serumPneumocystis carinii DNA during human and experimentally inducedP. carinii pneumonia. Journal of Experimental Medicine 1992, 176: 1327–1333.
Hughes WT: Natural mode of acquisition for de novo infection withPneumocystis carinii. Journal of Infectious Diseases 1992, 145: 842–848.
Ruskin J, LaRiviere M: Low-dose co-trimoxazole for prevention ofPneumocystis carinii pneumonia in humans with immunodeficiency virus disease. Lancet 1991, 337: 468–471.
Hughes WT, Kuhn S, Chaudhary S, Feldam S, Verzosa M, Aur RJA, Prath C, George SL: Successful chemoprophylaxis forPneumocystis carinii pneumonitis. New England Journal of Medicine 1977, 297: 1419–1426.
Peterson PK, Ferguson R, Fryd DS, Balfour HH, Rynasiewicz J, Simmons RL: Infectious diseases in hospitalized renal-transplant recipients: a prospective study of a complex and evolving problem. Medicine 1982, 61: 360–372.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Hennequin, C., Page, B., Roux, P. et al. Outbreak ofPneumocystis carinii pneumonia in a renal transplant unit. Eur. J. Clin. Microbiol. Infect. Dis. 14, 122–126 (1995). https://doi.org/10.1007/BF02111870
Issue Date:
DOI: https://doi.org/10.1007/BF02111870