ArticleTransplantation2013
Outbreak of pneumocystis pneumonia in renal and liver transplant patients caused by genotypically distinct strains of Pneumocystis jirovecii.
Article in Transplantation, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
27 citing papers in PubMed, 1 synthesis or guideline pooled it, 69 citations in OpenAlex.
- Prophylaxis for Pneumocystis pneumonia (PCP) in non-HIV immunocompromised patients.The Cochrane database of systematic reviews · 2014Pooled it
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- Outbreaks of Fungal Infections in Hospitals: Epidemiology, Detection, and Management.Journal of fungi (Basel, Switzerland) · 2023Review
- Trends in the Epidemiology ofJournal of fungi (Basel, Switzerland) · 2023Review
- Risk ofJournal of fungi (Basel, Switzerland) · 2022Article
- The Pathogenesis and Diagnosis ofJournal of fungi (Basel, Switzerland) · 2022Review
- Genetic and Epidemiologic Analyses of an Outbreak of Pneumocystis jirovecii Pneumonia Among Kidney Transplant Recipients in the United States.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022Article
- Pneumocystis jirovecii pneumonia in liver transplant recipients in an era of routine prophylaxis.Immunity, inflammation and disease · 2022Article
- Distinct Clinical and Laboratory Patterns ofJournal of fungi (Basel, Switzerland) · 2021Article
- Transmission and Colonization ofJournal of fungi (Basel, Switzerland) · 2021Review
- Pneumocystis pneumonia in liver transplant recipients.American journal of translational research · 2021Article
- Consensus Multilocus Sequence Typing Scheme forJournal of fungi (Basel, Switzerland) · 2020Review
- Outbreak-Causing Fungi: Pneumocystis jirovecii.Mycopathologia · 2020Review
- Article
- Genotyping of Pneumocystis jirovecii by Use of a New Simplified Nomenclature System Based on the Internal Transcribed Spacer Regions and 5.8S rRNA Gene of the rRNA Operon.Journal of clinical microbiology · 2019Article
- Article
- A Molecular Window into the Biology and Epidemiology of Pneumocystis spp.Clinical microbiology reviews · 2018Review
- Emerging issues, challenges, and changing epidemiology of fungal disease outbreaks.The Lancet. Infectious diseases · 2017Review
- Added Value of Next-Generation Sequencing for Multilocus Sequence Typing Analysis of a Pneumocystis jirovecii Pneumonia Outbreak1.Emerging infectious diseases · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundAn outbreak of 29 cases of Pneumocystis jirovecii pneumonia (PCP) occurred among renal and liver transplant recipients (RTR and LTR) in the largest Danish transplantation centre between 2007 and 2010, when routine PCP prophylaxis was not used.
methodsP. jirovecii isolates from 22 transplant cases, 2 colonized RTRs, and 19 Pneumocystis control samples were genotyped by restriction fragment length polymorphism and multilocus sequence typing analysis. Contact tracing was used to investigate transmission. Potential risk factors were compared between PCP cases and matched non-PCP transplant patients.
resultsThree unique Pneumocystis genotypes were shared among 19 of the RTRs, LTRs, and a colonized RTR in three distinct clusters, two of which overlapped temporally. In contrast, Pneumocystis control samples harbored a wide range of genotypes. Evidence of possible nosocomial transmission was observed. Among several potential risk factors, only cytomegalovirus viremia was consistently associated with PCP (P=0.03; P=0.009). Mycophenolate mofetil was associated with PCP risk only in the RTR population (P=0.04).
conclusionWe identified three large groups infected with unique strains of Pneumocystis and provide evidence of an outbreak profile and nosocomial transmission. LTRs may be infected in PCP outbreaks simultaneously with RTRs and by the same strains, most likely by interhuman transmission. Patients are at risk several years after transplantation, but the risk is highest during the first 6 months after transplantation. Because patients at risk cannot be identified clinically and outbreaks cannot be predicted, 6 months of PCP chemoprophylaxis should be considered for all RTRs and LTRs.
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Registered trials
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