Department of Infectious Diseases, Saint-Louis Hospital, Assistance-Publique Hôpitaux de Paris, University of Paris Diderot, Paris, France.
Clin Microbiol Infect. 2010 Sep;16(9):1375-7. doi: 10.1111/j.1469-0691.2009.03143.x.
A case-control study was conducted to identify risk factors for Pneumocystis jirovecii pneumonia (PCP) in renal transplant recipients. Eleven cases of PCP were matched with 22 controls. Cases occurred a median of 18 months after transplantation, and none of the recipients was receiving prophylaxis. Univariate analysis showed that graft rejection, duration of steroid use, use of mammalian target of rapamycin (mTOR) inhibitors and lymphocytopenia at the time of prophylaxis discontinuation were risk factors for PCP. In the multivariate model, only graft rejection (OR 8.66, p 0.017) remained significantly associated with PCP. In patients with a history of graft rejection, PCP prophylaxis should be maintained, especially among those with lymphocytopenia.
一项病例对照研究旨在确定肾移植受者中肺孢子菌肺炎（PCP）的危险因素。11 例 PCP 与 22 例对照相匹配。病例发生在移植后中位数 18 个月，且均未接受预防治疗。单因素分析显示，移植物排斥反应、类固醇使用时间、使用雷帕霉素（mTOR）抑制剂和预防停药时淋巴细胞减少是 PCP 的危险因素。在多变量模型中，只有移植物排斥反应（OR 8.66，p 0.017）与 PCP 显著相关。在有移植物排斥反应史的患者中，应维持 PCP 的预防治疗，尤其是淋巴细胞减少症患者。
