Transmission of Pneumocystis Species among Renal Transplant Recipients

Nosocomial fungal infections: epidemiology, infection control, and prevention

Fungal infections are an increasing cause of morbidity and mortality in hospitalized patients. This article reviews the current epidemiology of nosocomial fungal infections in adult patients, with an emphasis on invasive candidiasis and aspergillosis. Recently published recommendations and guidelines for the control and prevention of these nosocomial fungal infections are summarized.

Cluster outbreak of Pneumocystis pneumonia among kidney transplant patients within a single center

Pneumocystis pneumonia (PCP), a life-threatening opportunistic infection occurring in immunocompromised hosts, developed in 10 patients in the past 35 years at our hospital. Among the 7 outpatients and 3 inpatients, 9 cases clustered within 7 months. The mean time was 32.1 +/- 27.5 months between transplantation and PCP diagnosis. The mortality rate was 33.3%. The patients developing PCP were older at transplantation (46.9 +/- 11.8 vs 34.0 +/- 11.1 years; P = .003) and had a longer pretransplantation dialysis period (146.3 +/- 120.0 vs 51.3 +/- 66.6 months; P < .0001). Multivariate analysis showed that age at transplantation and the use of mycophenolate mofetil (MMF) were risk factors for development of PCP. Despite prophylaxis with trimethoprim-sulfamethoxazole (TMP-SMX) during the first 3 to 6 months after transplantation, the time period that showed the highest incidence rate of PCP, the disease may occur at later intervals.