Risk of Pneumocystis jirovecii Pneumonia among Solid Organ Transplant Recipients: A Population-Based Study

• Published in: Journal of fungi (Basel) Vol. 9; no. 1; p. 23
• Main Authors: Cheng, Yih-Dih, Huang, Ching-Hua, Gau, Shuo-Yan, Chung, Ning-Jen, Huang, Shiang-Wen, Huang, Cheng-Yang, Lee, Chien-Ying
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 22.12.2022; MDPI
• Subjects: adjusted odds ratio; Chronic obstructive pulmonary disease; Comorbidity; Hematology; Hemodialysis; Hepatitis; HIV; Hospitals; Human immunodeficiency virus; Hyperlipidemia; Hypertension; Immunocompetence; Infections; Kidney transplants; Liver transplants; Lung transplants; Malignancy; National health insurance; Patients; Peritoneal dialysis; Pneumocystis jirovecii; Pneumocystis jirovecii pneumonia; Pneumonia; Population studies; Population-based studies; Regression analysis; Sensitivity analysis; solid organ transplant; Steroids; Transplantation; Urbanization; Variables; Vasculitis; Taiwan; adjusted odds ratio; Pneumocystis jirovecii pneumonia; solid organ transplant
• ISSN: 2309-608X; 2309-608X
• DOI: 10.3390/jof9010023

Few studies have comprehensively investigated the occurrence of pneumonia (PJP) among solid organ transplant (SOT) recipients. This study investigated the risk of PJP after organ transplantation. Each patient who underwent SOT was propensity-score-matched with four non-SOT individuals in terms of sex, age, insured salary, urbanization of residence, comorbidities, and year of enrollment. When considering the 3-year follow-up, the patients who had undergone SOT were at higher risk of PJP, with the adjusted odds ratio (aOR) being 17.18 (95% confidence interval (CI): 8.80-33.53). Furthermore, SOT recipients were also at higher PJP risk than the patients without SOT at 6 months, 1 year, and 2 years, with the aOR being 22.64 (95% CI: 7.53-68.11), 26.19 (95% CI: 9.89-69.37), and 23.06 (95% CI: 10.23-51.97), respectively. Patients comorbid with HIV infection, hematological malignancies, or vasculitis were at higher risk (aOR = 59.08, 95% CI = 20.30-171.92), (aOR = 11.94, 95% CI = 5.36-26.61), and (aOR = 21.72, 95% CI = 2.41-195.81), respectively. The recipients of SOT were at higher risk of PJP, and PJP can develop at any stage after transplantation. SOT recipients comorbid with HIV, hematologic malignancies, or vasculitis were at higher PJP risk.