Abstract | BACKGROUND: METHODS: We have conducted a retrospective before-after study in adult renal allograft recipients with one year follow-up after transplantation. We compared the ("after") group that received TMP-SMX as PJP prophylaxis to the ("before") group that did not receive it. RESULTS: In total, 343 renal allograft recipients were analysed, of whom 212 (61.8 %) received TMP-SMX as PJP prophylaxis. In this study, 63 (18.4 %) did only develop ASB without UTI, 26 (7.6 %) developed cystitis and 43 (12.5 %) developed AGPN. The remaining 211 (61.5 %) renal allograft recipients did not develop any bacteriuria at all. Multivariable Cox proportional regression analysis indicated that TMP-SMX as PJP prophylaxis was not associated with reduced prevalence of ASB (Hazard ratio (HR) = 1.52, 95 % CI = 0.79-2.94, p = 0.213), nor with reduced incidence of cystitis (HR = 2.21, 95 % CI = 0.76-6.39, p = 0.144), nor AGPN (HR = 1.12, 95 % CI = 0.57-2.21, p = 0.751). Among the group receiving TMP-SMX as PJP prophylaxis there was a trend was observed in increase of both amoxicillin (86 % versus 70 %) and TMP-SMX (89 % versus 48 %) resistance which already appeared within the first 30 days after TMP-SMX exposure. CONCLUSIONS: Among renal allograft recipients, administration of TMP-SMX as PJP prophylaxis does not prevent ASB nor UTI, however it is associated with tendency towards increased amoxicillin and TMP-SMX resistance.
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Authors | Ramandeep Singh, Frederike J Bemelman, Caspar J Hodiamont, Mirza M Idu, Ineke J M Ten Berge, Suzanne E Geerlings |
Journal | BMC infectious diseases
(BMC Infect Dis)
Vol. 16
Pg. 90
(Feb 25 2016)
ISSN: 1471-2334 [Electronic] England |
PMID | 26912326
(Publication Type: Evaluation Study, Journal Article)
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Chemical References |
- Anti-Bacterial Agents
- Trimethoprim, Sulfamethoxazole Drug Combination
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Topics |
- Adult
- Anti-Bacterial Agents
(therapeutic use)
- Asymptomatic Diseases
- Bacteriuria
(diagnosis, etiology, microbiology)
- Controlled Before-After Studies
- Cystitis
(diagnosis, etiology, microbiology)
- Drug Resistance, Bacterial
- Female
- Follow-Up Studies
- Humans
- Kidney Transplantation
- Male
- Middle Aged
- Pneumocystis carinii
- Pneumonia, Pneumocystis
(etiology, prevention & control)
- Postoperative Complications
(diagnosis, etiology, microbiology, prevention & control)
- Pyelonephritis
(diagnosis, etiology, microbiology)
- Retrospective Studies
- Transplantation, Homologous
- Treatment Outcome
- Trimethoprim, Sulfamethoxazole Drug Combination
(therapeutic use)
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