{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T18:03:42Z","timestamp":1791655422678,"version":"4.3.4"},"reference-count":17,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2018,3,31]],"date-time":"2018-03-31T00:00:00Z","timestamp":1522454400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2018,6]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n \n Pneumocystis jirovecii<\/jats:italic>\n pneumonia (\n PJ<\/jats:italic>\n P) affected 5%\u201015% of solid organ transplant (\n SOT<\/jats:styled-content>\n ) recipients prior to universal prophylaxis, classically with trimethoprim\u2010sulfamethoxazole (\n TMP<\/jats:styled-content>\n \u2010\n SMX<\/jats:styled-content>\n ). Guidelines generally recommend 6\u201012\u00a0months of prophylaxis post\u2010\n SOT<\/jats:styled-content>\n , yet optimal duration and robust\n PJ<\/jats:italic>\n P risk stratification have not been established.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n A retrospective, single\u2010center, case\u2010control study of\n PJ<\/jats:italic>\n P among\n SOT<\/jats:styled-content>\n recipients from January 1998 to December 2013 was conducted. Cases had positive\n PJ<\/jats:styled-content>\n direct fluorescent antibody assay of respiratory specimens. Controls were matched 4:1 by nearest date of\n SOT<\/jats:styled-content>\n . Univariate testing and multivariate logistic regressions were performed.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Fifteen cases were identified among 5505\n SOT<\/jats:styled-content>\n recipients (0.27% rate) and analyzed vs 60 controls.\n PJ<\/jats:italic>\n P occurred on average 6.1\u00a0years (range 0.9\u201013.8) post\u2010\n SOT<\/jats:styled-content>\n ; no case was receiving\n PJ<\/jats:italic>\n P prophylaxis at diagnosis. Most were treated with reduced immunosuppression and\n TMP<\/jats:styled-content>\n \u2010\n SMX<\/jats:styled-content>\n plus steroids (80%). Six patients (40%) required critical care; 3 (20%) died. There were no significant demographic differences, though cases tended to be older at\n SOT<\/jats:styled-content>\n (54 vs 48\u00a0years,\n P<\/jats:italic>\n \u00a0=\u00a0.1). In univariate analysis, prior viral infection was more common among cases (67% vs 37%,\n P<\/jats:italic>\n \u00a0=\u00a0.08). Lower absolute lymphocyte count (\n ALC<\/jats:styled-content>\n ) at diagnosis date was strongly associated with\n PJ<\/jats:italic>\n P (400 vs 1230\u00a0\u00d7\u00a010\n 6<\/jats:sup>\n \u00a0cells\/\u03bcL,\n P<\/jats:italic>\n \u00a0<\u00a0.001); odds of infection were high with\n ALC<\/jats:styled-content>\n \u2264 500\u00a0\u00d7\u00a010\n 6<\/jats:sup>\n cells (\n OR<\/jats:styled-content>\n 18.7,\n P<\/jats:italic>\n \u00a0<\u00a0.01).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n Pneumocystis jirovecii<\/jats:italic>\n pneumonia is a rare, late complication of\n SOT<\/jats:styled-content>\n with significant morbidity and mortality. Severe lymphopenia may be useful in identifying\n SOT<\/jats:styled-content>\n recipients who warrant continued or reinstated\n PJ<\/jats:italic>\n P prophylaxis.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/tid.12876","type":"journal-article","created":{"date-parts":[[2018,3,7]],"date-time":"2018-03-07T05:08:37Z","timestamp":1520399317000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":52,"title":["Lymphopenia is associated with late onset\n Pneumocystis jirovecii<\/i>\n pneumonia in solid organ transplantation"],"prefix":"10.1111","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2943-5895","authenticated-orcid":false,"given":"W.A.","family":"Werbel","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases Johns Hopkins University School of Medicine Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3347-9671","authenticated-orcid":false,"given":"M.G.","family":"Ison","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Northwestern University Feinberg School of Medicine Chicago IL USA"},{"name":"Division of Organ Transplantation Northwestern University Feinberg School of Medicine Chicago IL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.P.","family":"Angarone","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Northwestern University Feinberg School of Medicine Chicago IL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Preventative Medicine Northwestern University Feinberg School of Medicine Chicago IL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V.","family":"Stosor","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Northwestern University Feinberg School of Medicine Chicago IL USA"},{"name":"Division of Organ Transplantation Northwestern University Feinberg School of Medicine Chicago IL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,3,31]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1086\/515126"},{"key":"e_1_2_9_3_1","article-title":"Trimethoprim\u2010sulfamethoxazole compared with ciprofloxacin for the prevention of urinary tract infection in renal transplant recipients. A double\u2010blind, randomized controlled trial","author":"Hibberd PL","year":"1992","journal-title":"Online J Curr Clin Trials"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-199308000-00021"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2014.09.156"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1086\/651262"},{"issue":"10","key":"e_1_2_9_7_1","first-page":"CD005590","article-title":"Prophylaxis for Pneumocystis pneumonia (PCP) in non\u2010HIV immunocompromised patients","author":"Stern A","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.12119"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2015.11.012"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cit413"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.12947"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3062.2011.00645.x"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1399-3062.2003.00018.x"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2010.03143.x"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.155.1.9001290"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1553-2712.2011.01031.x"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.12651"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.21833"}],"container-title":["Transplant Infectious Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Ftid.12876","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tid.12876","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,23]],"date-time":"2023-09-23T19:29:42Z","timestamp":1695497382000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/tid.12876"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,3,31]]},"references-count":17,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2018,6]]}},"alternative-id":["10.1111\/tid.12876"],"URL":"https:\/\/doi.org\/10.1111\/tid.12876","archive":["Portico"],"relation":{},"ISSN":["1398-2273","1399-3062"],"issn-type":[{"value":"1398-2273","type":"print"},{"value":"1399-3062","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,3,31]]},"assertion":[{"value":"2017-07-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-12-24","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-03-31","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e12876"}}