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We aimed to describe its clinical presentation and treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>We collected microsporidiosis cases identified in RT recipients between 2005 and 2019 in six French centers from the Crystal, Divat and Astre prospective databases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We report 68 RT recipients with intestinal microsporidiosis; the patients were predominantly male (61.8%), with a median age of 58 (46\u201369) years. Infection occurred at a median time of 3 (0.8\u20136.8) years posttransplant. Only <jats:italic>Enterocytozoon bieneusi<\/jats:italic> was found. Microsporidiosis manifested as diarrhea (98.5% of patients) with weight loss (72.1%) and acute renal injury (57.4%) without inflammatory biological parameters. The therapeutic approaches were no treatment (<jats:italic>N<\/jats:italic>\u00a0=\u00a09), reduction of the immunosuppressive regimen (\u2206IS) (<jats:italic>N<\/jats:italic>\u00a0=\u00a022), fumagillin alone (<jats:italic>N<\/jats:italic>\u00a0=\u00a09), fumagillin and \u2206IS (<jats:italic>N<\/jats:italic>\u00a0=\u00a019), and albendazole or nitazoxanide and \u2206IS (<jats:italic>N<\/jats:italic>\u00a0=\u00a09). Overall clinical remission was observed in 60 patients (88.2%). We observed no acute kidney rejection, renal transplant failure, or death within 6 months after microsporidiosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p><jats:italic>E. bieneusi<\/jats:italic> is an underestimated opportunistic pathogen in RT recipients, and infection with <jats:italic>E. bieneusi<\/jats:italic> leads to diarrhea with important dehydration and acute renal injury. The treatment is based on the reduction of the immunosuppressive regimen and the administration of fumagillin if available.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tid.13708","type":"journal-article","created":{"date-parts":[[2021,7,29]],"date-time":"2021-07-29T19:45:02Z","timestamp":1627587902000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Epidemiological and clinical study of microsporidiosis in French kidney transplant recipients from 2005 to 2019: TRANS\u2010SPORE registry"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6983-7536","authenticated-orcid":false,"given":"Cl\u00e9ment","family":"Dumond","sequence":"first","affiliation":[{"name":"Department of Nephrology 3iHP Clermont\u2010Ferrand University Hospital  Clermont\u2010Ferrand 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