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. 2021 Oct;23(5):e13708.
doi: 10.1111/tid.13708. Epub 2021 Aug 5.

Epidemiological and clinical study of microsporidiosis in French kidney transplant recipients from 2005 to 2019: TRANS-SPORE registry

Clément Dumond  1 , Florence Aulagnon  2 , Isabelle Etienne  3 , Anne-Elisabeth Heng  1 , Marie-Elisabeth Bougnoux  4 , Loic Favennec  5 , Nassim Kamar  6 , Xavier Iriart  7   8 , Bruno Pereira  9 , Mathias Büchler  10 , Guillaume Desoubeaux  11 , Hannah Kaminski  12 , Florian Lussac-Sorton  13 , Gilles Gargala  5 , Dany Anglicheau  2 , Philippe Poirier  14 , Anne Scemla  2 , Cyril Garrouste  1 ; French Microsporidiosis Network
Collaborators, Affiliations

Epidemiological and clinical study of microsporidiosis in French kidney transplant recipients from 2005 to 2019: TRANS-SPORE registry

Clément Dumond et al. Transpl Infect Dis. 2021 Oct.

Abstract

Introduction: Microsporidiosis is an emerging opportunistic infection in renal transplantation (RT) recipients. We aimed to describe its clinical presentation and treatment.

Materials and methods: We collected microsporidiosis cases identified in RT recipients between 2005 and 2019 in six French centers from the Crystal, Divat and Astre prospective databases.

Results: We report 68 RT recipients with intestinal microsporidiosis; the patients were predominantly male (61.8%), with a median age of 58 (46-69) years. Infection occurred at a median time of 3 (0.8-6.8) years posttransplant. Only Enterocytozoon bieneusi 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 (N = 9), reduction of the immunosuppressive regimen (∆IS) (N = 22), fumagillin alone (N = 9), fumagillin and ∆IS (N = 19), and albendazole or nitazoxanide and ∆IS (N = 9). 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.

Conclusion: E. bieneusi is an underestimated opportunistic pathogen in RT recipients, and infection with E. bieneusi 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.

Keywords: fumagillin; immunosuppressive regimen; kidney transplantation; microsporidiosis.

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References

REFERENCES

    1. Mandell G, Benett J, Dolin R. Microsporidiosis. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 7th ed. Elsevier; 2009:3391-3408.
    1. Didier ES, Weiss LM. Microsporidiosis: current status. Curr Opin Infect Dis. 2006;19(5):485-492.
    1. Desportes I, Charpentier YL, Galian A, et al. 0n. sp., in the enterocytes of a human patient with AIDS. J Protozool. 1985;32:250-254.
    1. Didier ES, Weiss LM. Microsporidiosis: not just in AIDS patients. Curr Opin Infect Dis. 2011;24(5):490-495.
    1. Han B, Weiss LM. Microsporidia: obligate intracellular pathogens within the fungal kingdom. Microbiol Spectrum. 2017;5(2). https://doi.org/10.1128/microbiolspec.FUNK-0018-2016

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