To the Editor—Vindrios et al reported an outbreak of Pneumocystis jirovecii pneumonia (PJP) among 7 Spanish heart transplant recipients, 6 of whom were taking atovaquone and 1 of whom was on no relevant prophylaxis [1]. Trimethoprim/sulfamethoxazole (TMP/SMX) is the first-line drug for PJP prophylaxis, not only because of its efficacy against PJP but also because of its activity against Toxoplasma, Nocardia, Listeria, and other pathogens responsible for opportunistic infections (OIs) in solid organ transplant (SOT) recipients [2]. Although a few studies explore reasons that providers chose alternatives to TMP/SMX for PJP prophylaxis in kidney transplant patients, sparse data exist regarding the choice of PJP prophylaxis for thoracic SOT recipients [3, 4]. We aimed to analyze PJP prophylaxis choice at our institution among recent thoracic SOT recipients using a cross-sectional approach, as well as to describe OIs due to Pneumocystis, Toxoplasma, Nocardia, and Listeria over the prior 10 years.

中文翻译：

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使用替代药物预防心脏和肺移植受者的机会性感染

致编辑—Vindrios等人报道了7名西班牙心脏移植受者中爆发了吉氏肺孢子虫肺炎（PJP），其中6人正在服用阿托伐醌，其中1人没有相关的预防措施[1]。甲氧苄氨嘧啶/磺胺甲恶唑（TMP / SMX）是预防PJP的一线药物，不仅因为它对PJP有疗效，而且还因为它对弓形虫，诺卡氏菌，李斯特菌具有活性，以及导致实体器官移植（SOT）受者中机会感染（OI）的其他病原体[2]。尽管一些研究探讨了在肾脏移植患者中提供者选择TMP / SMX替代物预防PJP的原因，但关于为胸腔SOT接受者选择PJP预防的数据稀少[3，4]。我们旨在采用横断面分析方法，对本院近期接受胸腔镜手术的接受者进行PJP预防选择进行分析，并描述在过去10年中由于肺囊虫，弓形虫，诺卡氏菌和李斯特菌引起的OI。