Invasive Candida Infections in Liver Transplant Recipients: Clinical Features and Risk Factors for Mortality

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dc.citation.issue5
dc.citation.volume3
dc.contributor.authorBassetti, Matteo
dc.contributor.authorPeghin, Maddalena
dc.contributor.authorCarnelutti, Alessia
dc.contributor.authorRighi, Elda
dc.contributor.authorMerelli, Maria
dc.contributor.authorAnsaldi, Filippo
dc.contributor.authorTrucchi, Cecilia
dc.contributor.authorAlicino, Cristiano
dc.contributor.authorSartor, Assunta
dc.contributor.authorWauters, Joost
dc.contributor.authorLagrou, Katrien
dc.contributor.authorTascini, Carlo
dc.contributor.authorMenichetti, Francesco
dc.contributor.authorMesini, Alessio
dc.contributor.authorDe Rosa, Francesco G.
dc.contributor.authorLagunes, Leonel
dc.contributor.authorRello, Jordi [UNIFESP]
dc.contributor.authorColombo, Arnaldo L. [UNIFESP]
dc.contributor.authorVena, Antonio
dc.contributor.authorMunoz, Patricia
dc.contributor.authorTumbarello, Mario
dc.contributor.authorSganga, Gabriele
dc.contributor.authorMartin-Loeches, Ignacio
dc.contributor.authorViscoli, Claudio
dc.coveragePhiladelphia
dc.date.accessioned2020-07-13T11:53:21Z
dc.date.available2020-07-13T11:53:21Z
dc.date.issued2017
dc.description.abstractBackground. Invasive fungal infections remain a leading cause of morbidity and mortality among liver transplant recipients (LTRs). In this patient population, invasive Candida infections (ICIs) account for the largemajority of cases. To date, only small studies and case-series analysing clinical presentation and risk factors formortality in LTRs with ICIs are available. Methods. We performed a retrospective multicenter multinational study in 10 centers in Europe and Brazil. All consecutive LTRs developing ICIs during the period January 2011 to December 2013 were included in the study. Results. A total of 42 LTRs were included. Median age was 52.5 years, and 78.6% of patients weremen. Viral hepatitis was the most common cause for liver transplantation (42.9%). Candidemia represented the majority of cases (24, 57.1%), followed by intra-abdominal candidiasis (18, 42.9%). Overall 30-day mortality was 23.8%, with higher mortality in patients with candidemia compared with intra-abdominal candidiasis (37.5% vs 5.6%, P = 0.02). Multivariate analysis showed candidemia to be a risk factor associated with mortality among LTRs presenting ICIs (odds ratio, 11.86en
dc.description.abstract95% confidence interval, 1.5-280en
dc.description.abstractP = 0.01). Candida albicans represented the most common isolate (59.5%). High rates of antifungal resistances were found, with 16.7% and 4.8% of isolates displaying resistance to azoles and caspofungin, respectively. Conclusions. Our study confirms the occurrence of high mortality rates in LTRs developing ICIs. Mortality rates varied according to the type of infection, with candidemia representing a risk factor for mortality. The high rates of antifungal resistance should be considered in the choice of the empiric antifungal regimen.en
dc.description.affiliationUniv Udine, Dept Med, Infect Dis Clin, Udine, Italy
dc.description.affiliationAzienda Sanit Univ Integrata Udine, Udine, Italy
dc.description.affiliationUniv Genoa, Dept Hlth Sci, Genoa, Italy
dc.description.affiliationIRCCS AOU San Martino IST, Genoa, Italy
dc.description.affiliationUniv Hosp Leuven, Med Intens Care Unit, Leuven, Belgium
dc.description.affiliationUniv Hosp Leuven, Dept Lab Med, Leuven, Belgium
dc.description.affiliationUniv Hosp Leuven, Natl Reference Ctr Mycosis, Leuven, Belgium
dc.description.affiliationKatholieke Univ Leuven, Dept Microbiol & Immunol Leuven, Leuven, Belgium
dc.description.affiliationAzienda Osped Colli, Osped Cotugno, Infecious Dis Unit 1, Naples, Italy
dc.description.affiliationCisanello Hosp, Dept Infect Dis, Pisa, Italy
dc.description.affiliationUniv Genoa, IRCCS AOU San Martino IST, Infect Dis Unit, Genoa, Italy
dc.description.affiliationUniv Torino, Dept Med Sci, Turin, Italy
dc.description.affiliationUAB, Hosp Vall dHebron, Inst Recerca Vall dHebron, CIBERES,Crit Care, Barcelona, Spain
dc.description.affiliationUniv Fed Sao Paulo, Univ Hosp, Sao Paulo, Brazil
dc.description.affiliationHosp Gen Univ Gregorio Maranon, Clin Microbiol & Infect Dis Dept, Madrid, Spain
dc.description.affiliationUniv Cattolica Sacro Cuore, Policlin Gemelli, Infect Dis Inst, Rome, Italy
dc.description.affiliationSt James Univ Hosp, Multidisciplinary Intens Care, Dublin, Ireland
dc.description.affiliationUnifespUniv Fed Sao Paulo, Univ Hosp, Sao Paulo, Brazil
dc.description.sourceWeb of Science
dc.format.extent-
dc.identifierhttp://dx.doi.org/10.1097/TXD.0000000000000673
dc.identifier.citationTransplantation Direct. Philadelphia, v. 3, n. 5, p. -, 2017.
dc.identifier.doi10.1097/TXD.0000000000000673
dc.identifier.fileWOS000400508600007.pdf
dc.identifier.issn2373-8731
dc.identifier.urihttps://repositorio.unifesp.br/handle/11600/54559
dc.identifier.wosWOS:000400508600007
dc.language.isoeng
dc.publisherLippincott Williams & Wilkins
dc.relation.ispartofTransplantation Direct
dc.rightsinfo:eu-repo/semantics/openAccess
dc.titleInvasive Candida Infections in Liver Transplant Recipients: Clinical Features and Risk Factors for Mortalityen
dc.typeinfo:eu-repo/semantics/article
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