Invasive scedosporiosis in lung transplant recipients: A nine-year retrospective study in a tertiary care hospital.

Autor: Ibáñez-Martínez E; Unidad de Biomarcadores y Medicina de Precisión, Instituto de Investigación Sanitaria La Fe, València, Spain; Servicio de Microbiología, Hospital Universitari i Politècnic La Fe, València, Spain., Solé A; Unidad de Trasplante Pulmonar, Hospital Universitari i Politècnic La Fe, València, Spain; Grupo de Investigación Infección Grave, Instituto de Investigación Sanitaria La Fe, València, Spain. Electronic address: sole_amp@gva.es., Cañada-Martínez A; Servicio de Bioestadística y Bioinformática, Instituto de Investigación Sanitaria La Fe, València, Spain., Muñoz-Núñez CF; Servicio de Radiología, Hospital Universitari i Politècnic La Fe, València, Spain., Pastor A; Unidad de Trasplante Pulmonar, Hospital Universitari i Politècnic La Fe, València, Spain., Montull B; Unidad de Trasplante Pulmonar, Hospital Universitari i Politècnic La Fe, València, Spain., Falomir-Salcedo P; Servicio de Microbiología, Hospital Universitari i Politècnic La Fe, València, Spain; Grupo de Investigación Infección Grave, Instituto de Investigación Sanitaria La Fe, València, Spain., Valentín A; Servicio de Microbiología, Hospital Universitari i Politècnic La Fe, València, Spain; Grupo de Investigación Infección Grave, Instituto de Investigación Sanitaria La Fe, València, Spain., López-Hontangas JL; Servicio de Microbiología, Hospital Universitari i Politècnic La Fe, València, Spain; Grupo de Investigación Infección Grave, Instituto de Investigación Sanitaria La Fe, València, Spain., Pemán J; Servicio de Microbiología, Hospital Universitari i Politècnic La Fe, València, Spain; Grupo de Investigación Infección Grave, Instituto de Investigación Sanitaria La Fe, València, Spain.
Jazyk: angličtina
Zdroj: Revista iberoamericana de micologia [Rev Iberoam Micol] 2021 Oct-Dec; Vol. 38 (4), pp. 184-187. Date of Electronic Publication: 2021 Oct 10.
DOI: 10.1016/j.riam.2021.06.002
Abstrakt: Background: Scedosporium species and Lomentospora prolificans (Sc/Lp) are emerging molds that cause invasive disease associated with a high mortality rate. After Aspergillus, these molds are the second filamentous fungi recovered in lung transplant (LT) recipients.
Aims: Our objective was to evaluate the incidence, risk factors and outcome of Sc/Lp infections in LT recipients at a tertiary care hospital with a national reference LT program.
Methods: A nine-year retrospective study was conducted.
Results: During this period, 395 LT were performed. Positive cultures for Sc/Lp were obtained from twenty-one LT recipients. Twelve patients (incidence 3.04%) developed invasive scedosporiosis (IS). In 66.7% of the patients with IS the invasive infection was defined as a breakthrough one. The main sites of infection were lungs and paranasal sinuses. Most of the patients received combination antifungal therapy. The IS crude mortality rate after 30 days was 16.7%, and 33.3% after a year.
Conclusions: Our study highlights improved survival rates associated with combination antifungal therapy in LT recipients and underlines the risk of breakthrough infections in patients with allograft dysfunction on nebulized lipidic amphotericin B prophylaxis. In addition to pretransplant colonization, acute or chronic organ dysfunctions seem to be the main risk factors for IS.
(Copyright © 2021 Asociación Española de Micología. Publicado por Elsevier España, S.L.U. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: