Prophylaxis of fungal infections in transplant patients
| Autor: | M. L. Caramori, Karim Yaqub Ibrahim, Maria Aparecida Shikanai-Yasuda, Gisele Madeira Duboc de Almeida, Luis Sérgio Fonseca de Azevedo, Silvia Figueiredo Costa, Heloisa Helena de Souza Marques, Edson Abdala, Tania Mara Varejão Strabelli, Glaucia Fernanda Varkulja, Frederico Luiz Dulley, Lígia Camera Pierrotti, Gilberto de Castro Junior |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
medicine.medical_specialty
Antifungal Agents medicine.medical_treatment Hematopoietic stem cell transplantation Biology Aspergillosis Organ transplantation Internal medicine Technical Note medicine Humans Lung transplantation Antibiotic prophylaxis lcsh:R5-920 Organ Transplantation General Medicine Antibiotic Prophylaxis medicine.disease Transplantation surgical procedures operative medicine.anatomical_structure Graft-versus-host disease Mycoses Immunology Bone marrow lcsh:Medicine (General) |
| Zdroj: | Clinics; v. 67 n. 6 (2012); 681-684 Clinics; Vol. 67 Núm. 6 (2012); 681-684 Clinics; Vol. 67 No. 6 (2012); 681-684 Clinics Universidade de São Paulo (USP) instacron:USP Clinics, Volume: 67, Issue: 6, Pages: 681-684, Published: 2012 Clinics, Vol 67, Iss 6, Pp 681-684 (2012) |
| ISSN: | 1807-5932 1980-5322 |
| DOI: | 10.6061/clinics/2012(06)23 |
| Popis: | Fungi are an important cause of infection in patients undergoing solid organ transplantation and bone marrow or hematopoietic stem cell transplantation (BMT/HSCT). The incidence and mortality of fungal infections differ according to the organ and the time since transplantation. In the first 30 days after transplantation, yeast (primarily Candida spp.) predominate. After the first month, filamentous fungi, such as Aspergillus spp., are the most frequent agents of infection (1-6). In BMT/HSCT patients, however, invasive aspergillosis has two peaks of incidence: one at one month post-transplantation and another approximately 90 days after the transplant if the patient develops chronic graft versus host disease (7,8). Among solid organ transplantation, liver and lung transplant have the highest risk for fungal infection due to underlying diseases, surgical techniques and the graft itself (4,9). Antifungal prophylaxis use is well established following some transplant types, such as BMT/HSCT and liver (10,11). However, few studies have evaluated heart and pancreas transplants. One of the major challenges is the prevention of filamentous fungal infections, especially by Aspergillus spp., in high-risk patients, such as those who have undergone an allogeneic BMT and developed chronic graft versus host disease or undergone a lung transplantation (12,13). To standardize the use of primary prophylaxis in transplant patients, we analyzed the literature related to the following transplants: liver, kidney, heart, lung, and HSCT. The IDSA (Infectious Diseases Society of America) system was used to determine the levels of evidence. |
| Databáze: | OpenAIRE |
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