Outcomes of solid organ transplant recipients with invasive aspergillosis and other mold infections
| Autor: | Laurence Lavayssière, Cédric Farges, Federico Sallusto, Joelle Guitard, Eléna Charpentier, Fabrice Muscari, Nassim Kamar, Xavier Iriart, Marie-Béatrice Nogier, Shérazade Lakhdar-Ghazal, Laure Esposito, M. Murris, Camille Dambrin, Arnaud Del Bello, Sophie Cassaing, Olivier Cointault, L. Porte, Anne-Laure Hebral, Stanislas Faguer |
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| Přispěvatelé: | Service de Parasitologie et Mycologie, CHU Toulouse [Toulouse]-Institut Fédératif de Biologie (IFB) - Hôpital Purpan, Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse]-Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse], Service de Néphrologie - Hypertension Artérielle Dialyse - Transplantation, CHU Toulouse [Toulouse]-Hôpital de Rangueil, Service de pneumologie [Toulouse], CHU Toulouse [Toulouse]-Hôpital Larrey [Toulouse], Centre de Physiopathologie Toulouse Purpan (CPTP), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service d'Urologie - Transplantation Rénale - Andrologie, Hôpital de Rangueil, Service des maladies infectieuses et tropicales [Toulouse], CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse]-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Fédératif de Biologie (IFB) - Hôpital Purpan, CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Hôpital Purpan [Toulouse], Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Toulouse III - Paul Sabatier (UT3) |
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_treatment Hemodynamics MESH: Transplant Recipients 030230 surgery MESH: Female Humans Aspergillosis Logistic regression outcomes 0302 clinical medicine [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases Cumulative incidence MESH: Incidence solid organ transplantation MESH: Treatment Outcome Heart transplantation MESH: Aged Kidney MESH: Middle Aged Incidence Middle Aged 3. Good health Infectious Diseases medicine.anatomical_structure Treatment Outcome Aspergillus non-Aspergillus molds 030211 gastroenterology & hepatology Female MESH: Invasive Fungal Infections / mortality medicine.medical_specialty 03 medical and health sciences Internal medicine medicine Humans Renal replacement therapy Aged Retrospective Studies Mechanical ventilation Transplantation invasive aspergillosis business.industry MESH: Retrospective Studies Organ Transplantation medicine.disease Transplant Recipients MESH: Male MESH: Aspergillosis / epidemiology MESH: Organ Transplantation MESH: Invasive Fungal Infections / epidemiology business Invasive Fungal Infections |
| Zdroj: | Transplant Infectious Disease Transplant Infectious Disease, Wiley, 2019, 22 (1), ⟨10.1111/tid.13200⟩ |
| ISSN: | 1398-2273 1399-3062 |
| Popis: | International audience; Objectives: To characterize the clinical presentation and outcomes of invasive mold infections (IMI) in solid organ transplant (SOT) recipients.Methods: Inclusion of all SOT recipients with IMI diagnosed between 2008 and 2016 at a referral center for SOT. Univariable analyses identified factors associated with death at one year, and logistic regression models retained independent predictors.Results: Of the 1739 patients that received a SOT during this period, 68 developed IMI (invasive aspergillosis [IA] in 58). Cumulative incidence of IMI at 1 year ranged from 1.2% to 18.8% (kidney and heart transplantation, respectively). At baseline, compared with other IMI, the need for vasoactive drugs was more frequent in patients with IA. During follow-up, 35 patients (51%) were admitted to the ICU and required mechanical ventilation (n = 27), vasoactive drugs (n = 31), or renal replacement therapy (n = 31). The need for vasoactive drugs (OR 7.34; P = .003) and a positive direct examination (OR 10.1; P = .004) were independently associated with the risk of death at 1 year in patients with IA (n = 33; 57%) CONCLUSIONS: Characteristics of IMI at presentation varied according to the underlying transplanted organ and the mold species. Following IA, one-year mortality may be predicted by the need for hemodynamic support and initial fungal load |
| Databáze: | OpenAIRE |
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