Candiduria in kidney transplant recipients: Is antifungal therapy useful?
| Autor: | Matthieu Resche-Rigon, Prescillia Piron, Blandine Denis, Imad Abboud, Stéphane Bretagne, Marie-Noëlle Peraldi, Jean-Michel Molina, Dorothée Chopin, Maud Gits-Muselli |
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| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Adult Male medicine.medical_specialty Antifungal Agents 030106 microbiology Dermatology Asymptomatic 03 medical and health sciences 0302 clinical medicine Risk Factors Diabetes mellitus Internal medicine Medicine Humans 030212 general & internal medicine Aged Candida Proportional Hazards Models Retrospective Studies Candida glabrata biology business.industry Proportional hazards model Mortality rate Incidence (epidemiology) Incidence Candidiasis Retrospective cohort study General Medicine Middle Aged biology.organism_classification medicine.disease Kidney Transplantation Transplant Recipients Transplantation Infectious Diseases Treatment Outcome Urinary Tract Infections Female medicine.symptom business |
| Zdroj: | Mycoses. 61(5) |
| ISSN: | 1439-0507 |
| Popis: | A French single-centre retrospective study between 2010 and 2014 was undertaken to assess candiduria's incidence in kidney transplant recipients (KTR), and the use and impact of antifungal treatment on outcome. Candiduria was defined as a urine culture with ≥103 cfu/mL of Candida species. Candiduria clearance, severe complications and death rates were estimated by Kaplan-Meier methods and the effect of treatment by Cox models. 52/1223 (4.3%) KTR had ≥1 episode of candiduria, 42 (81%) were females, 18 (35%) had diabetes, with an incidence of 2.3/100 person-year of follow-up. Candiduria was asymptomatic in 51 (98%) patients. Candida glabrata was the most frequent pathogen identified. Overall fungal clearance rate was 89%. Antifungal therapy was initiated in only 14 episodes (12%), according to guidelines. Three patients (6%) developed severe complications in the first 2 weeks after transplantation, and 8 (15%) died. Antifungal treatment had no impact on candiduria clearance (HR, 0.6; 95% CI, 0.3-1.1; P = .10), on recurrence rate (HR, 0.5; 95% CI, 0.1-2.3; P = .41) and on the risk of severe complications or death (HR, 1.1; 95% CI, 0.3-4.8; P = .89). Candiduria is rare and usually asymptomatic among KTR. Candiduria management in the immediate post-transplant period deserves careful attention. |
| Databáze: | OpenAIRE |
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