Incidence and clinical predictors of primary opportunistic deep cutaneous mycoses in solid organ transplant recipients: a multicenter cohort study

Autor: Gianpaolo, Tessari, Luigi, Naldi, Stefano, Piaserico, Luigino, Boschiero, Francesco, Nacchia, Alberto, Forni, Carlo, Rugiu, Giuseppe, Faggian, Elena, Dall'olio, Anna Belloni, Fortina, Mauro, Alaibac, Fabrizia, Sassi, Eliana, Gotti, Roberto, Fiocchi, Stefano, Fagioli, Giampiero, Girolomoni
Přispěvatelé: Gianpaolo, T, Luigi, N, Stefano, P, Luigino, B, Francesco, N, Alberto, F, Carlo, R, Giuseppe, F, Elena Dall'Olio, Anna Belloni, F, Mauro, A, Fabrizia, S, Eliana, G, Roberto, F, Fagiuoli, S, Giampiero Girolomoni
Rok vydání: 2010
Předmět:
Popis: Primary opportunistic deep cutaneous fungal infections may cause significant morbidity and mortality in solid organ transplant recipients (OTR), but no data exist about their incidence, timing, and clinical predictors in a long-term follow-up. Patients and methods: A series of 3293 consecutive OTR including 1991 kidney, 929 heart, and 373 liver transplant recipients were enrolled. Patients were regularly followed up since time at transplantation (mean 5.5 yr ±5.9 SD) and primary opportunistic fungal infections registered. Persons-year at risk (PYs), incidence rates (IR), incidence rate ratios (IRR), and 95% confidence intervals were computed. Results: Twenty-two cases of deep cutaneous mycoses were detected, (IR 1.2 cases per 1000 PYs) after a mean follow-up time since transplantation of 2.5 yr ± 2.0 SD (median 1.8 yr). Six patients had subsequent systemic involvement and three patients died of systemic dissemination. A higher risk for mycoses was observed in the first two yr after transplantation, (IRR 35.9, p < 0.0001), in renal transplant recipients (IRR 5.1 p = 0.030), and in patients transplanted after the age of 50 (IRR 11.5 p = 0.020). Conclusions: Primary deep cutaneous opportunistic mycoses in OTR occur mainly in the first two yr after transplantation, in renal transplant recipients, and in older patients.
Databáze: OpenAIRE