Approach to the Solid Organ Transplant Patient with Suspected Fungal Infection

Anesi, Judith A; Baddley, John W.

doi:10.1016/j.idc.2015.10.001

Cited by 31 publications

(21 citation statements)

References 145 publications

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“…In our laboratory, the frequency of these diseases is high, with histoplasmosis being the most frequent IFD, followed by aspergillosis, cryptococcosis, pneumocystosis, PCM, invasive candidiasis, and less frequently, IFD caused by other emerging agents including some basidiomycetes and mucorales. Several publications related to IFD based on different methodological designs (prospective, retrospective, multicentric) and different patient populations (onco-hematological, transplant, intensive care unit) have reported for countries in Europe and the Americas a greater frequency of patients with invasive candidiasis and aspergillosis, which is different from the findings observed in our study [2,5,[18][19][20][21].…”

Section: Discussioncontrasting

confidence: 99%

Frequency of Invasive Fungal Disease in Adults: Experience of a Specialized Laboratory in Medellín, Colombia (2009–2015)

Valencia

Cáceres

Bedout

et al. 2020

JoF

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Invasive fungal diseases (IFD) contribute significantly to worldwide morbidity and mortality, but their frequency is not well-described in some countries. The present work describes the frequency of IFD in a specialized laboratory in Colombia. A retrospective, descriptive study was implemented between March 2009 and December 2015. Results: 13,071 patients with clinical suspicion of IFD were referred during the study period, from which 33,516 biological samples were processed and analyzed using 14 laboratory methods. Diagnosis was confirmed in 1425 patients (11%), distributed according to the mycoses of interest analyzed here: histoplasmosis in 641/11,756 patients (6%), aspergillosis in 331/10,985 patients (3%), cryptococcosis in 239/8172 patients (3%), pneumocystosis in 111/1651 patients (7%), paracoccidioidomycosis in 60/10,178 patients (0.6%), and invasive candidiasis in 48/7525 patients (0.6%). From the first year of the study period to the last year, there was a 53% increase in the number of cases of IFD diagnosed. Our laboratory experienced a high frequency of IFD diagnosis, possibly attributable to the availability of a greater range of diagnostic tools. Frequency of IFD in this study was atypical compared with other studies, probably as a result of the single laboratory-site analysis. This demonstrates that implementing educational strategies helps to create a high index of clinical suspicion, while the availability and utilization of appropriate diagnostic assays assure greater reliability in identification of these cases.

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Section: Discussioncontrasting

confidence: 99%

Frequency of Invasive Fungal Disease in Adults: Experience of a Specialized Laboratory in Medellín, Colombia (2009–2015)

Valencia

Cáceres

Bedout

et al. 2020

JoF

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“…In addition, time to onset of IFD may also differ based on antifungal prophylaxis, site of infection or transplant type. (28) Cytopaenia and administration of therapies to prevent and treat graft-versus-host disease (GvHD), which leads to an impaired cell immunity, are major risk factors of haematopoietic stem cell transplant (HSCT) recipients for acquiring IFD. (29,30) Due to induced neutropenia and lack of adequate immune reconstitution, invasive aspergillosis has been noted to be the most commonly observed IFD in HSCT recipients, followed by invasive candidiasis, Pneumocystis pneumonia, mucormycosis (caused by Mucormycetes) and infections caused by other molds such as Fusarium and Scedosporium species.…”

Section: Treatment-induced Immunosuppressionmentioning

confidence: 99%

“…In addition, time to onset of IFD may also differ based on antifungal prophylaxis, site of infection or transplant type. 28 …”

mentioning

confidence: 99%

Invasive fungal disease in humans: are we aware of the real impact?

Firacative

2020

Mem. Inst. Oswaldo Cruz

120

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Despite the medical advances and interventions to improve the quality of life of those in intensive care, people with cancer or severely immunocompromised or other susceptible hosts, invasive fungal diseases (IFD) remain severe and underappreciated causes of illness and death worldwide. Therefore, IFD continue to be a public health threat and a major hindrance to the success of otherwise life-saving treatments and procedures. Globally, hundreds of thousands of people are affected every year with Candida albicans, Aspergillus fumigatus, Cryptococcus neoformans, Pneumocystis jirovecii, endemic dimorphic fungi and Mucormycetes, the most common fungal species causing invasive diseases in humans. These infections result in morbidity and mortality rates that are unacceptable and represent a considerable socioeconomic burden. Raising the general awareness of the significance and impact of IFD in human health, in both the hospital and the community, is hence critical to understand the scale of the problem and to raise interest to help fighting these devastating diseases.

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“…It occurs in up to 5-20% of transplants and has a mortality rate of 25-80%; in patients with liver transplantation, the incidence of invasive aspergillosis is 2%. The risk factors for IFI in patients with SOT have been divided into four categories, (i) those related to patient factors (previous colonization history, cytomegalovirus disease, renal dysfunction and chronic rejection), (ii) surgery related (surgical time, technique, transfusions and complications), (iii) microbiological selection due to prior use of antimicrobial agents, and (iv) derive from immunosuppression [4][5][6] . In these cases, the group of opportunistic microorganisms, including fungi, is especially interesting.…”

Section: Introductionmentioning

confidence: 99%

Aspergilosis pulmonar invasora en pacientes pediátricos con trasplante hepático, a propósito de una sobreviviente

Botero

García

Delgado

et al. 2018

Rev. chil. pediatr.

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Invasive pulmonary aspergillosis in children with hepatic transplant: a survivorAspergilosis pulmonar invasora en pacientes pediátricos con trasplante hepático, a propósito de una sobreviviente AbstractIntroduction: Mycotic infections due to Aspergillus spp, are the main mycotic associated infections in liver transplant patients, with mortality rates up to 90% of the cases. Almost 50% of patients will develop an infection during the first months after transplantation, of which 10% are associated with opportunistic agents. Objective: To describe the diagnosis and management of an Invasive Pulmonary Aspergillosis (IPA) episode in a liver transplant patient. Case report: 11-months-old patient with liver transplant due to a biliary atresia who developed severe pneumonia associated with mechanical ventilation. The bronchoalveolar lavage showed high levels of galactomannan and positive culture for Aspergillus fumigatus leading to an IPA diagnosis. This episode was treated with antifungal with a favorable outcome. Conclusion: The IPA is an opportunistic infection in liver transplant patients, with high mortality rates, that must be suspected in this group of patients since an early diagnosis and treatment reduce mortality.

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Approach to the Solid Organ Transplant Patient with Suspected Fungal Infection

Cited by 31 publications

References 145 publications

Frequency of Invasive Fungal Disease in Adults: Experience of a Specialized Laboratory in Medellín, Colombia (2009–2015)

Frequency of Invasive Fungal Disease in Adults: Experience of a Specialized Laboratory in Medellín, Colombia (2009–2015)

Invasive fungal disease in humans: are we aware of the real impact?

Aspergilosis pulmonar invasora en pacientes pediátricos con trasplante hepático, a propósito de una sobreviviente

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