Incidence of Fungal Infections in a Solid Organ Recipients Dedicated Intensive Care Unit

Pugliese, Francesco; Ruberto, Franco; Cappannoli, A.; Perrella, S.; Bruno, Katelyn A.; Martelli, S.; Marcellino, V.; DaLio, Andrew L.; Diso, Daniele; Rossi, Massimo; Corradini, Stefano Ginanni; Morabito, Vincenzo; Rolla, M.; Ferretti, G.; Venuta, Federico; Berloco, P.; Coloni, Giorgio F.; Pietropaoli, P

doi:10.1016/j.transproceed.2007.05.060

Cited by 28 publications

(16 citation statements)

References 13 publications

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“…In our study, Candida was the most common cause of fungal infection. Sites of infection were comparable to those reported in other studies (1, 9). We found a relatively higher number of Candida and Aspergillus mixed infections compared with the literature (6), although Fujishita et al (28) reported 3 hemato‐oncological cases of pulmonary mycosis due to mixed Candida and Aspergillus infection in 32 patients (9.4%).…”

Section: Discussionsupporting

confidence: 88%

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Caspofungin for post solid organ transplant invasive fungal disease: results of a retrospective observational study

Winkler

Pratschke

Schulz

et al. 2010

Transplant Infectious Disease

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M. Winkler, J. Pratschke, U. Schulz, S. Zheng, M. Zhang, W. Li, M. Lu, D. Sgarabotto, G. Sganga, P. Kaskel, S. Chandwani, L. Ma, J. Petrovic, M. Shivaprakash. Caspofungin for post solid organ transplant invasive fungal disease: results of a retrospective observational study. Transpl Infect Dis 2010: 12: 230–237. All rights reservedObjectiveThis study was designed to determine clinical outcomes with caspofungin in patients with proven or probable invasive fungal infection (IFI) after a solid organ transplant (SOT) procedure.MethodsIn this retrospective observational study, data were collected for a single episode of IFI in patients with an SOT between January 2004 and June 2007. Response was determined by the investigator as favorable (complete or partial) or unfavorable (stable disease or failure) at the end of caspofungin therapy (EOCT). The primary effectiveness population was the proportion of patients who received ≥5 doses of caspofungin (modified all-patients-treated population). Safety was assessed for patients who received ≥1 dose of caspofungin.ResultsA total 81 of patients from 13 sites in China, Germany, Italy, and the United Kingdom were enrolled, including 49 (60%) liver, 22 (27%) heart, 5 (6%) lung, 2 (2%) kidney, 2 (2%) liver and kidney, and 1 (1%) pancreas and kidney recipients. Candidiasis was diagnosed in 64/81 patients (79%) and aspergillosis in 22/81 patients (27%). Most patients received caspofungin monotherapy (75%). Caspofungin was given as first-line therapy to 59 (73%) patients. The overall favorable response at EOCT was 87% (58/67; 95% confidence interval [CI]: 76%, 94%), with favorable responses in 88% (43/49; 95% CI: 75%, 95%) of patients receiving caspofungin monotherapy and 83% (15/18; 95% CI: 59%, 96%) of patients receiving combination therapy with caspofungin (modified all-patients-treated population). Response by type of SOT was as follows: liver 87% (39/45), heart 93% (14/15), kidney 100% (5/5), and lung 50% (2/4). An overall survival rate (all-patients-treated) of 69% (56/81; 95% CI: 59%, 79%) was observed at 7 days post EOCT. No serious drug-related adverse events were reported.ConclusionIn this study, caspofungin was effective and well tolerated in the treatment of IFIs involving SOT recipients.

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Section: Discussionsupporting

confidence: 88%

“…Aspergillus species have been isolated from approximately 9–34% of patients with invasive fungal infection (IFI) after liver transplantation (6) and 20–50% after lung transplantation (5–7). Increased mortality rates (20–90%) have been reported among SOT recipients suffering from IFIs compared with SOT patients with no IFI (6, 8, 9).…”

mentioning

confidence: 99%

Caspofungin for post solid organ transplant invasive fungal disease: results of a retrospective observational study

Winkler

Pratschke

Schulz

et al. 2010

Transplant Infectious Disease

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“…Pappas, unpublished data, July 2009). This distribution has been shown in other studies of SOT recipients as well [8,9]. Less common overall but seen more frequently than in the HSCT population were infections due to Cryptococcus and endemic fungi, causing 8% and 5% of IFIs, respectively.…”

supporting

confidence: 78%

Fungal Infections in Transplant and Oncology Patients

Person

Kontoyiannis

Alexander

2011

Hematology/Oncology Clinics of North America

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“…Despite advances during the last decade, invasive fungal infections are still associated with a high morbidity and mortality in immunocompromised and critically ill patients (Hsiao et al, 2006;Pugliese et al, 2007). Considerable progress has been made in non-culture diagnostics, particularly in genomic amplification methods.…”

Section: Introductionmentioning

confidence: 99%

Comparison of serum and whole-blood specimens for the detection of Candida DNA in critically ill, non-neutropenic patients

Metwally

Fairley

Coyle

et al. 2008

Journal of Medical Microbiology

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In contrast to the multitude of studies on fungal PCR assay methods, little work has been reported evaluating Candida PCR performance when using whole blood compared with serum in candidaemic patients. Here, a comparison of the performance of whole-blood and serum specimens using a set of real-time PCR Candida species assays is described. Specimens were collected prospectively from non-neutropenic adults who were recruited to a diagnostic clinical trial, the primary purpose of which was to verify the performance of the assays using serum; in all, 104 participants also had whole-blood specimens submitted for analysis in addition to the serum specimen. Of these participants, 10 had laboratory-confirmed candidaemia and 94 were categorized as being 'unlikely' to have invasive Candida infection. PCR results from the wholeblood specimens are presented here and compared with the results from serum specimens in this subgroup among whom both specimen types were obtained contemporaneously. All participants with candidaemia were PCR-positive from serum samples; however, only seven were PCR-positive from whole blood. All specimens from patients in the 'unlikely' category were PCR-negative in both types of specimen. Moreover, DNA extraction from serum required 1 h; extraction from whole blood required approximately 3 h. These data tentatively suggest that, overall, serum is an appropriate specimen for Candida PCR for detection of candidaemia in non-neutropenic adults.

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Incidence of Fungal Infections in a Solid Organ Recipients Dedicated Intensive Care Unit

Cited by 28 publications

References 13 publications

Caspofungin for post solid organ transplant invasive fungal disease: results of a retrospective observational study

Caspofungin for post solid organ transplant invasive fungal disease: results of a retrospective observational study

Fungal Infections in Transplant and Oncology Patients

Comparison of serum and whole-blood specimens for the detection of Candida DNA in critically ill, non-neutropenic patients

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