Investigations of Fungal Infections Among Liver and Kidney Transplanted Patients

Abstract

The medical interventions (therapy, immunosuppression, surgery, etc.) attached to the organ transplantation make good opportunity to increasing frequency of the fungal colonisation and the development of deep-seated opportunistic mycoses. The fungal cases of 1030 kidneyand 127 liver transplanted patients were investigated in the period of 1995-2001. While the fungal positive culture was only 23% among the kidney transplanted patients, this was 68% in the case of liver transplanted patients. There is a remarkable difference between these two groups in the type of colonisation. While the kidney transplanted patients have two or more fungal positive bodysites/fluids only in 32%, this number was 88% in the case of liver transplanted patients. Most frequently the urine and throat samples were fungal positive. There could not be found an unambiguous correlations between the development and severity of fungal infections and the site and frequency of fungal colonisation. Certain preventive antifungal therapies make the selection of resistant fungal strains and species possible. In this respect the frequent occiirence of Caiidida krusa' in the organ transplanted patients must be taken into consideration as an important factor. PRELIMINARY IN VITROSUSCEPTIBILITY OF MALASSEZZA FURFUR AGAINST ALBACONAZOLE (UR-9825) Purpose: The minimum imhibitory concentrations (MICs) for 10 isolates of Malassezia&rfur of albaconazole (UR-9825) (AZ) were determined and compared with 5-fluorocytosine (5-FC), ketoconazole (KZ), fluconazole (FZ), itraconazole (IZ), and voriconazole (VZ).The strains were isolated from neonates in ICUs. Methods:The assessement was done in microliter plates as described previously elsewhere [I]. Results: All the strains were in vitro resistant to 5-FC (MIC > 64pg.mlk'). KZ and IZ showed always MICs Values < 0.03pg.ml-I. For FZ the range of MICs was between 2 and 4pg.ml-1, and for VZ between < 0.03 and 0.12pg.n11-1. All the straiiis had a MIC value of < 0.06pg.ml-1 against AZ. Conclusions: These preliminary results show the first iri vitro work against a lipophilic yeast of AZ, a new antifungal under development by Uriach & Cia S.A., Barcelona, Spain. AZ shows a favourable in vitro profile when compared with other available systemic antifungals. Deep infections caused by M. & f i r and M. pachydermatis have been reported in special care neonatal units.Currently the management of deep infections due to lipophilic yeasts is not defined although these preliminary data show that AZ might be a potential drug to use in this setting.1 Schmidt A, Kill-Horster B. In vitro susceptibility ofh'alassezia fuifix Objectives: 127 liver and 1030 renal transplantation has been performed at the Semmelweis Medical University, Department of Transplantation and Surgery since 1995. In addition to improving surgical and modern immunsuppression therapy increasing incidence of fungal infection (FI) can be diagnosed after organ transplantation. The immunosuppression, thc prolonged antibiotic treatment, the operating time, reoperation, bac...