HUSAIN S, TOLLEMAR J, BAUMGARTEN K, HUMAR A, DOMINGUEZ E, KUSNE S, PATERSON D, SINGH N; Interscience Conference on Antimicrobial Agents and Chemotherapy (41st : 2001 : Chicago, Ill.).
Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 2001 Dec 16-19; 41: abstract no. J-1627.
U. of Pitt., Pittsburgh, PA
BACKGROUND: To evaluate whether the spectrum, risk factors and outcome of invasive candidiasis in liver transplant recipients have evolved in the late 1990s. METHODS: In a 6 hospital study since 1998, 30 liver transplant recipients with inv. cand. (by EORTC/MSG criteria) were prospectively identified. One control was matched with the case for duration of hospitalization and one for antibiotic use so that risk factors unique in liver transplantation could be elicited. RESULTS: Of 30 patients, the Candida sp. was albicans in 67%, glabrata in 17%, tropicalis in 10%, parapsilosis in 3% and guilliermondii in 3%. Cases vs. controls were significantly more likely to have received fluconazole prophylaxis (p=0.007). In matched pair analysis, antibiotic prophylaxis for SBP (p=0.004), duration of mechanical ventilation (p=0.02), posttransplant dialysis (p=0.004), retransplantation (p=0.05) and CMV viremia (p=0.049) were significantly associated with inv. cand. Operation time and blood loss did not predict inv. cand. With prophylaxis for SBP, retransplantation, CMV viremia, dialysis and return to surgery in the predictive model, the frequency of inv. cand. was 12% with <1 risk factor (O.R. 1.0), 35% with 1 (O.R. 4.2), 63% with 2 (O.R. 13.1), 80% with 3 (O.R. 30.0) and 100% with > 3 risk factors present (chi square for trend=0.001). Overall mortality was 38% for cases (25% for albicans vs. 50% for non-albicans sp.) and 4% for controls (p=0.001). CONCLUSIONS: One-third of Candida infections in liver transplant recipients were due to non-albicans sp. Patients with invasive candidiasis were more likely to have received fluconazole prophylaxis. Predictors determined can potentially identify a vast majority of high-risk patients.
Publication Types:
Keywords:
- Candidiasis
- Case-Control Studies
- Cytomegalovirus Infections
- Follow-Up Studies
- Humans
- Liver Transplantation
- Longitudinal Studies
- Prospective Studies
- Risk Factors
- surgery
- transplantation
Other ID:
UI: 102268967
From Meeting Abstracts