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Incidence of fungal infections in a solid organ recipients dedicated intensive care unit

F Pugliese1, F Ruberto, A Cappannoli

  • 1Dipartimento di Scienze Anestesiologiche, Medicina Critica e Terapia del Dolore, Universita' Degli Studi di Roma La Sapienza, Roma, Italy. mavif@tiscali.it

Transplantation Proceedings
|August 19, 2007
PubMed
Abstract

Insights

Invasive fungal infections impact solid organ transplant recipients, with Candida albicans being the most frequent cause. Longer intensive care unit (ICU) stays significantly increase the risk of these infections and associated mortality.

Area of Science:

  • Infectious Diseases
  • Transplantation Medicine
  • Critical Care Medicine

Background:

  • Invasive fungal infections (IFIs) pose a significant threat to solid organ transplant (SOT) recipients, contributing to substantial morbidity and mortality.
  • Post-transplant intensive care units (ICUs) are critical environments for managing SOT patients, where IFIs can arise.
  • Understanding the incidence and risk factors for IFIs in this vulnerable population is crucial for improving patient outcomes.

Purpose of the Study:

  • To determine the incidence of invasive fungal infections in patients who have undergone solid organ transplantation.
  • To identify the common fungal pathogens responsible for infections in this patient cohort.
  • To investigate potential risk factors associated with the development of IFIs in SOT recipients.

Main Methods:

  • Retrospective analysis of 278 solid organ transplant recipients admitted to a dedicated post-transplant ICU between May 2002 and May 2005.
  • Inclusion criteria: patients undergoing liver, kidney, lung, or combined organ transplantation.
  • Definition of fungal infection: positivity in sterile biological samples or elevated positivity in non-sterile samples; superficial infections and asymptomatic colonization were excluded.

Main Results:

  • 16.5% (46 out of 278) of SOT recipients developed invasive fungal infections.
  • Candida albicans was the predominant pathogen, identified in 71% of infected patients.
  • Infected patients had a significantly higher mortality rate (35%) compared to non-infected recipients (3.5%).
  • Total length of ICU stay was identified as the most significant risk factor for IFIs (30.26 days vs. 5.04 days, P < .0001).

Conclusions:

  • Invasive fungal infections represent a major clinical challenge in solid organ transplantation, associated with considerable morbidity and mortality.
  • Candida albicans is the most frequently isolated fungal pathogen in this population.
  • Prolonged intensive care unit stay is a critical risk factor for developing invasive fungal infections post-transplantation.

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