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Published on: October 11, 2014
Pulmonary fungal infections in kidney transplant recipients: an 8-year study
F Sharifipour1, F Rezaeetalab, M Naghibi
1Mashhad University of Medical Sciences, Mashhad, Iran.
Unlabelled:
Invasive fungal infections are among the most important causes of mortality among transplant patients. One of the most common manifestations of these infections is pulmonary fungal infection (PFI). The present study sought to evaluate the rate of PFI in kidney transplant patients.
Materials And Methods:
We retrospectively analyzed the data of 595 patients who underwent kidney transplantation from February 1999 to February 2007. Bronchoalveolar lavage (BAL) culture and tissue biopsy were used to confirm PFI.
Results:
Thirteen of 595 patients (2.2%) experienced PFI. The most common pathogen (8/13, 41.5%) was Aspergillus, with 5 (38.5%) infected with Aspergillus only, 2 (15.4%) with both Aspergillus and Candida, and 1 (7.7%) with Aspergillus and mucormycosis. Seven of 13 (53.8%) died and 4 (30.7%) lost the transplanted kidney. Immunosuppressive therapy following rejection and prescription of broad spectrum antibiotics were the most important risk factors for fungal infections in these patients.
Conclusions:
Fungal infections are among the most important causes of mortality among transplant patients, of which the most common manifestation is pulmonary. Immunosuppressive therapy and broad spectrum antibiotics are important risk factors, and Aspergillus is the most common pathogen responsible for fungal infections.
Insights
Pulmonary fungal infections (PFI) affect 2.2% of kidney transplant patients, with Aspergillus being the most common cause. Immunosuppression and broad-spectrum antibiotics are key risk factors for these life-threatening infections.
Area of Science:
- Medical Mycology
- Transplant Infectious Diseases
- Critical Care Medicine
Background:
- Invasive fungal infections (IFIs) are a significant cause of mortality in transplant recipients.
- Pulmonary fungal infection (PFI) is a common and serious manifestation of IFIs.
Purpose of the Study:
- To determine the incidence rate of PFI in kidney transplant recipients.
- To identify common fungal pathogens and risk factors associated with PFI in this population.
Main Methods:
- Retrospective analysis of 595 kidney transplant patients from February 1999 to February 2007.
- Confirmation of PFI using bronchoalveolar lavage (BAL) cultures and tissue biopsies.
Main Results:
- The incidence of PFI was 2.2% (13 out of 595 patients).
- Aspergillus was the most frequent pathogen (41.5%), followed by Candida and mucormycosis in co-infections.
- Mortality was high (53.8%), with 30.7% experiencing graft loss. Immunosuppressive therapy and broad-spectrum antibiotics were identified as major risk factors.
Conclusions:
- PFI is a critical complication in kidney transplant patients, contributing significantly to mortality.
- Aspergillus species are the predominant pathogens causing PFI.
- Immunosuppressive therapy and broad-spectrum antibiotic use are crucial modifiable risk factors that warrant careful management.
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