Invasive fungal infections in renal transplant patients: a single center study

Area of Science:

• Nephrology
• Infectious Diseases
• Transplantation Immunology

Background:

• Renal transplant (RT) patients on immunosuppression face challenges in timely diagnosis of invasive fungal infections (IFI).
• IFI can jeopardize patient survival and graft function.
• This study investigates IFI and their causative agents in post-RT patients.

Purpose of the Study:

• To identify the incidence and types of invasive fungal infections (IFI) in renal transplant (RT) patients.
• To determine the causative fungal agents and associated risk factors for IFI in this population.
• To evaluate the impact of IFI on patient morbidity and mortality post-renal transplantation.

Main Methods:

• A retrospective 6-year clinical study (2010-2015) involving 1900 RT patients.
• Analysis of clinical data including demographics, infection onset, risk factors, and graft function (serum creatinine).
• Conventional mycological methods were used to identify IFI from bronchoalveolar lavage (BAL), blood, tissue, and wound swab samples.

Main Results:

• IFI were diagnosed in 30 (1.56%) RT patients, primarily males, at a mean of 13.12 months post-transplant.
• Aspergillus species, Candida albicans, and Mucor were identified as causative agents, with significant associated mortality and graft loss.
• Risk factors included triple immunosuppression, prolonged broad-spectrum antibiotic use, diabetes, and cytomegalovirus co-infection.

Conclusions:

• IFI are linked to increased morbidity and mortality in renal transplant recipients.
• Triple immunosuppression, extended antibiotic use, diabetes, and superadded infections are identified as significant risk factors.
• Prompt prevention, diagnosis, and management strategies are essential to enhance patient prognosis.