Yeast Infections in Solid Organ Transplantation

Sarah Taimur1

  • 1Division of Infectious Diseases, Icahn School of Medicine at Mount Sinai, One-Gustave L. Levy Place, New York, NY 10029, USA.

Insights

Invasive fungal infections like candidiasis are increasing in solid-organ transplant recipients. Evolving drug resistance and new species necessitate re-evaluating antifungal strategies for better patient outcomes.

Area of Science:

  • Mycology
  • Transplant Infectious Diseases
  • Antimicrobial Resistance

Background:

  • Invasive candidiasis (IC) is the most frequent invasive fungal infection (IFI) post-solid-organ transplant (SOT).
  • Emerging challenges include drug-resistant non-albicans species and novel pathogens like Candida auris.
  • Cryptococcosis is the second most common IFI in SOT, with Cryptococcus gattii showing potential antifungal resistance.

Purpose of the Study:

  • To highlight the evolving landscape of IFIs in SOT recipients.
  • To underscore the need for re-examining preventive antifungal strategies.
  • To raise awareness of Cryptococcus gattii and Cryptococcus-associated immune reconstitution inflammatory syndrome (IRIS) in SOT.

Main Methods:

  • Review of current literature on IFIs in SOT.
  • Analysis of emerging fungal pathogens and resistance patterns.
  • Clinical case discussion of Cryptococcus-associated IRIS in SOT.

Main Results:

  • Drug-resistant non-albicans Candida species and Candida auris pose significant threats in SOT.
  • Cryptococcus gattii presents an emerging risk with potential for reduced antifungal susceptibility.
  • Cryptococcus-associated IRIS requires prompt recognition and management in SOT patients.

Conclusions:

  • Preventive antifungal strategies in SOT require urgent re-evaluation due to evolving resistance and species.
  • Heightened clinical awareness for Cryptococcus gattii and associated IRIS is crucial for timely management in SOT.
  • Addressing these challenges is vital for improving outcomes in SOT recipients with IFIs.

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