Risk Factors and Outcomes of Invasive Candida Infections in Heart Transplant Recipients: A Case-Control Study

Area of Science:

• Infectious Diseases
• Transplantation Medicine
• Critical Care Medicine

Background:

• Invasive Candida infections (ICI) are a significant concern in solid organ transplant recipients.
• Contemporary data on ICI risk factors in heart transplant (HT) recipients are limited, particularly with increased use of temporary mechanical circulatory support (MCS).

Purpose of the Study:

• To identify risk factors for invasive Candida infections in heart transplant recipients.
• To analyze the outcomes associated with ICI in this vulnerable patient population.

Main Methods:

• A case-control study was conducted involving heart transplant recipients from January 2022 to January 2024.
• Cases were patients with ICI confirmed by Candida species detection from sterile sites; controls were matched HT recipients.
• Statistical analysis utilized Fisher's exact or Mann-Whitney tests.

Main Results:

• The incidence of ICI was 10.6% (12 cases out of 117 transplants).
• Identified risk factors included pre-transplant antibiotic use (>7 days), tracheostomy, prolonged chest tube placement, and temporary MCS.
• ICI was associated with a significantly higher 90-day all-cause mortality (33.3% vs. 4.2%).

Conclusions:

• Several key risk factors for ICI following heart transplantation have been identified.
• Further research is needed to develop targeted interventions to mitigate these risks and improve outcomes.