Invasive scedosporiosis in lung transplant recipients: A nine-year retrospective study in a tertiary care hospital

IF 1.5 4区生物学 Q4 MYCOLOGY

Revista Iberoamericana De Micologia Pub Date : 2021-10-01 DOI:10.1016/j.riam.2021.06.002

Elisa Ibáñez-Martínez , Amparo Solé , Antonio Cañada-Martínez , Carlos F. Muñoz-Núñez , Amparo Pastor , Beatriz Montull , Patricia Falomir-Salcedo , Amparo Valentín , José Luis López-Hontangas , Javier Pemán

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引用次数: 3

Abstract

Background

Scedosporium species and Lomentospora prolificans (Sc/Lp) are emerging molds that cause invasive disease associated with a high mortality rate. After Aspergillus, these molds are the second filamentous fungi recovered in lung transplant (LT) recipients.

Aims

Our objective was to evaluate the incidence, risk factors and outcome of Sc/Lp infections in LT recipients at a tertiary care hospital with a national reference LT program.

Methods

A nine-year retrospective study was conducted.

Results

During this period, 395 LT were performed. Positive cultures for Sc/Lp were obtained from twenty-one LT recipients. Twelve patients (incidence 3.04%) developed invasive scedosporiosis (IS). In 66.7% of the patients with IS the invasive infection was defined as a breakthrough one. The main sites of infection were lungs and paranasal sinuses. Most of the patients received combination antifungal therapy. The IS crude mortality rate after 30 days was 16.7%, and 33.3% after a year.

Conclusions

Our study highlights improved survival rates associated with combination antifungal therapy in LT recipients and underlines the risk of breakthrough infections in patients with allograft dysfunction on nebulized lipidic amphotericin B prophylaxis. In addition to pretransplant colonization, acute or chronic organ dysfunctions seem to be the main risk factors for IS.

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肺移植受者侵袭性孢子虫病:一项三级医院9年回顾性研究

背景塞多孢子菌和增毒骆孢菌(Lomentospora prolificans, Sc/Lp)是一种新兴的霉菌，可引起侵袭性疾病，死亡率高。在曲霉之后，这些霉菌是在肺移植(LT)受者中发现的第二种丝状真菌。目的:本研究的目的是评估一家三级医院肝移植受者Sc/Lp感染的发生率、危险因素和结果。方法采用9年回顾性研究。结果本组共行肝移植395例。21例肝移植受体获得Sc/Lp阳性培养。12例(发病率3.04%)发生侵袭性孢子病(IS)。66.7%的IS患者将侵袭性感染定义为突破性感染。主要感染部位为肺部和鼻窦。大多数患者接受联合抗真菌治疗。30天后IS粗死亡率为16.7%，一年后为33.3%。结论:我们的研究强调了肝移植受者联合抗真菌治疗的生存率提高，并强调了雾化脂质两性霉素B预防异体移植物功能障碍患者突破性感染的风险。除了移植前定植外，急性或慢性器官功能障碍似乎是IS的主要危险因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Revista Iberoamericana De Micologia MYCOLOGY-

CiteScore

1.90

自引率

0.00%

发文量

审稿时长

81 days

期刊介绍： Revista Iberoamericana de Micología (Ibero-American Journal of Mycology) is the official journal of the Asociación Española de Micología, Asociación Venezolana de Micología and Asociación Argentina de Micología (The Spanish, Venezuelan, and Argentinian Mycology Associations). The Journal gives priority to publishing articles on studies associated with fungi and their pathogenic action on humans and animals, as well as any scientific studies on any aspect of mycology. The Journal also publishes, in Spanish and in English, original articles, reviews, mycology forums, editorials, special articles, notes, and letters to the editor, that have previously gone through a scientific peer review process.