Risk Factors for Invasive Aspergillosis in Solid-Organ Transplant Recipients: A Case-Control Study
Author:
J. Gavalda, O. Len, R. San Juan, J. M. Aguado, J. Fortun, C. Lumbreras, A. Moreno, P. Munoz, M. Blanes, A. Ramos, G. Rufi, M. Gurgui, J. Torre-Cisneros, M. Montejo, M. Cuenca-Estrella, J. L. Rodriguez-Tudela, and A. Pahissa, for RESITRA (Spanish Network
Date: 8 June 2005
Abstract:
Background. To facilitate the design of strategies for prevention of invasive aspergillosis in solid-organ transplantrecipients, this study investigates whether the development of early-onset and late-onset aspergillosis arerelated to different risk factors, thereby distinguishing 2 risk populations for this serious complication.Methods. A retrospective case-control study was performed, including 156 cases of proven or probableinvasive aspergillosis in patients recruited from 11 Spanish centers since the start of the centers’ transplantationprograms.Results. Among all patients, 57% had early-onset IA (i.e., occurred during the first 3 months after transplantation).Risk factor analysis in this group identified as significantly associated risk factors a more complicatedpostoperative period, repeated bacterial infections or cytomegalovirus disease, and renal failure or the need fordialysis. Among patients with late-onset infections (i.e., occurred 13 months after transplantation), who comprised43% of cases, the patients at risk were older, were in an overimmunosuppressed state because of chronic transplantrejection or allograft dysfunction, and had posttransplantation renal failure.Conclusions. Risk factors in patients with early-onset cases and patients with late-onset cases of posttransplantationinvasive aspergillosis are not the same, a fact that could have implications for the preventive approachesused for this infection.
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