Objectives: Invasive fungal infections constitute an important cause of morbidity and mortality in solid organ transplantation recipients. Epidemiology of invasive fungal infections (IFI) after kidney transplantation in the modern era of immunosuppression is poorly described. We aim to describe the IFI epidemiology in our centre.
Methods: We retrospectively analyzed the epidemiology of IFI in a single-center cohort of kidney transplant adult recipients between January 2011 and December 2018.
Results: There were 1646 kidney transplanted patients hospitalized during the study period; 68 (4%) cases of IFI were identified. Sex ratio (M/F) was 1.1 and mean age 63 years (44 – 77). IFI occurred 12 (1-144) months after transplantation, in patients with immunosuppressive therapy containing tacrolimus, mofetil mycophenolate and corticosteroids. 100% of them had renal insufficiency, 68% had diabetes and 50% were neutropenic at the time of the IFI diagnosis. A. fumigatus proven or probable invasive aspergillosis (IA) was the leading cause (n = 28, 1.7 %) followed by pneumocystosis (n = 20, 1.22%), candidemia (n = 15. 0.92%) and other IFI (n = 6 (0.3%). Urinary source was identified in 77% of patients with candidemia. C. albicans (60%) was the leading species followed by C. glabrata and C. parapsilosis (20% each). Loss of graft occurred in 20% of them. Mortality was 50%, 40% and 10% for IA, candidemia and pneumocystosis respectively
Conclusion: In our centre IFIs, excepted pneumocystosis, were associated with high mortality rates in renal transplant patients. IA was the most common and was associated with the higher mortality. Candidemia occurred rarely but was associated with high mortality and loss of graft rates.
Full conference title:
- TIMM (2019)