Incidence, Characteristics and Risk Factors of Candida Infection (CI) and Colonization (CC) in Liver Transplant Patients (LTP)Receiving Fluconazole Prophylaxis.

C.J. LUMBRERAS, A. DEL PALACIO, A. GONZíLEZ, C. LOINAZ, J. AGUADO, M. LIZASOAIN, E. MORENO

Abstract: 

Background: Antifungal prophylaxis against Candida infection is widely used in LTR. The aim of this study was to analyze CI and CC in LTP receiving Fluconazole (F) prophylaxis.Methods: From 2/1997 to 10/1999 one-hundred and fourteen LTP were prospectively followed for the presence of CI and/or CC for the first 90 days following transplantation. All patients received F (100 mg/day) prophylaxis from day 3 to day 28 after surgery. Samples for mycologic cultures from oropharynx, feces and urine were obtained on days 0,14,128,45,60,90 and when clinically indicated. CC and CI was defined according standard criteria. The analysis of risk factors associated with CC and CI included variables related with underlying liver disease, surgery, immunosupression, other infections, and in the case of CI, colonization pattern.Results: Nine patients (8%) developed CI (muguet-7-, esophagitis-1-, disseminated-1-) at a mean of 43 days (15-60) after transplantation. C. glabrata caused 5 episodes, C. krusei -1-, and C. albicans -3-. Thirty-eight patients (33%) had CC during the follow-up; 25 patients (22%) were colonized at day 0, 12 patients at day 28 (11%) and 32 (30%) at day 90. No significant increase in colonization by C. krusei and/or C glabrata occurred during the follow-up. Colonization at day 0 (OR: 4,3; 95% CI 1,55-12,14), and use of antibiotic therapy beyond day 28 (OR: 4,2; 95% CI 1,24-12,2) were significantly associated with CC. Candida colonization of any type (OR: 5,3; 95% CI 1,87-11,61) and colonization by C. krusei and/or C. glabrata (OR: 1,23; 95% CI 1,08-7,21) were associated with CI. Conclusions: F prophylaxis in LTP was associated with a low incidence of CI mostly due to C. glabrata and/or C. krusei. Candida colonization increased the risk of developing CI. Patients who were colonized by C. krusei or C. glabrata had a higher risk of developing CI than those colonized by other Candida species.
2002

abstract No: 

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Full conference title: 

42nd Interscience Conference on Antimicrobial Agents and Chemotherapy
    • ICAAC 42nd