Invasive aspergillosis (IA) in Solid Organ Transplant (SOT) Recipients: Risk Factors (RF) of Death.

O. LEN, J. GAVALDÀ, R. SAN JUAN, J. AGUADO, C. LUMBRERAS, J. FORTÚN, P. MUÑOZ, M. BLANES, A. RAMOS, M. GURGUÍ, J. DE LA TORRE, M. MONTEJO, G. RUFÍ, A. MORENO, M. CUENCA-ESTRELLA, J. RODRIGUEZ-TUDELA, A. PAHISSA

Author address: 

GESITRA, Barcelona, Spain.

Abstract: 

Background: IA is a major cause of morbidity and mortality in SOT recipients. The Spanish Network for Study of Infection in SOT (GESITRA) have performed a nation-wide protocol to describe epidemiological and clinical aspects as well as a study of RF of death in SOT with IA. Methods: Patients were identified by reviewing the clinical diagnosis and necropsy records from 11 centres from the onset of transplantation programs to December 2001. Diagnostic criteria for IA as accepted criteria. Pre, intra and posttransplant variables as possible RF of death were analyzed. The RF defined from the univariate analysis were evaluated with a multivariate logistic regression analysis. P value of 90 d), 53 (42.7%). Clinical types: pulmonary nodular 23 (18.5%); pneumonia 44 (35.5%); disseminated 57 (46%); CNS involvement 21 (16.9%). Diagnosis at necropsy: 49 (39.5%). Mortality: global 94 (75.8%); onset to 1992, 5 (78.2%); 1993-1996, 43 (74.1%); 1997-2001, 33 (76.7%); liver 54 (83%); heart 28 (71.8%); lung 12 (70.6%); kidney 0 (0%); nodular 9 (39.1%); pneumonia 34 (77.2%); disseminated 31 (86.1%); CNS involvement 20 (95.2%). The RF of death were (multivariate analysis): disseminated disease, mechanical ventilation, need of transfussion and therapy with liposomal amphotericin B (LAB) RR: 0,03 (protective). Conclusions: The greatest incidence was between 1993-1996 with no variation in the mortality rate through time. Patients that have a disseminated disease and need mechanical ventilation due to IA had a mortality higher risk while the therapy with LAB was protective.
2003

abstract No: 

M-999

Full conference title: 

43rd Interscience Conference on Antimicrobial Agents
    • ICAAC 43rd