Yeast-Like Organisms In The Blood In Solid Organ Transplant (Sot) Recipients: Choosing Echinocandins Or Fluconazole

H-Y. Sun1, Y-S. Huang2, A. Cheng2, C-M. Ho1, R-H. Hu1, S-S. Wang1, C-C. Hung1, Y-C. Chen1, S-C. Chang1

Author address: 

1Natl. Taiwan Univ. Hosp., Taipei, Taiwan, 2Natl. Taiwan Univ. Hosp., Hsin-Chu Branch, Hsin-Chu City, Taiwan

Abstract: 

Background: An echinocandin is recommended as initial therapy for candidemia, but it is not active against Cryptococcus. Both mycosis cause significant mortality in SOT recipients, and it is critical to distinguish the two mycosis to optimize the empirical treatment. The present study aimed to characterize the differences between the two mycosis in SOT recipients. Methods: From Jan 2001 to Dec 2014 at National Taiwan University Hospital, a total of 37 SOT recipients with Candida species and 7 SOT recipients with Cryptococcus neoformans isolated from the blood were included for analysis to identify factors to distinguish these two mycosis in SOT recipients. The date of fungemia onset and diagnosis was the date of blood sampling. No antifungal prophylaxis was given post-transplant. Results: Candidemia developed in 10 heart, 14 liver, 9 kidney, and 4 lung transplant recipients while cryptococcocemia in 5 heart, 2 liver transplant recipients. The mortality within 2 weeks of fungemia onset was 32% and 29%, respectively. Fungemia developed within 3 months post-transplant in 21.6% of SOT recipients with candidemia and 42.9% of SOT recipients with cryptococcocemia (p=0.341). Patients with cryptococcocemia were more likely to presented with meningitis (28.6% vs. 0%) and was diagnosed sooner after admission than those with candidemia (median duration after admission 14 vs. 24 days) while candidemia developed more frequently in intensive care unit (ICU) than cryptococcemia (72.2% vs. 28.6%) (all P
2016

abstract No: 

SATURDAY-307

Full conference title: 

ASM Microbe 2016
    • ASM microbe 1st (2016)