Epidemiology, risk factors and outcomes of invasive aspergillosis in solid organ transplant recipients in the Swiss Transplant Cohort Study.
Details
Serval ID
serval:BIB_B74350F70BA5
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Epidemiology, risk factors and outcomes of invasive aspergillosis in solid organ transplant recipients in the Swiss Transplant Cohort Study.
Journal
Transplant infectious disease
Working group(s)
Swiss Transplant Cohort Study
Contributor(s)
Amico P., Aubert J.D., Banz V., Beldi G., Benden C., Binet I., Bochud P.Y., Boëly E., Bucher H., Carell T., Catana E., Chalandon Y., de Geest S., de Rougemont O., Dickenmann M., Duchosal M., Elkrief L., Fehr T., Ferrari-Lacraz S., Gasche Soccal P., Gasche Soccal P., Gaudet C., Giostra E., Golshayan D., Hadaya K., Halter J., Heim D., Hess C., Hillinger S., Hirsch H.H., Hofbauer G., Huynh-Do U., Immer F., Klaghofer R., Koller M., Laesser B., Lehmann R., Lovis C., Majno P., Marti H.P., Martin P.Y., Meylan P., Mohacsi P., Morel P., Mueller U., Mueller-McKenna H., Müller A., Müller T., Müllhaupt B., Pascual M., Passweg J., Posfay-Barbe K., Rick J., Roosnek E., Rosselet A., Rothlin S., Ruschitzka F., Schanz U., Schaub S., Schnyder A., Seiler C., Sprachta J., Stampf S., Steiger J., Stirnimann G., Toso C., Venetz J.P., Villard J., Wick M., Wilhelm M., Yerly P.
ISSN
1399-3062 (Electronic)
ISSN-L
1398-2273
Publication state
Published
Issued date
08/2018
Peer-reviewed
Oui
Volume
20
Number
4
Pages
e12898
Language
english
Notes
Publication types: Journal Article ; Multicenter Study ; Observational Study
Publication Status: ppublish
Publication Status: ppublish
Abstract
There is lack of recent multicenter epidemiological data on invasive aspergillosis (IA) among solid organ transplant recipient (SOTr) in the mold-acting antifungal era. We describe the epidemiology and outcomes of IA in a contemporary cohort of SOTr using the Swiss Transplant Cohort Study.
All consecutive SOTr with proven or probable IA between 01.05.2008 and 31.12.2014 were included. A case-control study to identify IA predictors was performed: 1-case was matched with 3-controls based on SOT type, transplant center, and time post-SOT.
Among 2868 SOTr, 70 (2.4%) patients were diagnosed with proven (N: 30/70, 42.9%) or probable (N: 40/70, 57.1%) IA. The incidence of IA was 8.3%, 7.1%, 2.6%, 1.3%, and 1.2% in lung, heart, combined, kidney, and liver transplant recipients, respectively, Galactomannan immunoassay was positive in 1/3 of patients tested. Only 33/63 (52.4%) of patients presented with typical pulmonary radiographic findings. Predictors of IA included: renal insufficiency, re-operation, and bacterial and viral infections. 12-week mortality was higher in liver (85.7%, 6/7) compared to other (15.9%, 10/63; P < .001) SOTr.
Invasive aspergillosis remains a rare complication post-SOT, with atypical radiographic presentations and low positivity rates of biomarkers posing significant diagnostic challenges. Although overall mortality has decreased in SOTr, it remains high in liver SOTr.
All consecutive SOTr with proven or probable IA between 01.05.2008 and 31.12.2014 were included. A case-control study to identify IA predictors was performed: 1-case was matched with 3-controls based on SOT type, transplant center, and time post-SOT.
Among 2868 SOTr, 70 (2.4%) patients were diagnosed with proven (N: 30/70, 42.9%) or probable (N: 40/70, 57.1%) IA. The incidence of IA was 8.3%, 7.1%, 2.6%, 1.3%, and 1.2% in lung, heart, combined, kidney, and liver transplant recipients, respectively, Galactomannan immunoassay was positive in 1/3 of patients tested. Only 33/63 (52.4%) of patients presented with typical pulmonary radiographic findings. Predictors of IA included: renal insufficiency, re-operation, and bacterial and viral infections. 12-week mortality was higher in liver (85.7%, 6/7) compared to other (15.9%, 10/63; P < .001) SOTr.
Invasive aspergillosis remains a rare complication post-SOT, with atypical radiographic presentations and low positivity rates of biomarkers posing significant diagnostic challenges. Although overall mortality has decreased in SOTr, it remains high in liver SOTr.
Keywords
Adolescent, Adult, Aged, Aspergillus/isolation & purification, Biomarkers/analysis, Case-Control Studies, Female, Follow-Up Studies, Graft Rejection/prevention & control, Humans, Immunosuppression/adverse effects, Incidence, Invasive Pulmonary Aspergillosis/diagnosis, Invasive Pulmonary Aspergillosis/epidemiology, Invasive Pulmonary Aspergillosis/microbiology, Lung/diagnostic imaging, Lung/microbiology, Male, Middle Aged, Organ Transplantation/adverse effects, Prospective Studies, Radiography, Risk Factors, Switzerland/epidemiology, Transplant Recipients, Young Adult, epidemiology, invasive aspergillosis, solid organ transplant recipients
Pubmed
Web of science
Create date
19/04/2018 17:18
Last modification date
27/01/2024 7:36
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