Incidence and clinical predictors of primary opportunistic deep cutaneous mycoses in solid organ transplant recipients: a multicenter cohort study.

Abstract

BACKGROUND:

Primary opportunistic deep cutaneous fungal infections may cause significant morbidity and mortality in solid organ transplant recipients (OTR), but no data exist about their incidence, timing, and clinical predictors in a long-term follow-up.

PATIENTS AND METHODS:

A series of 3293 consecutive OTR including 1991 kidney, 929 heart, and 373 liver transplant recipients were enrolled. Patients were regularly followed up since time at transplantation (mean 5.5 yr +/-5.9 SD) and primary opportunistic fungal infections registered. Persons-year at risk (PYs), incidence rates (IR), incidence rate ratios (IRR), and 95% confidence intervals were computed.

RESULTS:

Twenty-two cases of deep cutaneous mycoses were detected, (IR 1.2 cases per 1000 PYs) after a mean follow-up time since transplantation of 2.5 yr +/- 2.0 SD (median 1.8 yr). Six patients had subsequent systemic involvement and three patients died of systemic dissemination. A higher risk for mycoses was observed in the first two yr after transplantation, (IRR 35.9, p < 0.0001), in renal transplant recipients (IRR 5.1 p = 0.030), and in patients transplanted after the age of 50 (IRR 11.5 p = 0.020).

CONCLUSIONS:

Primary deep cutaneous opportunistic mycoses in OTR occur mainly in the first two yr after transplantation, in renal transplant recipients, and in older patients.

• Authors: Gianpaolo Tessari, Luigi Naldi, Stefano Piaserico, Luigino Boschiero, Francesco Nacchia, Alberto Forni, Carlo Rugiu, Giuseppe Faggian, Elena Dall'olio, Anna Belloni Fortina, Mauro Alaibac, Fabrizia Sassi, Eliana Gotti, Roberto Fiocchi, Stefano Fagioli, Giampiero Girolomoni
• Journal: Clinical transplantation (Clin Transplant) 2010 May-Jun Vol. 24 Issue 3 Pg. 328-33 ISSN: 1399-0012 [Electronic] Denmark
• PMID: 19712084 (Publication Type: Journal Article, Multicenter Study)

Topics

• Adult
• Cohort Studies
• Dermatomycoses (diagnosis, epidemiology)
• Female
• Follow-Up Studies
• Heart Transplantation
• Humans
• Incidence
• Kidney Transplantation
• Liver Transplantation
• Male
• Middle Aged
• Opportunistic Infections (diagnosis, epidemiology)
• Prognosis
• Retrospective Studies
• Risk Factors