Risk factors for invasive aspergillosis in solid-organ transplant recipients: a case-control study.

Abstract

BACKGROUND:

To facilitate the design of strategies for prevention of invasive aspergillosis in solid-organ transplant recipients, this study investigates whether the development of early-onset and late-onset aspergillosis are related to different risk factors, thereby distinguishing 2 risk populations for this serious complication.

METHODS:

A retrospective case-control study was performed, including 156 cases of proven or probable invasive aspergillosis in patients recruited from 11 Spanish centers since the start of the centers' transplantation programs.

RESULTS:

Among all patients, 57% had early-onset IA (i.e., occurred during the first 3 months after transplantation). Risk factor analysis in this group identified as significantly associated risk factors a more complicated postoperative period, repeated bacterial infections or cytomegalovirus disease, and renal failure or the need for dialysis. Among patients with late-onset infections (i.e., occurred > 3 months after transplantation), who comprised 43% of cases, the patients at risk were older, were in an overimmunosuppressed state because of chronic transplant rejection or allograft dysfunction, and had posttransplantation renal failure.

CONCLUSIONS:

Risk factors in patients with early-onset cases and patients with late-onset cases of posttransplantation invasive aspergillosis are not the same, a fact that could have implications for the preventive approaches used for this infection.

• Authors: J Gavalda, O Len, R San Juan, J M Aguado, J Fortun, C Lumbreras, A Moreno, P Munoz, M Blanes, A Ramos, G Rufi, M Gurgui, J Torre-Cisneros, M Montejo, M Cuenca-Estrella, J L Rodriguez-Tudela, A Pahissa, RESITRA (Spanish Network for Research on Infection in Transplantation)
• Journal: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America (Clin Infect Dis) Vol. 41 Issue 1 Pg. 52-9 (Jul 01 2005) ISSN: 1537-6591 [Electronic] United States
• PMID: 15937763 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Adolescent
• Adult
• Aged
• Aspergillosis (diagnosis, epidemiology, mortality)
• Case-Control Studies
• Female
• Humans
• Incidence
• Lung Diseases, Fungal (diagnosis, epidemiology, mortality)
• Male
• Middle Aged
• Organ Transplantation (adverse effects)
• Risk Factors
• Time Factors