z-logo
Premium
Invasive fungal infection after heart transplantation: A 7‐year, single‐center experience
Author(s) -
Echenique Ignacio A.,
Angarone Michael P.,
Gordon Robert A.,
Rich Jonathan,
Anderson Allen S.,
McGee Edwin C.,
Abicht Travis O.,
Kang Joseph,
Stosor Valentina
Publication year - 2017
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/tid.12650
Subject(s) - medicine , interquartile range , heart transplantation , cumulative incidence , hazard ratio , transplantation , odds ratio , incidence (geometry) , prospective cohort study , univariate analysis , confidence interval , immunology , multivariate analysis , physics , optics
Background Invasive fungal infections ( IFI s) are an infrequent but major complication of heart transplantation ( HT ). We sought to describe the epidemiology at our institution. Methods A prospective cohort study of 159 heart transplant recipients was performed from June 2005 to December 2012. IFI s were defined by European Organization for Research and Treatment of Cancer/Mycoses Study Group criteria. Results By univariate analysis, Hispanic ethnicity was associated with IFI ( P =.01, odds ratio [ OR ] 7.0, 95% confidence interval [ CI ] 1.7‐27.9). Subsequently, a multivariate logistic regression was performed adjusting for Hispanic ethnicity, age, and gender. Seventeen IFI s were identified, occurring at a median 110 days post HT (interquartile range: 32‐411 days). Five IFI s (29% of IFI s and 3.1% of all HT ) occurred during the HT hospitalization, with 13 IFI s during the first year (incidence 8.2%). Conclusions The cumulative incidence was 10.7%. IFI s were associated with pre‐ and post‐ HT vancomycin‐resistant Enterococcus colonization and/or infection, post‐ HT renal replacement therapy, anti‐thymocyte globulin induction, and antibody‐mediated rejection. There were no associations with diabetes mellitus, desensitization, 2R/3R cellular rejection, treatments for rejection, re‐operation, neutropenia, or cytomegalovirus infection. IFI s were associated with death ( P =.02, OR 3.9, 95% CI 1.3‐12.1) and 1‐year mortality ( P <.001, OR 9.0, 95% CI 2.3‐35.7), but not 3‐year mortality. Associations with Hispanic ethnicity must be validated. Optimal strategies for risk reduction and prophylaxis remain undefined.

This content is not available in your region!

Continue researching here.

Having issues? You can contact us here