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Clinical outcome of cystic fibrosis patients colonized by Scedosporium species following lung transplantation: A single‐center 15‐year experience
Author(s) -
Parize Perrine,
Boussaud Veronique,
Poinsig Vianney,
Sitterlé Emilie,
Botterel Francoise,
Lefeuvre Sandrine,
Guillemain Romain,
Dannaoui Eric,
Billaud Eliane M.
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.12738
Subject(s) - scedosporium apiospermum , medicine , contraindication , lung transplantation , cystic fibrosis , transplantation , colonization , voriconazole , surgery , pathology , biology , dermatology , antifungal , microbiology and biotechnology , alternative medicine
Background Fungi of the genus S cedosporium are emerging pathogens responsible for severe infections in lung transplant recipients. These infections are associated with poor prognosis and some centers consider now S cedosporium species colonization as a contraindication to lung transplantation ( LT ) even though no published evidence demonstrates that S cedosporium species colonization is associated with higher morbidity or mortality after LT . Methods Here, we aim to describe characteristics and outcome of cystic fibrosis ( CF ) lung transplant recipients colonized with S cedosporium species in a single center over a 15‐year period. Results During the study period, 14 patients had scedosporial colonization reported. Only one patient, colonized before transplantation by L omentospora prolificans , developed scedosporial disease. Among the eight patients colonized before transplantation by S cedosporium apiospermum complex, the median survival was 1.92 year (range 0.21‐12.5). All these patients except one became free of fungal colonization after transplantation with antifungal prophylaxis including voriconazole or posaconazole. For the five patients colonized after LT , including two with L . prolificans , the median survival was 1.75 years (range 0.1‐13); three of them are still alive. Conclusions It appears to us that scedosporial colonization may not be a contraindication for LT in CF patients, as long as S . apiospermum complex is involved and a life‐long azole prophylaxis prescribed.