Invasive aspergillosis in liver transplant recipients in the current era

被引：2

作者：

Kimura, Muneyoshi ^{[1
]}

Rinaldi, Matteo ^{[2
,3
]}

Kothari, Sagar ^{[1
]}

Giannella, Maddalena ^{[2
,3
]}

Anjan, Shweta ^{[4
,5
]}

Natori, Yoichiro ^{[4
,5
]}

Phoompoung, Pakpoom ^{[1
,6
]}

Gault, Emily ^{[7
]}

Hand, Jonathan ^{[8
]}

D'Asaro, Matilde ^{[9
]}

Neofytos, Dionysios ^{[9
]}

Mueller, Nicolas J. ^{[10
,11
]}

Kremer, Andreas E. ^{[12
]}

Rojko, Tereza ^{[13
,14
]}

Ribnikar, Marija ^{[15
]}

Silveira, Fernanda P. ^{[16
]}

Kohl, Joshua ^{[17
]}

Cano, Angela ^{[18
]}

Torre-Cisneros, Julian ^{[18
]}

San-Juan, Rafael ^{[19
,20
]}

Maria Aguado, Jose ^{[19
,20
]}

Mansoor, Armaghan-e-Rehman ^{[21
]}

George, Ige Abraham ^{[21
]}

Mularoni, Alessandra ^{[22
]}

Russelli, Giovanna ^{[23
]}

Me-Linh Luong ^{[24
]}

AlJishi, Yamama A. ^{[25
]}

AlJishi, Maram N. ^{[26
]}

Hamandi, Bassem ^{[27
,28
]}

Selzner, Nazia ^{[29
]}

Husain, Shahid ^{[1
]}

机构：

[1] Univ Hlth Network, Ajmera Transplant Program, Transplant Infect Dis, 585 Univ Ave,9 MaRS 9080, Toronto, ON M5G 2N2, Canada

[2] Azienda Osped Univ Bologna, IRCCS, Infect Dis Unit, Bologna, Italy

[3] Univ Bologna, Dept Med & Surg Sci, Bologna, Italy

[4] Jackson Hlth Syst, Miami Transplant Inst, Miami, FL USA

[5] Univ Miami, Miller Sch Med, Dept Med, Div Infect Dis, Miami, FL 33136 USA

[6] Mahidol Univ, Siriraj Hosp, Div Infect Dis & Trop Med, Dept Med,Fac Med, Bangkok, Thailand

[7] Univ Queensland, Sch Med, Ochsner Clin Sch, Jefferson, LA USA

[8] Univ Queensland, Sch Med, Ochsner Clin Sch, Ochsner Hlth, Jefferson, LA USA

[9] Geneva Univ Hosp, Div Infect Dis, Transplant Infect Dis Unit, Geneva, Switzerland

[10] Univ Zurich, Univ Hosp Zurich, Swiss Transplant Cohort Study, Zurich, Switzerland

[11] Univ Zurich, Univ Hosp Zurich, Div Infect Dis & Hosp Epidemiol, Zurich, Switzerland

[12] Univ Zurich, Univ Hosp Zurich, Dept Gastroenterol & Hepatol, Zurich, Switzerland

[13] Univ Med Ctr Ljubljana, Dept Infect Dis, Ljubljana, Slovenia

[14] Univ Ljubljana, Fac Med, Ljubljana, Slovenia

[15] Univ Med Ctr Ljubljana, Dept Gastroenterol, Ljubljana, Slovenia

[16] Univ Pittsburgh, Sch Med, Dept Med, Div Infect Dis, Pittsburgh, PA 15260 USA

[17] Univ Pittsburgh, Clin & Translat Sci Inst, Pittsburgh, PA 15260 USA

[18] Inst Salud Carlos III, Ctr Invest Biomed Red Enfermedades Infecciosas CI, Cordoba, Spain

[19] Hosp Univ 12 Octubre, Inst Invest Sanitaria Hosp Octubre Imas12 12, CIBER INFEC, Madrid, Spain

[20] Hosp Univ 12 Octubre, Inst Invest Sanitaria Hosp Octubre Imas12 12, Unit Infect Dis, Madrid, Spain

[21] Washington Univ, Dept Med, Div Infect Dis, St Louis, MO USA

[22] Mediterranean Inst Transplantat & Adv Specialized, Sci Hospitalizat & Treatment Inst, Mediterranean Inst Transplants & Highly Specializ, Dept Infect Dis, Palermo, Italy

[23] Mediterranean Inst Transplantat & Adv Specialized, Sci Hospitalizat & Treatment Inst, Mediterranean Inst Transplants & Highly Specializ, Res Dept, Palermo, Italy

[24] Ctr Hosp Univ Montreal, Div Infect Dis, Dept Med, Montreal, PQ, Canada

[25] King Fahad Specialist Hosp Dammam, Sect Infect Dis, Dammam, Saudi Arabia

[26] King Fahad Specialist Hosp Dammam, Dept Med, Dammam, Saudi Arabia

[27] Univ Hlth Network, Dept Pharm, Toronto, ON, Canada

[28] Univ Toronto, Leslie Dan Fac Pharm, Toronto, ON, Canada

[29] Univ Hlth Network, Ajmera Transplant Ctr, Toronto, ON, Canada

来源：

AMERICAN JOURNAL OF TRANSPLANTATION | 2024年 / 24卷 / 11期

基金：

瑞士国家科学基金会;

关键词：

invasive aspergillosis; liver transplantation; targeted antifungal prophylaxis; FUNGAL-INFECTIONS; ANTIFUNGAL PROPHYLAXIS; RISK-FACTORS; DEFINITIONS; DISEASES; FLUCONAZOLE; SOCIETY; TRIAL;

D O I：

10.1016/j.ajt.2024.05.016

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Invasive aspergillosis (IA) is a rare but fatal disease among liver transplant recipients (LiTRs). We performed a multicenter 1:2 case-control study comparing LiTRs diagnosed with proven/probable IA and controls with no invasive fungal infection. We included 62 IA cases and 124 matched controls. Disseminated infection occurred only in 8 cases (13%). Twelve-week all-cause mortality of IA was 37%. In multivariate analyses, systemic antibiotic usage (adjusted odds ratio [aOR], 4.74; P = .03) and history of pneumonia (aOR, 48.7; P = .01) were identified as independent risk factors associated with the occurrence of IA. Moreover, reoperation (aOR, 5.99; P = .01), systemic antibiotic usage (aOR, 5.03; P = .04), and antimold prophylaxis (aOR, 11.9; P = .02) were identified as independent risk factors associated with the occurrence of early IA. Among IA cases, Aspergillus colonization (adjusted hazard ratio [aHR], 86.9; P <.001), intensive care unit stay (aHR, 3.67; P = .02), disseminated IA (aHR, 8.98; P <.001), and dialysis (aHR, 2.93; P = .001) were identified as independent risk factors associated with 12-week all-cause mortality, while recent receipt of tacrolimus (aHR, 0.11; P = .001) was protective. Mortality among LiTRs with IA remains high in the current era. The identified risk factors and protective factors may be useful for establishing robust targeted antimold prophylactic and appropriate treatment strategies against IA.

引用

页码：2092 / 2107

页数：16

共 28 条

[21] Invasive fungal infections in low-risk liver transplant recipients: A multi-center prospective observational study [J].

Pappas, PG ;

Andes, D ;

Schuster, M ;

Hadley, S ;

Rabkin, J ;

Merion, RM ;

Kauffman, CA ;

Huckabee, C ;

Cloud, GA ;

Dismukes, WE ;

Karchmer, AW .

AMERICAN JOURNAL OF TRANSPLANTATION, 2006, 6 (02) :386-391

[22] Practice Guidelines for the Diagnosis and Management of Aspergillosis: 2016 Update by the Infectious Diseases Society of America [J].

Patterson, Thomas F. ;

Thompson, George R., III ;

Denning, David W. ;

Fishman, Jay A. ;

Hadley, Susan ;

Herbrecht, Raoul ;

Kontoyiannis, Dimitrios P. ;

Marr, Kieren A. ;

Morrison, Vicki A. ;

Nguyen, M. Hong ;

Segal, Brahm H. ;

Steinbach, William J. ;

Stevens, David A. ;

Walsh, Thomas J. ;

Wingard, John R. ;

Young, Jo-Anne H. ;

Bennett, John E. .

CLINICAL INFECTIOUS DISEASES, 2016, 63 (04) :E1-E60

[23] Randomized Trial of Micafungin for the Prevention of Invasive Fungal Infection in High-Risk Liver Transplant Recipients [J].

Saliba, Faouzi ;

Pascher, Andreas ;

Cointault, Olivier ;

Laterre, Pierre-Francois ;

Cervera, Carlos ;

De Waele, Jan J. ;

Cillo, Umberto ;

Langer, Robert M. ;

Lugano, Manuela ;

Goeran-Ericzon, Bo ;

Phillips, Stephen ;

Tweddle, Lorraine ;

Karas, Andreas ;

Brown, Malcolm ;

Fischer, Lutz .

CLINICAL INFECTIOUS DISEASES, 2015, 60 (07) :997-1006

[24] Trends in risk profiles for and mortality associated with invasive aspergillosis among liver transplant recipients [J].

Singh, N ;

Avery, RK ;

Munoz, P ;

Pruett, TL ;

Alexander, B ;

Jacobs, R ;

Tollemar, JG ;

Dominguez, EA ;

Yu, CM ;

Paterson, DL ;

Husain, S ;

Kusne, S ;

Linden, P .

CLINICAL INFECTIOUS DISEASES, 2003, 36 (01) :46-52

[25] Invasive aspergillosis in liver transplant recipients in the 1990s [J].

Singh, N ;

Arnow, PM ;

Bonham, A ;

Dominguez, E ;

Paterson, DL ;

Pankey, GA ;

Wagener, MM ;

Yu, VL .

TRANSPLANTATION, 1997, 64 (05) :716-720

[26] Aspergillosis in Solid Organ Transplantation [J].

Singh, N. M. ;

Husain, S. .

AMERICAN JOURNAL OF TRANSPLANTATION, 2013, 13 :228-241

[27] Calcineurin controls growth, morphology, and pathogenicity in Aspergillus fumigatus [J].

Steinbach, William J. ;

Cramer, Robert A., Jr. ;

Perfect, B. Zachary ;

Asfaw, Yohannes G. ;

Sauer, Theodor C. ;

Najvar, Laura K. ;

Kirkpatrick, William R. ;

Patterson, Thomas F. ;

Benjamin, Daniel K., Jr. ;

Heitman, Joseph ;

Perfect, John R. .

EUKARYOTIC CELL, 2006, 5 (07) :1091-1103

[28] Randomized, Double-Blind Trial of Anidulafungin Versus Fluconazole for Prophylaxis of Invasive Fungal Infections in High-Risk Liver Transplant Recipients [J].

Winston, D. J. ;

Limaye, A. P. ;

Pelletier, S. ;

Safdar, N. ;

Morris, M. I. ;

Meneses, K. ;

Busuttil, R. W. ;

Singh, N. .

AMERICAN JOURNAL OF TRANSPLANTATION, 2014, 14 (12) :2758-2764

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