首页|期刊导航|中华医学杂志（英文版）|Spectrum and risk factors for invasive candidiasis and non-Candida fungal infections after liver transplantation
中华医学杂志（英文版）2008，Vol.121Issue(7)：625-630,6.
Spectrum and risk factors for invasive candidiasis and non-Candida fungal infections after liver transplantation
Spectrum and risk factors for invasive candidiasis and non-Candida fungal infections after liver transplantation
摘要
Abstract
Background Invasive fungal infections are an important cause of posttransplant mortality in solid-organ recipients.The current trend is that the incidence of invasive candidiasis decreases significantly and invasive aspergillosis occurs later in the liver posttransplant recipients.The understanding of epidemiology and its evolving trends in the particular locality is beneficial to prophylactic and empiric treatment for transplant recipients.Methods A retrospective analysis was made of recorded data on the epidemiology,risk factors,and mortality of jnvasive fungal infections in 352 liver transplant recipients.Results Forty-two(11.9%)patients suffered from Invasive fungal infection.Candida species infections(53.3%)were the most common,followed by Aspergillus species(40.0%).There were 21 patients with a superficial fungal infection.The median time to onset of first invasive fungal infection was 13 days,first invasive Candida infection 9 days,and first invasive Aspergillus infection 21 days.Fifteen deaths were related to invasive fungal infection,10 to Aspergillus infection,and 5 to Candida infection.Invasive Candida species infections were associated with encephalopathy(P=0.009)and postoperative bacterial infection(P=0.0003)as demonstrated by multivariate analysis.Three independent risk factors of invasive Aspergillus infection were posttransplant laparotomy(P=0.004),renal dysfunction(P=0.005)and hemodialysis (P=0.001).Conclusions The leading etiologic species of invasive fungal infections are Candida and Aspergillus,which frequently occur in the first posttransplant month.EncephalOpathy and postoperative bacterial infection predispose to invasive Candida infection.POsttransDlant laparotomy and poor perioperative clinical status contribute to invasive Aspergillus infection.More studies are needed to determine the effect of prophylactic antifungal therapy in high risk Patients.关键词
candidiasis/aspergillosis/risk factors/liver transplantationKey words
candidiasis/aspergillosis/risk factors/liver transplantation分类
医药卫生引用本文复制引用
SHI Shao-hua,LU An-wei,SHEN Yan,JIA Chang-ku,WANG Wei-lin,XIE Hai-yang,ZHANG Min,LIANG Ting-bo,ZHENG Shu-sen..Spectrum and risk factors for invasive candidiasis and non-Candida fungal infections after liver transplantation[J].中华医学杂志（英文版）,2008,121(7):625-630,6.基金项目
The work was supported by a grant from the"973"Proiect of the Ministry of Science and Tcchnology of China(No.2003CB515506). （No.2003CB515506）
