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Fungal infections in liver transplant recipients

Abstract number: P1580

Avkan-Oguz V., Eren-Kutsoylu O., Karademir S., Astarcioglu H., Unek T.

Objectives: The incidence of fungal infections ranges 7–42% in liver transplantations. Invasive fungal infections usually occur in three months following transplant surgery. In liver transplant recipients 62–91% of fungal infections are caused by Candida. Although most specialists recommend antifungal prophylaxis for liver transplant recipients, the frequency of fungal infections differs from centre to centre, geographic locations patients live and to the type of transplant surgery done. We aimed to find out fungal infection incidence in liver transplant patients in DEU Hospital (Izmir/Turkey) in order to make a decision for antifungal prophylaxis.

Methods: Between January 2003 and December 2006, 150 cases of liver transplantation were performed at our centre. Case records were examined retrospectively for fungal infection risk factors. Re-exploration, rejection, retransplantation, drainage catheters, reintubation, prolonged broad-spectrum antibiotic use, massive blood transfusion, and CMV infection were accepted as independent risk factors. The patients were grouped as definite, possible and probable diagnosis

Results: In this study 64 of 150 patients were consulted with infectious disease and clinical microbiology specialists because of post-transplant infections and five patients were required antifungal treatment. In three patients fungal pathogens were isolated either in peritoneal fluid or blood culture. In one patient Candida albicans was isolated from urine sample. C. albicans was isolated from all specimens. Case 3 was reexplorated for seven times and massive blood transfusion was performed. Through the patients given antifungal therapy, only in one patient any fungal pathogen was isolated (see table for details). Even there was no microbiological proof, clinical response was determined with antifungal therapy. There was no Aspergillus infections detected.

Conclusion: As a result the incidence of fungal infection is 3.2% in liver transplant recipients at our centre. The use of prolonged and broad-spectrum antibiotics and re-exploration were common risk factors in all cases. When possible and probable fungal infections were analysed, the incidence of fungal infections in liver transplant patients was lower than expected. According to these findings antifungal prophylaxis after transplantation is not recommended for the recipients in Dokuz Eylul University Hospital.

Session Details

Date: 19/04/2008
Time: 00:00-00:00
Session name: 18th European Congress of Clinical Microbiology and Infectious Diseases
Subject:
Location: Barcelona, Spain
Presentation type:
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