論文

査読有り
2016年1月

Epidemiology of invasive fungal infections after liver transplantation and the risk factors of late-onset invasive aspergillosis

JOURNAL OF INFECTION AND CHEMOTHERAPY
  • Miki Nagao
  • ,
  • Yasuhiro Fujimoto
  • ,
  • Masaki Yamamoto
  • ,
  • Yasufumi Matsumura
  • ,
  • Toshimi Kaido
  • ,
  • Shunji Takakura
  • ,
  • Shinji Uemoto
  • ,
  • Satoshi Ichiyama

22
1-2
開始ページ
84
終了ページ
89
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1016/j.jiac.2015.11.005
出版者・発行元
ELSEVIER SCIENCE BV

Invasive fungal infection (IFI) in liver transplant recipients is associated with poor outcomes. Targeted antifungal prophylaxis is recommended for high-risk populations; however, the epidemiology of IFI has changed, and the risk criteria remain unclear. In addition, the risk factors for late-onset invasive aspergillosis (IA) have not been fully characterized. We examined 279 recipients over 16 years of age to uncover their IFI epidemiology, clinical characteristics and outcomes. In addition, a case control study was performed to identify the risk factors of late-onset IA. Of the 279 recipients, 96.1% underwent living donor liver transplantation. Antifungal prophylaxis was administered to 80.6% of the recipients. IFI occurred in 15 patients, among which 8 cases were early-onset (<= 90 days after liver transplantation) and 7 cases were late-onset (>90 days after liver transplantation). Five of the late-onset cases were invasive pulmonary aspergillosis, and 2 were fungemia cases. The mortality rate of late-onset IA was 80.0%. According to a multivariate analysis, steroid use before liver transplantation, bloodstream infection within 90 days after liver transplantation and reoperation within 90 days after liver transplantation were significant risk factors for late-onset IA after liver transplantation. The prevalence of IFI was low in our population given that over 80% of liver recipients received antifungal prophylaxis. The prognosis of late onset IA remains poor, and predictors associated with late-onset IA, such as steroid use before liver transplantation, bloodstream infection and reoperation after liver transplantation, may help clinicians to optimize prevention measures for these devastating infections. (C) 2015, Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

リンク情報
DOI
https://doi.org/10.1016/j.jiac.2015.11.005
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/26683245
Web of Science
https://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=JSTA_CEL&SrcApp=J_Gate_JST&DestLinkType=FullRecord&KeyUT=WOS:000371369400015&DestApp=WOS_CPL
ID情報
  • DOI : 10.1016/j.jiac.2015.11.005
  • ISSN : 1341-321X
  • eISSN : 1437-7780
  • PubMed ID : 26683245
  • Web of Science ID : WOS:000371369400015

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