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Transpl Infect Dis. 2010 Dec;12(6):497-504. doi: 10.1111/j.1399-3062.2010.00542.x.

Incidence and outcome of fungal infections in pediatric small bowel transplant recipients.

Author information

1
Department of Internal Medicine, Transplant Infectious Diseases Program, University of Nebraska Medical Center, Omaha, Nebraska 68198-5400, USA. dflorescu@unmc.edu

Abstract

BACKGROUND:

Data on the incidence, timing, and outcome of fungal infections in pediatric small bowel transplantation (SBT) are lacking.

METHODS:

Cases of pediatric SBT from January 2003 through December 2007 were collected. Standard induction was with thymoglobulin and/or basiliximab and maintenance immunosuppression was a tacrolimus-based regimen. Chi-square was used for categorical variables and Kaplan-Meier for survival analyses.

RESULTS:

A total 98 recipients were included; 25 patients developed 59 episodes of Candida infections and 4 episodes of invasive aspergillosis (incidence 25.5%, 95% confidence interval [CI] 17%, 34%). Of the Candida species, 37.3% were Candida albicans and 62.7% non-albicans Candida. Of all yeast infections, 66.1% were fungemia, 28.8% intra-abdominal infections, 1.7% empyema, and 3.4% urinary tract infection. Of the Candida intra-abdominal infections, 41.2% developed in the first month post transplantation, while 79.5% of candidemia developed after >6 months. Median time from transplantation to fungal infection was significantly shorter for abdominal infections compared with fungemia (9 versus 163 days; P=0.004). All-cause mortality was not significantly different between patients with and without fungal infections (32.3% versus 29.8%; odds ratio=1.12, 95% CI 0.45, 2.8).

CONCLUSION:

Fungal infections occurred in 25% of SBT recipients and C. albicans was the most common species. Intra-abdominal fungal infections occurred earlier (<1 month) than fungemia (>6 months) post transplantation.

[Indexed for MEDLINE]

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