Journal Article

Risk Factors for Invasive Aspergillosis in Solid-Organ Transplant Recipients: A Case-Control Study

J. Gavalda, O. Len, R. San Juan, J. M. Aguado, J. Fortun, C. Lumbreras, A. Moreno, P. Munoz, M. Blanes, A. Ramos, G. Rufi, M. Gurgui, J. Torre-Cisneros, M. Montejo, M. Cuenca-Estrella, J. L. Rodriguez-Tudela and A. Pahissa

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 41, issue 1, pages 52-59
Published in print July 2005 | ISSN: 1058-4838
Published online July 2005 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/430602
Risk Factors for Invasive Aspergillosis in Solid-Organ Transplant Recipients: A Case-Control Study

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Background. To facilitate the design of strategies for prevention of invasive aspergillosis in solid-organ transplant recipients, this study investigates whether the development of early-onset and late-onset aspergillosis are related to different risk factors, thereby distinguishing 2 risk populations for this serious complication.

Methods. A retrospective case-control study was performed, including 156 cases of proven or probable invasive aspergillosis in patients recruited from 11 Spanish centers since the start of the centers' transplantation programs.

Results. Among all patients, 57% had early-onset IA (i.e., occurred during the first 3 months after transplantation). Risk factor analysis in this group identified as significantly associated risk factors a more complicated postoperative period, repeated bacterial infections or cytomegalovirus disease, and renal failure or the need for dialysis. Among patients with late-onset infections (i.e., occurred >3 months after transplantation), who comprised 43% of cases, the patients at risk were older, were in an overimmunosuppressed state because of chronic transplant rejection or allograft dysfunction, and had posttransplantation renal failure.

Conclusions. Risk factors in patients with early-onset cases and patients with late-onset cases of posttransplantation invasive aspergillosis are not the same, a fact that could have implications for the preventive approaches used for this infection.

Journal Article.  4569 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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