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Title: Multinational case-control study of risk factors for the development of late invasive pulmonary aspergillosis following kidney transplantation
Author: López Medrano, Francisco
Fernández Ruiz, Mario
Silva, José Tiago
Carver, Peggy L.
Delden, Christian van
Merino, Esperanza
Pérez Sáez, María José
Montero, María Milagro
Coussement, Julien
Abreu Mazzolin, Milene de
Cervera, Carlos
Santos, Lidia
Sabé, Nuria
Scemla, Anne
Cordero, Elisa
Cruzado Vega, Leónidas
Martín Moreno, Paloma Leticia
Len, Óscar
Rudas, Eddison
Ponce de León, Alfredo
Arriola, Mariano
Lauzurica, Ricardo
David, Miruna D.
González Rico, Claudia
Henríquez Palop, Fernando
Fortún, Jesús
Nucci, Marcio
Manuel, Oriol
Paño Pardo, José Ramón
Montejo, Miguel
Vena, Antonio
Sánchez Sobrino, Beatriz
Mazuecos, María A.
Pascual, Julio (Pascual Santos)
Horcajada Gallego, Juan Pablo
Lecompte, Thanh
Moreno Camacho, Ma. Asunción
Carratalà, Jordi
Blanes, Marino
Perelló Carrascosa, Manuel
Muñoz, Patricia
Andrés, Amado
Aguado, José María
Spanish Network for Research in Infectious Diseases (REIPI)
Group for the Study of Infection in Transplant Recipients (GESITRA) of the Spanish Society of Clinical Microbiology and Infectious Diseases (SEIMC)
Study Group for Infections in Compromised Hosts (ESGICH) of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID)
Swiss Transplant Cohort Study (STCS)
Keywords: Trasplantament renal
Factors de risc en les malalties
Malalties de l'aparell respiratori
Kidney transplantation
Risk factors in diseases
Respiratory diseases
Issue Date: Feb-2018
Publisher: European Society of Clinical Microbiology and Infectious Diseases
Abstract: OBJECTIVES: To assess the risk factors for development of late-onset invasive pulmonary aspergillosis (IPA) after kidney transplantation (KT). METHODS: We performed a multinational case-control study that retrospectively recruited 112 KT recipients diagnosed with IPA between 2000 and 2013. Controls were matched (1:1 ratio) by centre and date of transplantation. Immunosuppression-related events (IREs) included the occurrence of non-ventilator-associated pneumonia, tuberculosis, cytomegalovirus disease, and/or de novo malignancy. RESULTS: We identified 61 cases of late (>180 days after transplantation) IPA from 24 participating centres (accounting for 54.5% (61/112) of all cases included in the overall study). Most diagnoses (54.1% (33/61)) were established within the first 36 post-transplant months, although five cases occurred more than 10 years after transplantation. Overall mortality among cases was 47.5% (29/61). Compared with controls, cases were significantly older (p 0.010) and more likely to have pre-transplant chronic obstructive pulmonary disease (p 0.001) and a diagnosis of bloodstream infection (p 0.016) and IRE (p <0.001) within the 6 months prior to the onset of late IPA. After multivariate adjustment, previous occurrence of IRE (OR 19.26; 95% CI 2.07-179.46; p 0.009) was identified as an independent risk factor for late IPA. CONCLUSION: More than half of IPA cases after KT occur beyond the sixth month, with some of them presenting very late. Late IPA entails a poor prognosis. We identified some risk factors that could help the clinician to delimit the subgroup of KT recipients at the highest risk for late IPA.
Note: Versió postprint del document publicat a:
It is part of: Clinical Microbiology and Infection, 2018, vol. 24, num. 2, p. 192-198
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ISSN: 1198-743X
Appears in Collections:Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)
Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))
Articles publicats en revistes (Medicina)

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