title: Risk factors for invasive aspergillosis in solid-organ transplant recipients: a case-control study.
abstract: 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.
authors.affiliation: Hospital Vall d'Hebron, Barcelona, Spain. jgavalda@vhebron.net
authors.forename: J
authors.initials: J
authors.lastname: Gavalda
authors.forename: O
authors.initials: O
authors.lastname: Len
authors.forename: R
authors.initials: R
authors.lastname: San Juan
authors.forename: J M
authors.initials: JM
authors.lastname: Aguado
authors.forename: J
authors.initials: J
authors.lastname: Fortun
authors.forename: C
authors.initials: C
authors.lastname: Lumbreras
authors.forename: A
authors.initials: A
authors.lastname: Moreno
authors.forename: P
authors.initials: P
authors.lastname: Munoz
authors.forename: M
authors.initials: M
authors.lastname: Blanes
authors.forename: A
authors.initials: A
authors.lastname: Ramos
authors.forename: G
authors.initials: G
authors.lastname: Rufi
authors.forename: M
authors.initials: M
authors.lastname: Gurgui
authors.forename: J
authors.initials: J
authors.lastname: Torre-Cisneros
authors.forename: M
authors.initials: M
authors.lastname: Montejo
authors.forename: M
authors.initials: M
authors.lastname: Cuenca-Estrella
authors.forename: J L
authors.initials: JL
authors.lastname: Rodriguez-Tudela
authors.forename: A
authors.initials: A
authors.lastname: Pahissa
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001228:Aspergillosis / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008172:Lung Diseases, Fungal / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality; D008297:Male; D008875:Middle Aged; D016377:Organ Transplantation / Q000009:adverse effects*; D012307:Risk Factors; D013997:Time Factors