Incidence of fungal infections in a solid organ recipients dedicated intensive care unit.
Invasive fungal infections are a significant cause of morbidity and mortality for patients undergoing solid organ transplantation. Our aim was to evaluate the incidence of invasive fungal infections in solid organ recipients within a dedicated intensive care unit (ICU).


METHODS
From May 2002 to May 2005, 278 patients undergoing solid organ transplantation (105 liver, 142 kidney, 20 lung, 2 combined liver-kidney, 9 combined pancreas-kidney) were admitted to our posttransplant intensive care unit. We retrospectively analyzed data obtained from the ICU stay. Fungal infection was defined by positivity of normally sterile biological samples and by elevated positivity of normally non sterile biological samples. We did not consider superficial fungal infections and asymptomatic colonizations.


RESULTS
Forty-six patients (16.5%) developed a fungal infection; at least one mycotic agent was isolated from each patient. Candida albicans was the most common pathogen, isolated from 71 % of infected patients (33 of 46). Infected patients showed a mortality rate of 35%, while that for non infected recipients was 3.5%. Total length of ICU stay was the most significant risk factor among infected patients (30.26 days vs 5.04 days P < .0001). Mean time between transplantation and first positive samples was 6.17 days (SD 8.88).


CONCLUSIONS
Fungal infections in solid organ transplant patients are a major issue because of their associated morbidity and mortality. Candida albicans was the most common pathogen and total length of ICU stay was the most important risk factor.
Pugliese
F
F
Dipartimento di Scienze Anestesiologiche, Medicina Critica e Terapia del Dolore, Universita' Degli Studi di Roma La Sapienza, Roma, Italy. mavif@tiscali.it
Ruberto
F
F
Cappannoli
A
A
Perrella
S M
SM
Bruno
K
K
Martelli
S
S
Marcellino
V
V
D'Alio
A
A
Diso
D
D
Rossi
M
M
Corradini
S G
SG
Morabito
V
V
Rolla
M
M
Ferretti
G
G
Venuta
F
F
Berloco
P B
PB
Coloni
G F
GF
Pietropaoli
P
P
D002177:Candidiasis / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units; D009181:Mycoses / Q000453:epidemiology*; D016377:Organ Transplantation / Q000009:adverse effects*; D011183:Postoperative Complications / Q000453:epidemiology / Q000382:microbiology*; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors