Fungal infections in pediatric lung transplant recipients: colonization and invasive disease.
BACKGROUND
The purpose of this study was to evaluate the epidemiology and investigate the impact of colonization and pulmonary fungal infections (PFIs).


METHODS
In this investigation we performed a retrospective analysis of 55 pediatric lung transplant recipients from 2002 to 2007 at a single institution. Associations between risk factors and time to post-transplant colonization, PFI, and other outcomes were assessed using Cox proportional hazard models.


RESULTS
Although 29 patients had positive pre-transplant colonization, 33 (60%) were colonized post-transplant and 20% (11 subjects) developed proven or probable PFI. In a multivariate model, post-transplant fungal colonization was associated with older age (hazard ratio [HR] 2.9, 95% confidence interval [CI] 1.1 to 7.6), cytomegalovirus (CMV) prophylaxis (HR 5.6, 95% CI 1.3 to 24.6) and respiratory viral infection prior to fungal colonization (HR 2.9, 95% CI 1.0 to 8.3).


CONCLUSIONS
Neither fungal colonization nor PFI was associated with the development of chronic allograft rejection or death.
Department of Pediatrics, Children's Hospital, The Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
Michael
M
Liu
Sarah
S
Worley
George B
GB
Mallory
Sarah
S
Arrigain
John
J
Robertson
Marc G
MG
Schecter
Okan
O
Elidemir
Lara A
LA
Danziger-Isakov
D000293:Adolescent; D000367:Age Factors; D000935:Antifungal Agents / Q000627:therapeutic use; D001989:Bronchiolitis Obliterans / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D016001:Confidence Intervals; D003550:Cystic Fibrosis / Q000601:surgery; D003586:Cytomegalovirus Infections / Q000517:prevention & control; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000601:surgery; D007223:Infant; D017563:Lung Diseases, Interstitial / Q000601:surgery; D016040:Lung Transplantation / Q000009:adverse effects*; D008297:Male; D009181:Mycoses / Q000453:epidemiology*; D016016:Proportional Hazards Models
D000935:Antifungal Agents