Determining the incidence of aspergillosis after liver transplant.
OBJECTIVE
Aspergillus has become an increasingly frequent cause of life-threatening opportunistic infections in liver transplant recipients. This study seeks to determine the incidence of invasive aspergillosis in liver transplant recipients using routine and molecular methods in a teaching hospital in Shiraz, the unique center for liver transplant in Iran.


METHODS
Four hundred eight recipients who underwent liver transplant were followed for Aspergillus infections by microscopic examination, culture, and nested polymerase chain reaction. Blood samples were cultured by bedside inoculation to BACTEC medium.


RESULTS
The female-to-male ratio was 151:257 (mean age, 29.6 years; mean hospitalization, 26 days). Sensitivity and specificity of the nested polymerase chain reaction was 92.8% and 94%. Aspergillosis was detected in 19 recipients (4.6%) by routine and molecular method (4 proven, 10 probable, and 5 possible) of whom 12 recipients died (63.2%).


CONCLUSIONS
This study found the incidence rate of invasive aspergillosis as an uncommon complication of liver transplant recipient cases but associated with poor outcomes. The rate is consistent with those reported in previous studies, but molecular assay that is more-sensitive and specific was used in the present study.
Badiee
Parisa
P
Prof. Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. Badieep@yahoo.com
Alborzi
Abdolvahab
A
Malekhosseini
Seyed Ali
SA
Nikeghbalian
Saman
S
Shakiba
Elaheh
E
D000293:Adolescent; D000328:Adult; D000935:Antifungal Agents / Q000008:administration & dosage; D001230:Aspergillus / Q000145:classification / Q000235:genetics; D002648:Child; D002675:Child, Preschool; D004271:DNA, Fungal / Q000097:blood; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D006784:Hospitals, Teaching / Q000706:statistics & numerical data; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015994:Incidence; D007223:Infant; D055744:Invasive Pulmonary Aspergillosis / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality / Q000517:prevention & control; D007492:Iran / Q000453:epidemiology; D007902:Length of Stay; D016031:Liver Transplantation / Q000009:adverse effects* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D021521:Ribotyping; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
D000935:Antifungal Agents; D004271:DNA, Fungal; D007166:Immunosuppressive Agents