Superficial fungal infections in renal transplant recipients.
BACKGROUND
Renal transplant recipients (RTRs) are predisposed to fungal infections because of long-term graft-preserving immunosuppressive therapy.


METHODS
We prospectively enrolled 223 consecutive adult RTRs. Patients were transplanted at 1 of 2 transplant centers in Poland. The group consisted of 97 women (43%) and 126 men (57%). The control group consisted of 100 patients (39 women and 61 men) randomly selected from the outpatient dermatology clinic and from hospital personnel. All RTRs and the control group were screened for the presence of superficial fungal infections. All patients were examined by the same dermatologist. The oral mucosa and the entire body surface were fully examined. Mucosal swabs were obtained from all patients in both the examined and control groups. Skin scrapings and swabs were obtained from any clinically suspicious lesions. Nail clippings were collected in the case of any nail changes.


RESULTS
Superficial fungal infections have been detected in 133 RTRs (60%)and 27 controls (27%; P = .00001). One hundred eight RTRs (62%) developed superficial fungal infections in the first year after transplantation (P < .008). The most common site for superficial fungal infections in the RTRs group was the oral cavity. Candida albicans was the most frequently isolated species in the oral cavity.


CONCLUSIONS
Superficial fungal infections in RTRs are statistically more common among RTRs than in the general population. Whether the drug was used separately or administrated under immunosuppressive combinations had no influence on the occurrence of fungal infections. The final results showed no correlation between patient age and the occurrence of fungal infections. Dermatologists who care for transplant patients should be aware of the clinical course of fungal species in RTRs compared with the general population.
Copernicus, Dermatological Out-patients Clinic, Gdansk; College of Health, Beauty Care and Education, Poznan. Electronic address: bimko@wp.pl.
B B
BB
Imko-Walczuk
Copernicus, Dermatological Out-patients Clinic, Gdansk.
A
A
Prędota
Copernicus, Dermatological Out-patients Clinic, Gdansk.
A
A
Okuniewska
Clinical Department of Oncological Surgery, Medical University, Gdansk.
J
J
Jaśkiewicz
Department of Cosmetology Nicolaus Copernicus University Torun, Collegium Medicum, Bydgoszcz.
B
B
Zegarska
Department of Dermatology, Sexually Transmitted Diseases and Medical University, Gdansk.
W
W
Placek
Department of Transplantation and General Surgery, University Hospital, Collegium Medicum, Bydgoszcz, University of Nicolaus Copernicus, Torun.
Z
Z
Włodarczyk
Department of Nephrology, Transplantology and Internal Medicine, Immunodermatology, University Hospital, Collegium Medicum, Bydgoszcz, University of Nicolaus Copernicus, Torun, Poland.
A
A
Dębska-Slizień
Department of Nephrology, Transplantology and Internal Medicine, Immunodermatology, University Hospital, Collegium Medicum, Bydgoszcz, University of Nicolaus Copernicus, Torun, Poland.
B
B
Rutkowski
D000293:Adolescent; D000328:Adult; D000368:Aged; D002176:Candida albicans / Q000302:isolation & purification; D002177:Candidiasis / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D003881:Dermatomycoses / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology; D011446:Prospective Studies; D055815:Young Adult