Invasive Fungal Infections in Renal Transplant Recipients: Epidemiology and Risk Factors.
BACKGROUND
Invasive fungal infections are a major cause of morbidity and mortality among renal transplant recipients.


OBJECTIVE
The aim of this study was to investigate the frequency and risk factors for fungal infections in renal transplant recipients.


METHODS
We retrospectively evaluated all kidney transplant recipients at our center from December 1988 to June 2010 for the epidemiology, spectrum, risk factors, and mortality of invasive fungal infections.


RESULTS
In 32 patients (10.30 %), at least one fungal infection developed after the transplantation. The most common pathogens causing fungal infections in our patients were Candida spp. and Aspergillus spp. The independent risk factors associated with invasive fungal infection episodes were antibiotic treatment within the last 3 months (OR 15.88, 95 % CI 3.90-64.73, p < 0.001), cytomegalovirus infection (OR 18.54, 95 % CI 9.01-38.17, p < 0.001), and the presence of diabetes mellitus (OR 6.01, 95 % CI 2.95-12.25, p < 0.001). Mortality was significantly higher among patients with fungal infections than among other patients (53.10 and 17.80 %, respectively; p < 0.001).


CONCLUSIONS
It is difficult to diagnose and treat fungal infections early, and it can be useful to determine independent risk factors in order to identify and treat high-risk patients.
Department of Microbiology and Infectious Diseases, Uludag University Medical School, 16059, Gorukle, Nilufer, Bursa, Turkey, sezinz@hotmail.com.
Sezin Zorlu
SZ
Sahin
Halis
H
Akalin
Alparslan
A
Ersoy
Abdulmecit
A
Yildiz
Gökhan
G
Ocakoglu
Ezgi Demirdöven
ED
Cetinoglu
Oğuzhan Sıtkı
OS
Dizdar
Esra
E
Kazak
Beyza
B
Ener
D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003586:Cytomegalovirus Infections / Q000150:complications; D048909:Diabetes Complications; D005260:Female; D016469:Fungemia / Q000453:epidemiology* / Q000382:microbiology; D005658:Fungi / Q000145:classification / Q000302:isolation & purification; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D066027:Transplant Recipients; D055815:Young Adult
D000900:Anti-Bacterial Agents