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Invasive fungal infection in liver transplant recipients in a prophylactic era: A multicenter retrospective cohort study in Korea

Authors
 Youn Jeong Kim  ;  Sang Il Kim  ;  Jong Young Choi  ;  Seung Kew Yoon  ;  Gun Hyung Na  ;  Young Kyoung You  ;  Dong Goo Kim  ;  Myoung Soo Kim  ;  Jae Geun Lee  ;  Dong Jin Joo  ;  Soon Il Kim  ;  Yu Seun Kim  ;  Sang-Oh Lee  ;  Shin Hwang  ;  Eungeol Sim 
Citation
 MEDICINE, Vol.98(26) : e16179, 2019 
Journal Title
 MEDICINE 
ISSN
 0025-7974 
Issue Date
2019
MeSH
Adult ; Aged ; Antifungal Agents/therapeutic use ; Female ; Humans ; Incidence ; Invasive Fungal Infections/epidemiology* ; Invasive Fungal Infections/therapy ; Liver Transplantation* ; Male ; Middle Aged ; Postoperative Complications/epidemiology* ; Postoperative Complications/therapy ; Republic of Korea ; Retrospective Studies ; Risk Factors ; Treatment Outcome ; Young Adult
Abstract
The epidemiology of invasive fungal infections (IFIs) after liver transplantation (LT) is continuing to evolve in the current era of antifungal prophylactic therapy. This multicenter retrospective cohort study aimed to evaluate the epidemiology, risk factors, and outcomes of IFIs among LT recipients in the current era.We analyzed a total of 482 LT recipients aged 18 years and older who were admitted to 3 tertiary hospitals in Korea between January 2009 and February 2012.Twenty-four episodes of IFIs occurred in 23 patients (4.77%; 23/482). Of these episodes, 20 were proven cases and 4 were probable cases according to EORTC/MSG criteria. Among these cases, IFI developed within 30 days of transplantation in 47.8% of recipients, from 31 to 180 days in 34.8% of recipients, and from 181 to 365 days in 17.4% of recipients. The most common isolates were Candida species (n = 12, 52.2%; Candida albicans, 6 cases; Candida tropicalis, 1 case; Candida glabrata, 1 case; Candida parapsilosis, 1 case; and unspecified Candida species, 1 case) and Aspergillus species (n = 7, 30.4%). The mortality in patients with IFIs was significantly higher than that in patients without IFIs (47.83% [11/23] vs 7.18% [33/459], P < .001). The incidence of late-onset IFIs is increasing in the antifungal prophylactic era, and fluconazole-resistant non-albicans Candida species have not yet emerged in Korea.
Files in This Item:
T201905808.pdf Download
DOI
10.1097/MD.0000000000016179
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Myoung Soo(김명수) ORCID logo https://orcid.org/0000-0002-8975-8381
Kim, Soon Il(김순일) ORCID logo https://orcid.org/0000-0002-0783-7538
Kim, Yu Seun(김유선) ORCID logo https://orcid.org/0000-0002-5105-1567
Lee, Jae Geun(이재근) ORCID logo https://orcid.org/0000-0002-6722-0257
Joo, Dong Jin(주동진) ORCID logo https://orcid.org/0000-0001-8405-1531
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/175192
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