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The Prediction and Prognosis of Fungal Infection in Lung Transplant Recipients-A Retrospective Cohort Study in South Korea

 Yae-Jee Baek  ;  Yun-Suk Cho  ;  Moo-Hyun Kim  ;  Jong-Hoon Hyun  ;  Yu-Jin Sohn  ;  Song-Yee Kim  ;  Su-Jin Jeong  ;  Moo-Suk Park  ;  Jin-Gu Lee  ;  Hyo-Chae Paik 
 JOURNAL OF FUNGI, Vol.7(8) : 639, 2021-08 
Journal Title
Issue Date
Aspergillus spp . ; Candida spp. ; fungal infection ; fungal-positive respiratory sample ; lung transplantation
(1) Background: Lung transplant recipients (LTRs) are at substantial risk of invasive fungal disease (IFD), although no consensus has been reached on the use of antifungal agents (AFAs) after lung transplantation (LTx). This study aimed to assess the risk factors and prognosis of fungal infection after LTx in a single tertiary center in South Korea. (2) Methods: The study population included all patients who underwent LTx between January 2012 and July 2019 at a tertiary hospital. It was a retrospective cohort study. Culture, bronchoscopy, and laboratory findings were reviewed during episodes of infection. (3) Results: Fungus-positive respiratory samples were predominant in the first 90 days and the overall cumulative incidence of Candida spp. was approximately three times higher than that of Aspergillus spp. In the setting of itraconazole administration for 6 months post-LTx, C. glabrata accounted for 36.5% of all Candida-positive respiratory samples. Underlying connective tissue disease-associated interstitial lung disease, use of AFAs before LTx, a longer length of hospital stay after LTx, and old age were associated with developing a fungal infection after LTx. IFD and fungal infection treatment failure significantly increased overall mortality. Host factors, antifungal drug resistance, and misdiagnosis of non-Aspergillus molds could attribute to the breakthrough fungal infections. (4) Conclusions: Careful bronchoscopy, prompt fungus culture, and appropriate use of antifungal therapies are recommended during the first year after LTx.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Moo Hyun(김무현)
Kim, Song Yee(김송이) ORCID logo https://orcid.org/0000-0001-8627-486X
Park, Moo Suk(박무석) ORCID logo https://orcid.org/0000-0003-0820-7615
Baek, Yae Jee(백예지)
Paik, Hyo Chae(백효채) ORCID logo https://orcid.org/0000-0001-9309-8235
Sohn, Yujin(손유진)
Lee, Jin Gu(이진구)
Jeong, Su Jin(정수진) ORCID logo https://orcid.org/0000-0003-4025-4542
Cho, Yunsuk(조윤숙)
Hyun, Jong Hoon(현종훈) ORCID logo https://orcid.org/0000-0002-9621-0250
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