Candidemia in solid organ transplant recipients in Spain: Epidemiological trends and determinants of outcome
- Creators
- Fernandez-Ruiz M.
- Cardozo C.
- Salavert M.
- Aguilar-Guisado M.
- Escola-Verge L.
- Munoz P.
- Gioia F.
- Montejo M.
- Merino P.
- Cuervo G.
- Garcia-Vidal C.
- Aguado J. M.
- Padilla B.
- Guinea J.
- Pano-Pardo J. R.
- Garcia-Rodriguez J.
- Garcia Cerrada C.
- Fortun J.
- Martin-Davila P.
- Gomez-Garcia de la Pedrosa E.
- Ryan P.
- Campelo C.
- de los Santos Gil I.
- Buendia V.
- Perez Gorricho B.
- Alonso M.
- Sanz Sanz F.
- Gonzalez Romo F.
- Gorgolas M.
- Gadea I.
- Delgado-Iribarren A.
- Ramos A.
- Romero Y.
- Sanchez Romero I.
- Zaragoza O.
- Cuenca-Estrella M.
- Rodriguez-Bano J.
- Suarez A. I.
- Loza A.
- Aller Garcia A. I.
- Martin-Mazuelos E.
- Ruiz Perez de Pipaon M.
- Garnacho J.
- Ortiz C.
- Chavez M.
- Maroto F. L.
- Peman J.
- Blanquer J.
- Navarro D.
- Camarena J. J.
- Zaragoza R.
- Abril V.
- Gimeno C.
- Hernandez S.
- Ezpeleta G.
- Bereciartua E.
- Hernandez Almaraz J. L.
- Rivas R. A.
- Ayarza R.
- Planes A. M.
- Ruiz-Camps I.
- Almirante B.
- Mensa J.
- Almela M.
- Gurgui M.
- Sanchez-Reus F.
- Martinez-Montauti J.
- Sierra M.
- Horcajada J. P.
- Sorli L.
- Gomez J.
- Gene A.
- Urrea M.
- Valerio M.
- Diaz-Martin A.
- Puchades F.
- Mularoni A.
- Puerta-Alcalde P.
- Morata L.
- Rodriguez-Nunez O.
- Guerrero M. A.
- Carratala J.
- Sabe N.
- Ayats J.
- Grau I.
- Calabuig E.
- Castro I.
- Cuellar S.
- Fortun J.
- Martin-Davila P.
- Gomez-Garcia de la Pedrosa E.
- Perez-Ayala A.
- Losada I.
- Navarro D.
- Suarez M. I.
- Martin-Gomez M. T.
- Almirante B.
- Rodriguez-Alvarez R.
- Lopez-Soira L.
- Vena A.
- Valerio M.
- Bouza E.
- Guinea J.
- Martin C.
- Others:
- Fernandez-Ruiz, M.
- Cardozo, C.
- Salavert, M.
- Aguilar-Guisado, M.
- Escola-Verge, L.
- Munoz, P.
- Gioia, F.
- Montejo, M.
- Merino, P.
- Cuervo, G.
- Garcia-Vidal, C.
- Aguado, J. M.
- Padilla, B.
- Guinea, J.
- Pano-Pardo, J. R.
- Garcia-Rodriguez, J.
- Garcia Cerrada, C.
- Fortun, J.
- Martin-Davila, P.
- Gomez-Garcia de la Pedrosa, E.
- Ryan, P.
- Campelo, C.
- de los Santos Gil, I.
- Buendia, V.
- Perez Gorricho, B.
- Alonso, M.
- Sanz Sanz, F.
- Gonzalez Romo, F.
- Gorgolas, M.
- Gadea, I.
- Delgado-Iribarren, A.
- Ramos, A.
- Romero, Y.
- Sanchez Romero, I.
- Zaragoza, O.
- Cuenca-Estrella, M.
- Rodriguez-Bano, J.
- Suarez, A. I.
- Loza, A.
- Aller Garcia, A. I.
- Martin-Mazuelos, E.
- Ruiz Perez de Pipaon, M.
- Garnacho, J.
- Ortiz, C.
- Chavez, M.
- Maroto, F. L.
- Peman, J.
- Blanquer, J.
- Navarro, D.
- Camarena, J. J.
- Zaragoza, R.
- Abril, V.
- Gimeno, C.
- Hernandez, S.
- Ezpeleta, G.
- Bereciartua, E.
- Hernandez Almaraz, J. L.
- Rivas, R. A.
- Ayarza, R.
- Planes, A. M.
- Ruiz-Camps, I.
- Almirante, B.
- Mensa, J.
- Almela, M.
- Gurgui, M.
- Sanchez-Reus, F.
- Martinez-Montauti, J.
- Sierra, M.
- Horcajada, J. P.
- Sorli, L.
- Gomez, J.
- Gene, A.
- Urrea, M.
- Valerio, M.
- Diaz-Martin, A.
- Puchades, F.
- Mularoni, A.
- Puerta-Alcalde, P.
- Morata, L.
- Rodriguez-Nunez, O.
- Guerrero, M. A.
- Carratala, J.
- Sabe, N.
- Ayats, J.
- Grau, I.
- Calabuig, E.
- Castro, I.
- Cuellar, S.
- Fortun, J.
- Martin-Davila, P.
- Gomez-Garcia de la Pedrosa, E.
- Perez-Ayala, A.
- Losada, I.
- Navarro, D.
- Suarez, M. I.
- Martin-Gomez, M. T.
- Almirante, B.
- Rodriguez-Alvarez, R.
- Lopez-Soira, L.
- Vena, A.
- Valerio, M.
- Bouza, E.
- Guinea, J.
- Martin, C.
Description
Background: Despite being considered a high-risk population for invasive fungal disease, specific features of candidemia among solid organ transplant (SOT) recipients remain poorly characterized. Methods: We compiled prospective data from two multicenter studies on candidemia performed over two consecutive periods in Spain: the CANDIPOP Study (2010-2011) and the CANDI-Bundle Study (2016-2018). Episodes diagnosed in adult SOT recipients in 10 participating centers were included. Risk factors for clinical failure (all-cause 7-day mortality and/or persistent candidemia for ≥72 hours) and 30-day mortality were investigated by univariate analysis. Results: We included 55 episodes of post-transplant candidemia (32 and 23 of which occurred during the first and second periods). Kidney (38.2%) and liver recipients (30.9%) were the most common populations. Candida albicans accounted for 27.3% of episodes. The proportion of C glabrata increased over time (18.8% vs 30.4% for the first and second periods). There were no differences in the rate of fluconazole non-susceptible isolates (50.0% vs 60.0%, respectively). Clinical failure and 30-day mortality occurred in 25.5% and 27.3% of episodes and were associated with the severity of candidemia (Pitt score and severe sepsis/septic shock). Kidney transplantation (unadjusted odds ratio [uOR]: 0.17; 95% confidence interval [CI]: 0.03-0.85; P-value =.020), early catheter removal (uOR: 0.15; 95% CI: 0.03-0.76; P-value =.013), and appropriate early antifungal therapy (uOR: 0.14; 95% CI: 0.02-0.89; P-value =.041) were protective for 30-day mortality. Conclusions: High rates of non-albicans species and fluconazole non-susceptibility must be taken into account to optimize therapeutic management and outcomes in SOT recipients with candidemia.
Additional details
- URL
- http://hdl.handle.net/11567/1073468
- URN
- urn:oai:iris.unige.it:11567/1073468
- Origin repository
- UNIGE