FORTUN J, MARTIN-DAVILA P, ALVAREZ ME, SANCHEZ-SOUSA A, BARCENA R, DE VICENTE E, CANDELAS A, QUEREDA C, MORENO S; Interscience Conference on Antimicrobial Agents and Chemotherapy.

Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 2000 Sep 17-20; 40: 377.

Ramon y Cajal Hosp., Madrid, Spain

BACKGROUND: Identification of risk factors for developing invasive aspergillosis (IA) in liver transplant recipients (LTR) could help to start prompt specific therapy, improving survival in these patients.METHODS: A case-control study was performed. A CASE-PATIENT was defined as LTR who had a proven or probable diagnosis of IA. Three CONTROL-PATIENTS were chosen for each case. Controls were transplanted within one month of cases. Baseline characteristics, transplantation surgery events, intensive care unit (ICU) stay and follow-up were analyzed. Galactomannan Aspergillus antigen using a sandwich ELISA test (Platelia[TM], Sanofi Diagnostic Pasteur) was performed in serum samples in cases and controls. Uni- and multivariate analyses using logistic regression method were performed.RESULTS: Thirteen IA cases (incidence: 5.8%) and 38 controls were analyzed. Death was directly related to Aspergillus infection in 11 of 13 cases. Median time from transplantation date to IA diagnosis was 125 days (range: 20- 475 days). In the multivariate analysis we identified three independent risk factors for IA: dialysis previous to transplantation ( OR: 0.029; IC95%: 0.002-0.444); intubation >2 days ( OR: 0.058; IC95%: 0.004-0.710) and a positive antigenemia ( OR: 0.020; IC95%:0.0010- 0.281). Sensitivity, specificity, negative and positive predictive values of antigenemia were 55.6%, 93.9%, 71.4%, and 88.6%, respectively, within a likelihood ratio for a positive test of 9.2.CONCLUSIONS: Dialysis previous to transplant and prolonged intubation are independent risk factors for developing IA in LTR. Aspergillus antigenemia performed in patients at risk for IA could be useful as a marker for beginning preemptive therapy.KEYWORDS: Aspergillus spp.; Liver transplant; Risk factors

Publication Types:

• Meeting Abstracts

Keywords:

• Antigens
• Aspergillosis
• Aspergillus
• Case-Control Studies
• Enzyme-Linked Immunosorbent Assay
• Humans
• Liver Extracts
• Liver Transplantation
• Mannans
• Predictive Value of Tests
• Risk Factors
• Sensitivity and Specificity
• galactomannan
• immunology
• surgery
• transplantation

Other ID:

• GWAIDS0009684

UI: 102247182

From Meeting Abstracts