The Prediction and Prognosis of Fungal Infection in Lung Transplant Recipients—A Retrospective Cohort Study in South Korea
(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 af...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-08-01
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| Series: | Journal of Fungi |
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| Online Access: | https://www.mdpi.com/2309-608X/7/8/639 |
| _version_ | 1797523270078038016 |
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| author | 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 |
| author_facet | 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 |
| author_sort | Yae-Jee Baek |
| collection | DOAJ |
| description | (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 <i>Candida</i> spp. was approximately three times higher than that of <i>Aspergillus</i> spp. In the setting of itraconazole administration for 6 months post-LTx, <i>C. glabrata</i> accounted for 36.5% of all <i>Candida</i>-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-<i>Aspergillus</i> 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. |
| first_indexed | 2024-03-10T08:41:01Z |
| format | Article |
| id | doaj.art-738a4644c5c04486bbc320c316f8e34f |
| institution | Directory Open Access Journal |
| issn | 2309-608X |
| language | English |
| last_indexed | 2024-03-10T08:41:01Z |
| publishDate | 2021-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Fungi |
| spelling | doaj.art-738a4644c5c04486bbc320c316f8e34f2023-11-22T08:17:09ZengMDPI AGJournal of Fungi2309-608X2021-08-017863910.3390/jof7080639The Prediction and Prognosis of Fungal Infection in Lung Transplant Recipients—A Retrospective Cohort Study in South KoreaYae-Jee Baek0Yun-Suk Cho1Moo-Hyun Kim2Jong-Hoon Hyun3Yu-Jin Sohn4Song-Yee Kim5Su-Jin Jeong6Moo-Suk Park7Jin-Gu Lee8Hyo-Chae Paik9Division of Infectious Disease, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, KoreaDivision of Infectious Disease, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, KoreaDivision of Infectious Disease, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, KoreaDivision of Infectious Disease, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, KoreaDivision of Infectious Disease, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, KoreaDivision of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, KoreaDivision of Infectious Disease, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, KoreaDivision of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, KoreaDivision of Thoracic Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, KoreaDivision of Thoracic Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea(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 <i>Candida</i> spp. was approximately three times higher than that of <i>Aspergillus</i> spp. In the setting of itraconazole administration for 6 months post-LTx, <i>C. glabrata</i> accounted for 36.5% of all <i>Candida</i>-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-<i>Aspergillus</i> 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.https://www.mdpi.com/2309-608X/7/8/639fungal infectionlung transplantationfungal-positive respiratory sample<i>Aspergillus</i> spp.<i>Candida</i> spp. |
| spellingShingle | 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 The Prediction and Prognosis of Fungal Infection in Lung Transplant Recipients—A Retrospective Cohort Study in South Korea Journal of Fungi fungal infection lung transplantation fungal-positive respiratory sample <i>Aspergillus</i> spp. <i>Candida</i> spp. |
| title | The Prediction and Prognosis of Fungal Infection in Lung Transplant Recipients—A Retrospective Cohort Study in South Korea |
| title_full | The Prediction and Prognosis of Fungal Infection in Lung Transplant Recipients—A Retrospective Cohort Study in South Korea |
| title_fullStr | The Prediction and Prognosis of Fungal Infection in Lung Transplant Recipients—A Retrospective Cohort Study in South Korea |
| title_full_unstemmed | The Prediction and Prognosis of Fungal Infection in Lung Transplant Recipients—A Retrospective Cohort Study in South Korea |
| title_short | The Prediction and Prognosis of Fungal Infection in Lung Transplant Recipients—A Retrospective Cohort Study in South Korea |
| title_sort | prediction and prognosis of fungal infection in lung transplant recipients a retrospective cohort study in south korea |
| topic | fungal infection lung transplantation fungal-positive respiratory sample <i>Aspergillus</i> spp. <i>Candida</i> spp. |
| url | https://www.mdpi.com/2309-608X/7/8/639 |
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