Multinational case-control study of risk factors for the development of late invasive pulmonary aspergillosis following kidney transplantation

OBJECTIVES: To assess the risk factors for development of late-onset invasive pulmonary aspergillosis (IPA) after kidney transplantation (KT). METHODS: We performed a multinational case-control study that retrospectively recruited 112 KT recipients diagnosed with IPA between 2000 and 2013. Controls...

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Autores: López-Medrano, Francisco, Pérez-Sáez, María José, Montero, Maria Milagro, Pascual Santos, Julio, Horcajada Gallego, Juan Pablo, Aguado, José María
Tipo de recurso: artículo
Estado:Versión aceptada para publicación
Fecha de publicación:2018
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:10230/34582
Acceso en línea:http://hdl.handle.net/10230/34582
http://dx.doi.org/10.1016/j.cmi.2017.06.016
Access Level:acceso abierto
Palabra clave:Ronyons -- Trasplantació
Aspergillosis
Pulmons -- Malalties
Kidney transplantation
Case-control study
Late invasive pulmonary aspergillosis
Risk factors
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spelling Multinational case-control study of risk factors for the development of late invasive pulmonary aspergillosis following kidney transplantationLópez-Medrano, FranciscoPérez-Sáez, María JoséMontero, Maria MilagroPascual Santos, JulioHorcajada Gallego, Juan PabloAguado, José MaríaRonyons -- TrasplantacióAspergillosisPulmons -- MalaltiesKidney transplantationCase-control studyLate invasive pulmonary aspergillosisRisk factorsOBJECTIVES: To assess the risk factors for development of late-onset invasive pulmonary aspergillosis (IPA) after kidney transplantation (KT). METHODS: We performed a multinational case-control study that retrospectively recruited 112 KT recipients diagnosed with IPA between 2000 and 2013. Controls were matched (1:1 ratio) by centre and date of transplantation. Immunosuppression-related events (IREs) included the occurrence of non-ventilator-associated pneumonia, tuberculosis, cytomegalovirus disease, and/or de novo malignancy. RESULTS: We identified 61 cases of late (>180 days after transplantation) IPA from 24 participating centres (accounting for 54.5% (61/112) of all cases included in the overall study). Most diagnoses (54.1% (33/61)) were established within the first 36 post-transplant months, although five cases occurred more than 10 years after transplantation. Overall mortality among cases was 47.5% (29/61). Compared with controls, cases were significantly older (p 0.010) and more likely to have pre-transplant chronic obstructive pulmonary disease (p 0.001) and a diagnosis of bloodstream infection (p 0.016) and IRE (p <0.001) within the 6 months prior to the onset of late IPA. After multivariate adjustment, previous occurrence of IRE (OR 19.26; 95% CI 2.07-179.46; p 0.009) was identified as an independent risk factor for late IPA. CONCLUSION: More than half of IPA cases after KT occur beyond the sixth month, with some of them presenting very late. Late IPA entails a poor prognosis. We identified some risk factors that could help the clinician to delimit the subgroup of KT recipients at the highest risk for late IPA.Elsevier20182018info:eu-repo/semantics/articleinfo:eu-repo/semantics/acceptedVersionapplication/pdfapplication/pdfhttp://hdl.handle.net/10230/34582http://dx.doi.org/10.1016/j.cmi.2017.06.016reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésClinical Microbiology and Infection. 2018 Feb;24(2):192-8© Elsevier http://dx.doi.org/10.1016/j.cmi.2017.06.016info:eu-repo/semantics/openAccessoai:recercat.cat:10230/345822026-05-29T05:05:01Z
dc.title.none.fl_str_mv Multinational case-control study of risk factors for the development of late invasive pulmonary aspergillosis following kidney transplantation
title Multinational case-control study of risk factors for the development of late invasive pulmonary aspergillosis following kidney transplantation
spellingShingle Multinational case-control study of risk factors for the development of late invasive pulmonary aspergillosis following kidney transplantation
López-Medrano, Francisco
Ronyons -- Trasplantació
Aspergillosis
Pulmons -- Malalties
Kidney transplantation
Case-control study
Late invasive pulmonary aspergillosis
Risk factors
title_short Multinational case-control study of risk factors for the development of late invasive pulmonary aspergillosis following kidney transplantation
title_full Multinational case-control study of risk factors for the development of late invasive pulmonary aspergillosis following kidney transplantation
title_fullStr Multinational case-control study of risk factors for the development of late invasive pulmonary aspergillosis following kidney transplantation
title_full_unstemmed Multinational case-control study of risk factors for the development of late invasive pulmonary aspergillosis following kidney transplantation
title_sort Multinational case-control study of risk factors for the development of late invasive pulmonary aspergillosis following kidney transplantation
dc.creator.none.fl_str_mv López-Medrano, Francisco
Pérez-Sáez, María José
Montero, Maria Milagro
Pascual Santos, Julio
Horcajada Gallego, Juan Pablo
Aguado, José María
author López-Medrano, Francisco
author_facet López-Medrano, Francisco
Pérez-Sáez, María José
Montero, Maria Milagro
Pascual Santos, Julio
Horcajada Gallego, Juan Pablo
Aguado, José María
author_role author
author2 Pérez-Sáez, María José
Montero, Maria Milagro
Pascual Santos, Julio
Horcajada Gallego, Juan Pablo
Aguado, José María
author2_role author
author
author
author
author
dc.subject.none.fl_str_mv Ronyons -- Trasplantació
Aspergillosis
Pulmons -- Malalties
Kidney transplantation
Case-control study
Late invasive pulmonary aspergillosis
Risk factors
topic Ronyons -- Trasplantació
Aspergillosis
Pulmons -- Malalties
Kidney transplantation
Case-control study
Late invasive pulmonary aspergillosis
Risk factors
description OBJECTIVES: To assess the risk factors for development of late-onset invasive pulmonary aspergillosis (IPA) after kidney transplantation (KT). METHODS: We performed a multinational case-control study that retrospectively recruited 112 KT recipients diagnosed with IPA between 2000 and 2013. Controls were matched (1:1 ratio) by centre and date of transplantation. Immunosuppression-related events (IREs) included the occurrence of non-ventilator-associated pneumonia, tuberculosis, cytomegalovirus disease, and/or de novo malignancy. RESULTS: We identified 61 cases of late (>180 days after transplantation) IPA from 24 participating centres (accounting for 54.5% (61/112) of all cases included in the overall study). Most diagnoses (54.1% (33/61)) were established within the first 36 post-transplant months, although five cases occurred more than 10 years after transplantation. Overall mortality among cases was 47.5% (29/61). Compared with controls, cases were significantly older (p 0.010) and more likely to have pre-transplant chronic obstructive pulmonary disease (p 0.001) and a diagnosis of bloodstream infection (p 0.016) and IRE (p <0.001) within the 6 months prior to the onset of late IPA. After multivariate adjustment, previous occurrence of IRE (OR 19.26; 95% CI 2.07-179.46; p 0.009) was identified as an independent risk factor for late IPA. CONCLUSION: More than half of IPA cases after KT occur beyond the sixth month, with some of them presenting very late. Late IPA entails a poor prognosis. We identified some risk factors that could help the clinician to delimit the subgroup of KT recipients at the highest risk for late IPA.
publishDate 2018
dc.date.none.fl_str_mv 2018
2018
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/acceptedVersion
format article
status_str acceptedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10230/34582
http://dx.doi.org/10.1016/j.cmi.2017.06.016
url http://hdl.handle.net/10230/34582
http://dx.doi.org/10.1016/j.cmi.2017.06.016
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Clinical Microbiology and Infection. 2018 Feb;24(2):192-8
dc.rights.none.fl_str_mv © Elsevier http://dx.doi.org/10.1016/j.cmi.2017.06.016
info:eu-repo/semantics/openAccess
rights_invalid_str_mv © Elsevier http://dx.doi.org/10.1016/j.cmi.2017.06.016
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Elsevier
publisher.none.fl_str_mv Elsevier
dc.source.none.fl_str_mv reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15.812429

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