Risk Factors for Invasive Aspergillosis in Solid-Organ Transplant Recipients: A Case-Control Study

Clin Infect Dis. 2005 Jul 1;41(1):52-9. doi: 10.1086/430602. Epub 2005 May 26.

Abstract

Background: To facilitate the design of strategies for prevention of invasive aspergillosis in solid-organ transplant recipients, this study investigates whether the development of early-onset and late-onset aspergillosis are related to different risk factors, thereby distinguishing 2 risk populations for this serious complication.

Methods: A retrospective case-control study was performed, including 156 cases of proven or probable invasive aspergillosis in patients recruited from 11 Spanish centers since the start of the centers' transplantation programs.

Results: Among all patients, 57% had early-onset IA (i.e., occurred during the first 3 months after transplantation). Risk factor analysis in this group identified as significantly associated risk factors a more complicated postoperative period, repeated bacterial infections or cytomegalovirus disease, and renal failure or the need for dialysis. Among patients with late-onset infections (i.e., occurred > 3 months after transplantation), who comprised 43% of cases, the patients at risk were older, were in an overimmunosuppressed state because of chronic transplant rejection or allograft dysfunction, and had posttransplantation renal failure.

Conclusions: Risk factors in patients with early-onset cases and patients with late-onset cases of posttransplantation invasive aspergillosis are not the same, a fact that could have implications for the preventive approaches used for this infection.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aspergillosis / diagnosis
  • Aspergillosis / epidemiology*
  • Aspergillosis / mortality
  • Case-Control Studies
  • Female
  • Humans
  • Incidence
  • Lung Diseases, Fungal / diagnosis
  • Lung Diseases, Fungal / epidemiology
  • Lung Diseases, Fungal / mortality
  • Male
  • Middle Aged
  • Organ Transplantation / adverse effects*
  • Risk Factors
  • Time Factors