Fungal infections in pediatric lung transplant recipients: colonization and invasive disease

J Heart Lung Transplant. 2009 Nov;28(11):1226-30. doi: 10.1016/j.healun.2009.06.006. Epub 2009 Sep 26.

Abstract

Background: The purpose of this study was to evaluate the epidemiology and investigate the impact of colonization and pulmonary fungal infections (PFIs).

Methods: In this investigation we performed a retrospective analysis of 55 pediatric lung transplant recipients from 2002 to 2007 at a single institution. Associations between risk factors and time to post-transplant colonization, PFI, and other outcomes were assessed using Cox proportional hazard models.

Results: Although 29 patients had positive pre-transplant colonization, 33 (60%) were colonized post-transplant and 20% (11 subjects) developed proven or probable PFI. In a multivariate model, post-transplant fungal colonization was associated with older age (hazard ratio [HR] 2.9, 95% confidence interval [CI] 1.1 to 7.6), cytomegalovirus (CMV) prophylaxis (HR 5.6, 95% CI 1.3 to 24.6) and respiratory viral infection prior to fungal colonization (HR 2.9, 95% CI 1.0 to 8.3).

Conclusion: Neither fungal colonization nor PFI was associated with the development of chronic allograft rejection or death.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Age Factors
  • Antifungal Agents / therapeutic use
  • Bronchiolitis Obliterans / surgery
  • Child
  • Child, Preschool
  • Confidence Intervals
  • Cystic Fibrosis / surgery
  • Cytomegalovirus Infections / prevention & control
  • Female
  • Humans
  • Hypertension, Pulmonary / surgery
  • Infant
  • Lung Diseases, Interstitial / surgery
  • Lung Transplantation / adverse effects*
  • Male
  • Mycoses / epidemiology*
  • Proportional Hazards Models

Substances

  • Antifungal Agents