Clinical characteristics and outcomes of colonization and infection by yeast species in solid organ transplant recipients: molecular identification and antifungal susceptibility patterns of isolates.

Abstract

Fungal infections are serious complications after solid organ transplantation, with high mortality and morbidity. Given the importance of the local epidemiological data, and also extensive prophylactic regimens in solid organ transplant (SOT) recipients, this study aimed to investigate the clinical characteristics and resistance patterns of yeast isolates in SOT recipients at a main referral transplant center in Iran. Of the 275 recipients enrolled, 22 (8%) had at least one positive yeast culture at a median of 5 days after transplantation. Bacterial infection and reoperation were significantly associated with colonization or infection caused by yeast species (P:0.001). Moreover, mortality and length of ICU/hospital stay were significantly higher in patients with positive yeast cultures (P<0.05). The most frequent species isolated was Candida albicans (50%), followed by C. glabrata (22.7%). Of species with definite breakpoints, the fluconazole- resistant rate was 23%. Caspofungin and amphotericin B showed potent activity against all isolates. Regarding the high risk of fungal infections, awareness of local epidemiological trends and resistance patterns can help improve outcomes in SOT recipients.