Mucosal Candida infection and colonisation as well as associated risk factors in solid organ transplant recipients

Antoniewicz, Lukasz; Relijc, D.; Poitschek, C; Presterl, Elisabeth; Geusau, Alexandra

doi:10.1007/s10096-009-0730-8

Cited by 6 publications

(2 citation statements)

References 24 publications

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“…Advanced age is a described risk factor for developing candidiasis [29], and, therefore, these cases might be explained by this risk factor. The relationship between the consumption of cyclosporin and candidiasis is known; however, two of the reported cases were not being treated with cyclosporine, but with other immunosuppressive drugs: tacrolimus in one case and mycophenolate in the other, so the risk is the same because of the higher dosages of mycophenolate and tacrolimus correlated with symptomatic mucosal candidiasis [30]. …”

Section: Discussionmentioning

confidence: 99%

Integrity of the Oral Tissues in Patients with Solid-Organ Transplants

Rojas

Bravo

Cordero

et al. 2012

Journal of Transplantation

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The relationship between the use of immunosuppressants in solid-organ transplant patients and oral tissue abnormalities has been recognized. The objective of this study was to determine the state of oral tissue integrity in renal, heart, and liver transplant patients who are on continuous medical and dental control. Forty patients of both sexes were clinically evaluated at the Clinical Hospital of the University of Chile to identify pathologies of oral mucosa, gingival enlargement (GE), decayed, missing, filled teeth (DMFT) index, and salivary flow. The average age of the transplant subjects was 49.4 years, and the age range was 19 to 69 years. Most subjects maintained a good level of oral hygiene, and the rate mean of DMFT was 14.7. The degree of involvement of the oral mucosa and GE was low (10%). Unlike other studies, the frequency of oral mucosal diseases and GE was low despite the fact that these patients were immunosuppressed. Care and continuous monitoring seem to be of vital importance in maintaining the oral health of transplant patients.

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Section: Discussionmentioning

confidence: 99%

Integrity of the Oral Tissues in Patients with Solid-Organ Transplants

Rojas

Bravo

Cordero

et al. 2012

Journal of Transplantation

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“…4 Mucosal damage, bleeding, and surgical interventions increase Candida species' colonization or growth in the gastrointestinal, hepatobiliary, and urinary systems. 5,6 In the past 30 years, small-intestine transplantation has become a valid treatment option for patients with intestinal failure. However, small-intestine transplantation has a high mortality rate because of fatal infections occurring in patients under immunosuppressive treatment.…”

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confidence: 99%

Disseminated Candidiasis Developing during Prophylaxis with Fluconazole in a Small-Intestine Transplant Recipient

et al. 2012

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A 31-year-old man underwent immunosuppressive treatment and was treated with 150 mg per day of prophylactic oral fluconazole after receiving a small-intestine transplant. The patient had acute rejection by the end of the first week after the transplant. Endoscopic examination showed white plaques. In blood and urine cultures, growth of Candida albicans was detected. Biopsy specimens showed high levels of conidia and hyphae in all regions. Intravenous treatment with caspofungin was started for the patient. Candidal findings had regressed on follow-up endoscopy. However, the patient died 3 months after transplant because of the effects of immunosuppression on his bone marrow and the development of disseminated intravascular coagulation. Candida species are the most common cause of invasive fungal infections that develop after solid-organ transplant. Following transplant, candidemia may develop during systemic antifungal treatment with a high level of mortality.

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In Vitro Susceptibility of Candida Isolates from Organ Transplant Recipients to Newer Antifungals

et al. 2014

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Organ transplant recipients (OTR) are at higher risk of developing life-threatening infections. In this study, we tested 527 Candida isolates obtained from the oral and genital mucosa from OTR and healthy controls in order to monitor antifungal susceptibility patterns in this particular risk group. Testing was carried out in parallel for already marketed azoles and anidulafungin. Minimal inhibitory concentrations (MICs) were determined using the E-test(®) for azoles and CLSI broth microdilution for anidulafungin. Overall, there was no difference in the distribution of Candida spp. for both groups, C. albicans being the most frequently isolated Candida sp. followed by C. glabrata. Also, there were only minor differences in the susceptibility patterns to all antifungal agents. All C. albicans isolates were fully susceptible to fluconazole and voriconazole. In C. glabrata, 2.2% (n = 1) were resistant to fluconazole, and 82.6% (n = 38) to itraconazole, and in C. krusei, 66.7% (n = 2) were resistant in itraconazole. All strains were susceptible to voriconazole. Only fluconazole showed a higher rate of resistant C. glabrata isolates for OTR (3.7%), whereas the control group showed only intermediate susceptible and no resistant isolates. As there are no breakpoints established for posaconazole by CLSI, breakpoints determined by EUCAST were used. A total of 87.9% of C. albicans, 81.3% of C. parapsilosis and 66.7% of C. tropicalis were considered susceptible. C. glabrata and C. krusei showed higher MIC values and thus lesser susceptibility than the other Candida species. There were no differences observed between OTR and control groups. For anidulafungin, 99.8% of C. albicans isolates were susceptible, 0.2% were intermediate, whereas for C. glabrata, only 95.3% were susceptible, 0.2% were resistant and 4.5% were interpreted as intermediate. Interestingly, the two resistant isolates were found in the control group. Also, the controls showed a marginally higher percentage of intermediate strains compared to the transplant patients. All in all, resistant isolates were only observed for C. glabrata of the control group.

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Mucosal Candida infection and colonisation as well as associated risk factors in solid organ transplant recipients

Cited by 6 publications

References 24 publications

Integrity of the Oral Tissues in Patients with Solid-Organ Transplants

Integrity of the Oral Tissues in Patients with Solid-Organ Transplants

Disseminated Candidiasis Developing during Prophylaxis with Fluconazole in a Small-Intestine Transplant Recipient

In Vitro Susceptibility of Candida Isolates from Organ Transplant Recipients to Newer Antifungals

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