Fungal Infections in Pediatric Lung Transplant Recipients: Colonization and Invasive Disease
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 instit...
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| Veröffentlicht in: | The Journal of heart and lung transplantation 2009-11, Vol.28 (11), p.1226-1230 |
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| container_title | The Journal of heart and lung transplantation |
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| creator | Liu, Michael, BS Worley, Sarah, MS Mallory, George B., MD Arrigain, Sarah, MA Robertson, John, MD Schecter, Marc G., MD Elidemir, Okan, MD Danziger-Isakov, Lara A., MD, MPH |
| description | 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. |
| doi_str_mv | 10.1016/j.healun.2009.06.006 |
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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.</description><identifier>ISSN: 1053-2498</identifier><identifier>EISSN: 1557-3117</identifier><identifier>DOI: 10.1016/j.healun.2009.06.006</identifier><identifier>PMID: 19782585</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adolescent ; Age Factors ; Antifungal Agents - therapeutic use ; Biological and medical sciences ; Bronchiolitis Obliterans - surgery ; Cardiology. Vascular system ; 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 ; Medical sciences ; Mycoses - epidemiology ; Proportional Hazards Models ; Surgery ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the heart</subject><ispartof>The Journal of heart and lung transplantation, 2009-11, Vol.28 (11), p.1226-1230</ispartof><rights>International Society for Heart and Lung Transplantation</rights><rights>2009 International Society for Heart and Lung Transplantation</rights><rights>2009 INIST-CNRS</rights><rights>2009 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved. 2009</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c547t-644deb552308780124858ab7321c03956074e8ad6fb04adb55ed33a6ef5bc8373</citedby><cites>FETCH-LOGICAL-c547t-644deb552308780124858ab7321c03956074e8ad6fb04adb55ed33a6ef5bc8373</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.healun.2009.06.006$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,780,784,885,3548,27922,27923,45993</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=22108436$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19782585$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Liu, Michael, BS</creatorcontrib><creatorcontrib>Worley, Sarah, MS</creatorcontrib><creatorcontrib>Mallory, George B., MD</creatorcontrib><creatorcontrib>Arrigain, Sarah, MA</creatorcontrib><creatorcontrib>Robertson, John, MD</creatorcontrib><creatorcontrib>Schecter, Marc G., MD</creatorcontrib><creatorcontrib>Elidemir, Okan, MD</creatorcontrib><creatorcontrib>Danziger-Isakov, Lara A., MD, MPH</creatorcontrib><title>Fungal Infections in Pediatric Lung Transplant Recipients: Colonization and Invasive Disease</title><title>The Journal of heart and lung transplantation</title><addtitle>J Heart Lung Transplant</addtitle><description>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.</description><subject>Adolescent</subject><subject>Age Factors</subject><subject>Antifungal Agents - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Bronchiolitis Obliterans - surgery</subject><subject>Cardiology. Vascular system</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Confidence Intervals</subject><subject>Cystic Fibrosis - surgery</subject><subject>Cytomegalovirus Infections - prevention & control</subject><subject>Female</subject><subject>Humans</subject><subject>Hypertension, Pulmonary - surgery</subject><subject>Infant</subject><subject>Lung Diseases, Interstitial - surgery</subject><subject>Lung Transplantation - adverse effects</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Mycoses - epidemiology</subject><subject>Proportional Hazards Models</subject><subject>Surgery</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the heart</subject><issn>1053-2498</issn><issn>1557-3117</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkl2L1DAUhoso7rr6D0R6I161nnw1qReCjK4uDCi6ghdCSNPT3YydZEzagfXXmzLDrnrjVQLnPe_5eE5RPCVQEyDNy019jWacfU0B2hqaGqC5V5wSIWTFCJH38x8Eqyhv1UnxKKUNAFAm6MPihLRSUaHEafH9fPZXZiwv_IB2csGn0vnyE_bOTNHZcp3D5WU0Pu1G46fyM1q3c-in9KpchTF498ssaaXxfTbZm-T2WL51CU3Cx8WDwYwJnxzfs-Lr-bvL1Ydq_fH9xerNurKCy6lqOO-xE4IyUFIBoVwJZTrJKLHAWtGA5KhM3wwdcNNnJfaMmQYH0VnFJDsrXh98d3O3xd7m9qIZ9S66rYk3Ohin_454d62vwl7TvIaGq2zw4mgQw88Z06S3Llkc88gY5qQl4wSAtzQr-UFpY0gp4nBbhYBeuOiNPnDRCxcNjc5cctqzPzu8SzqCyILnR4FJ1oxD3rh16VZHKQHFWXM3KuZ97h1GnWzGYTOwmAHqPrj_dfKvgR2dd7nmD7zBtAlz9JmVJjpRDfrLckPLCUGbFyDlN_YbaZLDvw</recordid><startdate>20091101</startdate><enddate>20091101</enddate><creator>Liu, Michael, BS</creator><creator>Worley, Sarah, MS</creator><creator>Mallory, George B., MD</creator><creator>Arrigain, Sarah, MA</creator><creator>Robertson, John, MD</creator><creator>Schecter, Marc G., MD</creator><creator>Elidemir, Okan, MD</creator><creator>Danziger-Isakov, Lara A., MD, MPH</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20091101</creationdate><title>Fungal Infections in Pediatric Lung Transplant Recipients: Colonization and Invasive Disease</title><author>Liu, Michael, BS ; Worley, Sarah, MS ; Mallory, George B., MD ; Arrigain, Sarah, MA ; Robertson, John, MD ; Schecter, Marc G., MD ; Elidemir, Okan, MD ; Danziger-Isakov, Lara A., MD, MPH</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c547t-644deb552308780124858ab7321c03956074e8ad6fb04adb55ed33a6ef5bc8373</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Adolescent</topic><topic>Age Factors</topic><topic>Antifungal Agents - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Bronchiolitis Obliterans - surgery</topic><topic>Cardiology. Vascular system</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Confidence Intervals</topic><topic>Cystic Fibrosis - surgery</topic><topic>Cytomegalovirus Infections - prevention & control</topic><topic>Female</topic><topic>Humans</topic><topic>Hypertension, Pulmonary - surgery</topic><topic>Infant</topic><topic>Lung Diseases, Interstitial - surgery</topic><topic>Lung Transplantation - adverse effects</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Mycoses - epidemiology</topic><topic>Proportional Hazards Models</topic><topic>Surgery</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the heart</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Liu, Michael, BS</creatorcontrib><creatorcontrib>Worley, Sarah, MS</creatorcontrib><creatorcontrib>Mallory, George B., MD</creatorcontrib><creatorcontrib>Arrigain, Sarah, MA</creatorcontrib><creatorcontrib>Robertson, John, MD</creatorcontrib><creatorcontrib>Schecter, Marc G., MD</creatorcontrib><creatorcontrib>Elidemir, Okan, MD</creatorcontrib><creatorcontrib>Danziger-Isakov, Lara A., MD, MPH</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>The Journal of heart and lung transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Liu, Michael, BS</au><au>Worley, Sarah, MS</au><au>Mallory, George B., MD</au><au>Arrigain, Sarah, MA</au><au>Robertson, John, MD</au><au>Schecter, Marc G., MD</au><au>Elidemir, Okan, MD</au><au>Danziger-Isakov, Lara A., MD, MPH</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Fungal Infections in Pediatric Lung Transplant Recipients: Colonization and Invasive Disease</atitle><jtitle>The Journal of heart and lung transplantation</jtitle><addtitle>J Heart Lung Transplant</addtitle><date>2009-11-01</date><risdate>2009</risdate><volume>28</volume><issue>11</issue><spage>1226</spage><epage>1230</epage><pages>1226-1230</pages><issn>1053-2498</issn><eissn>1557-3117</eissn><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.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>19782585</pmid><doi>10.1016/j.healun.2009.06.006</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| source | Elsevier ScienceDirect Journals Complete - AutoHoldings; MEDLINE |
| subjects | Adolescent Age Factors Antifungal Agents - therapeutic use Biological and medical sciences Bronchiolitis Obliterans - surgery Cardiology. Vascular system 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 Medical sciences Mycoses - epidemiology Proportional Hazards Models Surgery Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the heart |
| title | Fungal Infections in Pediatric Lung Transplant Recipients: Colonization and Invasive Disease |
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