RUFFINI E, BALDI S, RAPELLINO M, MANCUSO M; Interscience Conference on Antimicrobial Agents and Chemotherapy (41st : 2001 : Chicago, Ill.).

Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 2001 Dec 16-19; 41: abstract no. J-1635.

University of Torino, Torino, Italy

BACKGROUND: Lung transplant recipients are a high-risk population for Aspergillus infections. This study aims at 1) defining prevalence and natural history of Aspergillus infection in lung transplant recipients and 2) evaluating the efficacy of treatment options. METHODS: From September 1993 to December 2000, 71 patients with end-stage lung disease received lung transplantation. Aspergillus airway infections were classified as Aspergillus colonization, isolated tracheobronchitis, invasive aspergillosis and the disseminated form. RESULTS: One patient died of disseminated form postoperatively. Analysis of Aspergillus infections was undertaken on 44 patients discharged from the hospital. Seventeen patients (38%) never coltured Aspergillus; four patients (9%) presented Aspergillus colonization; fifteen patients (34%) presented Aspergillus infections including: isolated tracheobronchitis, 5 patients; invasive aspergillosis, 9 patients; disseminated form, 1 patient. Treatment included oral itraconazole for isolated tracheobronchitis and Amphotericin B for invasive aspergillosis and the disseminated form. Liposomal Amphotericin B (dose 1 to 4 mg/Kg/day i.v., mean 2.1) was used in the last 7 patients with minimal side effects and no nephrotoxicity. All Aspergillus infections except the disseminated forms resolved with antifungal therapy and reduction of immunosuppression. Aerosolised liposomal Amphotericin B was used as pre-emptive therapy in Aspergillus colonization with eradication of the fungus in all cases. CONCLUSIONS: 1) Aspergillus infections occur frequently following lung transplantation. A favourable outcome may be anticipated in all forms of colonization and infection except for the disseminated form. 2) Among the treatment options, liposomal Amphotericin B is recommended for its low nephrotoxicity and minimal side effects.

Publication Types:

• Meeting Abstracts

Keywords:

• Amphotericin B
• Aspergillosis
• Aspergillus
• Humans
• Immunosuppression
• Itraconazole
• Lung
• Lung Transplantation
• Mycoses
• Prevalence
• surgery
• transplantation

Other ID:

• GWAIDS0029343

UI: 102268975

From Meeting Abstracts