Candida infection in pediatric liver transplant recipients

R. A. Gladdy, S. E. Richardson, H. D. Davies, R. A. Superina

Research output: Contribution to journalArticle

57 Citations (Scopus)

Abstract

A retrospective review of 100 liver transplantations in 98 children was performed to determine the incidence of infection caused by Candida organism in these patients and to identify risk factors that may predispose to serious fungal infection. Thirty-one infections caused by Candida organisms developed during the initial 28 days posttransplantation: 19 were definite invasive infections (one deep site or one positive blood culture), 2 were probable invasive infections (three superficial sites), and 10 were urinary tract infections. Eleven of 19 patients had fungemia or a disseminated infection (two noncontiguous deep organs involved and/or positive blood cultures) and 8 of 19 had peritoneal candidiasis. Infection caused by Candida organisms was a contributing factor to mortality in 7 of 21 patients (case fatality rate of 33%) with invasive infection. Risk factors that were predictive for invasive infection by univariate analysis included the following: pretransplantation antibiotic therapy, length of transplant operation, transfusion requirement, number of days in the intensive care unit, number of days intubated, number of concurrent bacterial infections, number of antibiotics administered, number of laparotomies performed post-transplantation, retransplantation, hepatic artery thrombosis, bile leaks, and renal and respiratory failure. By logistic regression analysis, bile leak, hepatic artery thrombosis, preoperative steroid use, transfusion requirement, and the number of days intubated were identified as independent risk factors for invasive infection caused by Candida organisms. The use of prophylactic antifungal agents in high-risk patients may be important in reducing the serious morbidity and mortality associated with sepsis caused by Candida organisms in pediatric liver transplant recipients.

Original languageEnglish (US)
Pages (from-to)16-24
Number of pages9
JournalLiver Transplantation and Surgery
Volume5
Issue number1
DOIs
StatePublished - Jan 1 1999

Fingerprint

Candida
Pediatrics
Liver
Infection
Hepatic Artery
Bile
Mortality
Thrombosis
Fungemia
Anti-Bacterial Agents
Transplant Recipients
Mycoses
Candidiasis
Antifungal Agents
Bacterial Infections
Urinary Tract Infections
Respiratory Insufficiency
Liver Transplantation
Laparotomy
Renal Insufficiency

ASJC Scopus subject areas

  • Surgery
  • Hepatology

Cite this

Candida infection in pediatric liver transplant recipients. / Gladdy, R. A.; Richardson, S. E.; Davies, H. D.; Superina, R. A.

In: Liver Transplantation and Surgery, Vol. 5, No. 1, 01.01.1999, p. 16-24.

Research output: Contribution to journalArticle

Gladdy, R. A. ; Richardson, S. E. ; Davies, H. D. ; Superina, R. A. / Candida infection in pediatric liver transplant recipients. In: Liver Transplantation and Surgery. 1999 ; Vol. 5, No. 1. pp. 16-24.
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