Factors affecting the prognosis of invasive pulmonary fungal infections after kidney transplantation: analysis of the ten-year single-center data / 南方医科大学学报

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the factors affecting the prognosis of invasive pulmonary fungal infection (IPFI) in patients after kidney transplantation.</p><p><b>METHODS</b>This retrospective study involved 80 concurrent patients with IPFI after receiving kidney transplantation in Zhujiang Hospital from January 1, 2000 to April 1, 2010. Fourteen factors including age, gender, pathogens, body temperature on day 5, renal insufficiency, mechanical ventilation, and clinical pulmonary infection score (CPIS) on day 5 were analyzed by univariate analysis and multivariate Logistic regression analysis to identify the factors related to the prognosis.</p><p><b>RESULTS</b>Univariate analysis showed that a normal body temperature on day 5 of antifungal treatment (P=0.024), fasting high blood glucose (P=0.001), renal insufficiency (P=0.002), malnutrition (P=0.018), time of infection after transplantation (P=0.046), low CPIS on day 5 (P=0.000) and mechanical ventilation (P=0.000) all affected the prognosis of the patients. Logistic regression analysis showed that renal insufficiency (OR=18.096), mechanical ventilation (OR=130.7) and low CPIS on day 5 (OR=0.011) were independent prognostic factors, among which the low CPIS on day 5 was a protective factor.</p><p><b>CONCLUSION</b>Timely and adequate empirical therapy and renal replacement therapy, along with adjusted anti-fungal therapy protocol according to the CPIS score on day 5, may improve the prognosis of IPFI after kidney transplantation.</p>