Ref ID: 17696
Author:
C.F. Neoh, G. Snell, B. Levvey, T. Kotsimbos, O. Morrissey, M. Slavin,
K. Stewart, D. Kong*
Author address:
(Melbourne, AU)
Full conference title:
22nd European Congress of Clinical Microbiology and Infectious Diseases
Abstract:
Objective: Invasive fungal infection is one of the major complications,
contributing to high mortality and morbidity among lung transplant
(LTx) patients. Data for voriconazole use in pre-emptive/targeted
prophylactic setting remain scant. This study aimed to investigate the
efficacy and safety of voriconazole pre-emptive/targeted prophylaxis
among LTx patients once airway fungal colonisation was confirmed.
Methods: A retrospective, single-centre, observational cohort study
was conducted. All adult LTx patients who received voriconazole preemptive/
targeted prophylaxis for the first time between July 2003 and
June 2010 were followed up for 1 year. Outcomes were determined at
6 months (primary end-point) and at 12 months after initiation of
voriconazole prophylaxis. Chi-square test was used to assess the
relationships between variables and outcomes (i.e. fungal infection,
Aspergillus colonisation, death and drug-related hepatotoxicity).
Cumulative survival rate at 12-month after initiation of prophylaxis
were estimated using the Kaplan-Meier method.
Results: A total of 62 LTx patients were included. A. fumigatus
(75.8%) was the most common colonising isolate. Median duration of
voriconazole prophylaxis was 84 days. At the 6-month end-point, one
(1.6%) had developed probable fungal pneumonia, 48 (77.5%) had
successful eradication of colonisation, three (4.8%) had persistent
colonisation, six (9.7%) had recurrent colonisation, two (3.2%) had
aspergilloma and two (3.2%) were clinically unstable but no culture
was performed. Sixteen (25.8%) had died by the 12-month end-point,
half due to Bronchiolitis Obliterans Syndrome. Ten (16.1%) had drugrelated
hepatotoxicity. Patients with diabetes mellitus within 30 days
before commencing voriconazole prophylaxis (OR: 8.4, 95% CI: 2.1-
33.4, p = 0.003) were at higher risk for Aspergillus colonisation at 12-
month end-point. Preliminary analyses suggest that acute rejection
(OR: 4.9, 95% CI: 1.2-19.4, p = 0.026) and chronic rejection (OR: 6.5,
95% CI: 1.3-31.5, p = 0.022) within 30 days prior to voriconazole
prophylaxis were significantly associated with 12-month mortality. LTx
patients older than 55 years old were 5.9 times more likely to have
hepatotoxicity after initiation of prophylaxis (95% CI: 1.1-30.6;
p = 0.036).
Abstract Number: P856
Conference Year: 2012
Link to conference website: NULL
New link: NULL
Conference abstracts, posters & presentations
-
Title
Author
Year
Number
Poster
-
v
L. Chouchana, I. Pierre, V. Poinsignon, E.M. Billaud*,
L. Weiss2012
NULL
n/a
-
v
M.J.P. van Wanrooy*, M.G.G. Rodgers, D.R.A. Uges, J.P. Arends,
J.G. Zijlstra, T.S. van der Werf, J.G.W. Kosterink, J.W.C.
Alffenaar2012
NULL
n/a
-
v
M.Z.R. Gomes*, R.E. Lewis, P.M.C.M. Farias, C. Wu,
D.P. Kontoyiannis2012
NULL
n/a
-
v
E.J. Bow*, D.J. Vanness, C. Cordonnier, O.A. Cornely, D.I. Marks,
A. Pagliuca, M. Slavin, C. Solano, A. Shaul, S. Sorensen, L. Cragin,
R. Chambers, M. Kantecki, D. Weinstein, H. Schlamm2012
P867
n/a
-
v
E. Giannatou1,4 , J. Cleverley2 , C. Symeonidou2 , A. Prentice3 , C.C.Kibbler1,4
2012
P869
n/a
-
v
Caira M, Busca A, Melillo L, Candoni A, Caramatti C, Specchia G, Fanci R, Rossi G, Cattaneo C, Vacca A, Quintavalle C,
Picardi M, Mitra ME, Delia M, Landini B, Gasbarrino C, Invernizzi R, Salutari P, Martino B, Garzia MG, Chierichini A, Venditti
A,2012
P868
n/a
-
v
I. Hoyo, C. Cervera, M. Bartoletti, G. Sanclemente, L. Linares,
J. Puig de la Bellacasa, J. Colmenero, A. Escorsell, M. Navasa,
A. Moreno*2012
P861
n/a
-
v
F. Farowski*, A. Hamprecht, C. Müller, A. Steinbach, J.J. Vehreschild,
M.J.G.T. Vehreschild, O.A. Cornely2012
NULL
n/a
-
v
E. Agwu*, J. Inyang, J. Ihongbe
2012
NULL
n/a
-
v
M. Hoenigl*, R. Raggam, T. Valentin, H. Salzer, A. Valentin,
A. Woelfler, K. Seeber, A. Strohmeier, I. Zollner-Schwetz, A. Grisold,
H. Sill, R. Krause2012
NULL
n/a