scholarly journals Utility of 1,3 β-d-Glucan Assay for Guidance in Antifungal Stewardship Programs for Oncologic Patients and Solid Organ Transplant Recipients

2021 ◽  
Vol 7 (1) ◽  
pp. 59
Author(s):  
Marina Machado ◽  
Esther Chamorro de Vega ◽  
María del Carmen Martínez-Jiménez ◽  
Carmen Guadalupe Rodríguez-González ◽  
Antonio Vena ◽  
...  
Keyword(s):  
Fungal Infections ◽  
Initial Period ◽  
Organ Transplant ◽  
Cost Effective ◽  
Solid Organ Transplant ◽  
Solid Organ ◽  
Antifungal Stewardship ◽  
Oncologic Patients ◽  
Before And After ◽  
Post Period

The implementation of 1,3 β-d-glucan (BDG) has been proposed as a diagnostic tool in antifungal stewardship programs (ASPs). We aimed to analyze the influence of serum BDG in an ASP for oncologic patients and solid organ transplant (SOT) recipients. We conducted a pre–post study. In the initial period (PRE), the ASP was based on bedside advice, and this was complemented with BDG in the post-period (POST). Performance parameters of the BDG assay were determined. Antifungal (AF) use adequacy was evaluated using a point score. Clinical outcomes and AF costs were also compared before and after the intervention. Overall, 85 patients were included in the PRE-period and 112 in the POST-period. Probable or proven fungal infections were similar in both groups (54.1% vs. 57.1%; p = 0.67). The determination of BDG contributed to improved management in 75 of 112 patients (66.9%). The AF adequacy score improved in the POST-period (mean 7.75 vs. 9.29; p < 0.001). Median days of empiric AF treatment was reduced in the POST-period (9 vs. 5 days, p = 0.04). All-cause mortality (44.7% vs. 34.8%; p = 0.16) was similar in both periods. The cost of AF treatments was reduced in the POST-period with a difference of 779.6 €/patient. Our data suggest that the use of BDG was a cost-effective strategy that contributed to safely improving the results of an ASP for SOT and oncologic patients.

Rashes associated with transplantations

2020 ◽  
pp. 535-538
Keyword(s):  
Fungal Infections ◽  
Solid Organ Transplantation ◽  
Organ Transplant ◽  
Solid Organ Transplant ◽  
Host Immunity ◽  
Solid Organ ◽  
Graft Versus Host ◽  
Gingival Hypertrophy ◽  
Life Threatening ◽  
Transplant Complications

Dermatological manifestations following transplantation are common but important to recognize and diagnose since they may be severe and life-threatening if not adequately and promptly treated. This chapter provides a systematic overview of the types of skin disease that may be encountered in children that have received a haematological or solid organ transplant. Complications relating to immunosuppression include an increased susceptibility to bacterial, viral, and fungal infections which may be significantly more virulent and hazardous in the context of reduced host immunity. Immune suppressant drugs may also cause drug rashes and aesthetic complications such as acne, hypertrichosis, or gingival hypertrophy, as well as longer-term risks from the development of malignancy. It is also important to recognize the range of mucocutaneous signs of acute and chronic graft versus host disease following bone marrow and solid organ transplantation which, again, may be severe and associated with significant morbidity and mortality.

scholarly journals Superficial and deep cutaneous fungal infections in solid organ transplant recipients

2016 ◽  
Vol 4 ◽  
pp. 259-272
Author(s):  
Berenika Olszewska ◽  
Beata Imko-Walczuk ◽  
Roman Nowicki ◽  
Alicja Dębska-Ślizień ◽  
Aleksandra Wilkowska ◽  
...  
Keyword(s):  
Fungal Infections ◽  
Organ Transplant ◽  
Solid Organ Transplant ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Organ Transplant Recipients ◽  
Solid Organ Transplant Recipients
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