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<title lang=en>Evidence that graft-site candidiasis after kidney transplantation is acquired during organ recovery: a multicenter study in France.</title>
<creator>Albano, Laetitia</creator>
<creator>Bretagne, Stéphane</creator>
<creator>Mamzer-Bruneel, Marie-France</creator>
<creator>Kacso, Irina</creator>
<creator>Desnos-Ollivier, Marie</creator>
<creator>Guerrini, Patrice</creator>
<creator>Le Luong, Thanh</creator>
<creator>Cassuto, Elisabeth</creator>
<creator>Dromer, Françoise</creator>
<creator>Lortholary, Olivier</creator>
<creator>Gangneux, Jean-Pierre</creator>
<contributor>Service de néphrologie ; Hôpital Pasteur Nice</contributor>
<contributor>Service de parasitologie [Mondor] ; Assistance publique - Hôpitaux de Paris (AP-HP) - Hôpital Henri Mondor - Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)</contributor>
<contributor>Mycologie Moléculaire ; CNRS - Institut Pasteur de Paris</contributor>
<contributor>Service de néphrologie adultes ; Assistance publique - Hôpitaux de Paris (AP-HP) - Hôpital Necker - Enfants Malades - Université Paris Descartes - Paris 5 (UPD5)</contributor>
<contributor>Agence de la Biomédecine ; Agence de la biomédecine</contributor>
<contributor>Service de transplantation ; Hospices Civils de Lyon - Hôpital Edouard Herriot</contributor>
<contributor>Service des maladies infectieuses et tropicales ; Assistance publique - Hôpitaux de Paris (AP-HP) - Hôpital Necker - Enfants Malades - Université Paris Descartes - Paris 5 (UPD5) - Centre d'infectiologie Necker-Pasteur</contributor>
<contributor>Signalisation et Réponses aux Agents Infectieux et Chimiques (SeRAIC) ; Université de Rennes 1 (UR1) - Institut de recherche, santé, environnement et travail [Rennes] (Irset) ; INSERM - École Nationale de la Santé Publique - Université de Rennes 1 (UR1) - Université des Antilles et de la Guyane (UAG) - Structure Fédérative de Recherche en Biologie-Santé de Rennes (Biosit) ; Université de Rennes 1 (UR1) - INSERM - CNRS - INSERM - CNRS - INSERM - École Nationale de la Santé Publique - Université de Rennes 1 (UR1) - Université des Antilles et de la Guyane (UAG) - Structure Fédérative de Recherche en Biologie-Santé de Rennes (Biosit) ; Université de Rennes 1 (UR1) - INSERM - CNRS - INSERM - CNRS - IFR140</contributor>
<contributor>Service de Parasitologie-Mycologie [Rennes] ; Hôpital Pontchaillou - Université de Rennes 1 (UR1) - CHU Rennes</contributor>
<description>International audience</description>
<source>Clinical Infectious Diseases</source>
<publisher>Oxford University Press (OUP): Policy A1 - Oxford Open Option C</publisher>
<identifier>hal-00676313</identifier>
<identifier>https://hal.archives-ouvertes.fr/hal-00676313</identifier>
<source>https://hal.archives-ouvertes.fr/hal-00676313</source>
<source>Clinical Infectious Diseases, Oxford University Press (OUP): Policy A1 - Oxford Open Option C, 2009, 48 (2), pp.194-202. <10.1086/595688></source>
<identifier>DOI : 10.1086/595688</identifier>
<identifier>PUBMED : 19090753</identifier>
<language>en</language>
<subject>[SDV.MP] Life Sciences/Microbiology and Parasitology</subject>
<type>Journal articles</type>
<description lang=en>BACKGROUND: Infections of renal grafts with Candida species can induce life-threatening complications in the recipient. METHODS: A 9-year retrospective study involving all of the transplant centers in France was designed to determine the incidence, origin, characteristics, and outcome of graft-site candidiasis that occurred after kidney transplantation. Yeasts cultured from preservation or drainage solutions and graft specimens were recorded. RESULTS: Among 18,617 kidney grafts, 18 recipients corresponding to 12 donors developed culture-confirmed graft-site candidiasis (incidence, 1 case per 1000 grafts) a median of 25 days after the graft procedure. Clinical presentations included 14 cases of renal arteritis (13 were complicated by aneurysm), 1 urinoma, 2 graft site abscesses, and 1 surgical site infection. Candida albicans was involved in 13 cases. A unique C. albicans genotype or a single rare Candida species was involved in each episode. Together with the clinical history, these findings demonstrate that organ contamination followed by transmission to the recipient occurred during recovery. Therapeutic management varied from simple monitoring in 1 case to a combination of surgery (nephrectomy in 9 cases and arterial bypass in 9 cases) and antifungal therapy (14 cases). Overall, 3 of 18 kidney transplant recipients died, and 9 had their graft surgically removed. CONCLUSION: Graft-transmitted candidiasis that ends most often in fungal arteritis is associated with high morbidity and mortality after kidney transplantation and is related to organ contamination during recovery in the donor.</description>
<date>2009-01-15</date>
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