Fungal infections are serious complications after solid organ transplantation, with high mortality and morbidity. Given the importance of the local epidemiological data and also extensive prophylactic regimens in solid organ transplant (SOT) recipients, this study aimed to investigate the clinical characteristics and resistance patterns of yeast isolates in SOT recipients at a main referral transplant center in Iran. Of the 275 recipients enrolled, 22 (8%) had at least one positive yeast culture at a median of 5 days after transplantation. Bacterial infection and reoperation were significantly associated with colonization or infection caused by yeast species (P = .001). Moreover, mortality and length of ICU/hospital stay were significantly higher in patients with positive yeast cultures (P < .05). The most frequent species isolated was Candida albicans (50%), followed by C. glabrata (22.7%). Of species with definite breakpoints, the fluconazole-resistant rate was 23%. Caspofungin and amphotericin B showed potent activity against all isolates. Regarding the high risk of fungal infections, awareness of local epidemiological trends and resistance patterns can help improve outcomes in SOT recipients.
Keywords: Candida; Pichia manshurica; antifungal susceptibility; fungal infections; solid organ transplantation.
Our study on solid organ transplant recipients showed significant differences in clinical outcomes between those with and without positive yeast cultures. We identified rare yeast species with high fluconazole MIC values, including Meyerozyma caribbica and Pichia manshurica.
© The Author(s) 2024. Published by Oxford University Press on behalf of The International Society for Human and Animal Mycology.