Başkent Üniversitesi Yayınları

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Author: search.filters.author.Kordbacheh, Parivash

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    Invasive Fungal Infection in Renal Transplant Recipients Demonstrated by Panfungal Polymerase Chain Reaction
    (Başkent Üniversitesi, 2007-06) Badiee, Parisa; Kordbacheh, Parivash; Alborzi, Abdolvahab; Malekhoseini, Seyed Ali
    Objectives: Invasive fungal infections following renal transplant are associated with high morbidity and mortality rates. This study reports our experience using molecular assay to diagnose invasive fungal infections in renal graft recipients. Patients and Methods: One hundred twenty patients who had undergone renal transplant at the Organ Transplant Unit of Nemazi Hospital in Shiraz, Iran, between September 2004 and January 2006 were followed up for fungal infections for 6 months following transplant. Blood samples were cultured by bedside inoculation to BACTEC fungal medium. Whole blood specimens were collected prospectively once per week and were evaluated for any invasive fungal infections using panfungal polymerase chain reaction and polymerase chain reaction–enzyme-linked immunosorbent assay. The female-to-male ratio was 44.2% to 55.8%, the mean age of the recipients was 34.7 years, and the mean length of hospitalization was 10.92 days. Results: The sensitivity and specificity for proven and probable infections were 80% and 95.6%, respectively. Using panfungal polymerase chain reaction– enzyme-linked immunosorbent assay, 4 recipients were diagnosed as having invasive fungal infections. The etiologic agents were C. albicans in 3 patients, and C. albicans and A. fumigatus in 1 patient. The mean interval of polymerase chain reaction–enzyme-linked immunosorbent assay positivity in blood samples before clinical signs was 27 days (range, 7-60 days). Conclusions: Polymerase chain reaction–enzyme-linked immunosorbent assay may improve early diagnosis of invasive fungal infections; however, correlating the results of polymerase chain reaction–enzyme-linked immunosorbent assay with clinical outcomes in renal transplant recipients will require further evaluation.
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    Fungal Infections in Solid Organ Recipients
    (Başkent Üniversitesi, 2005-12) Badiee, Parisa; Kordbacheh, Parivash; Alborzi, Abdolvahab; Zeini, Farideh; Mirhendy, Hossein; Mahmoody, Mahmood
    Background: Fungal infections are a major cause of morbidity and mortality after organ transplantation. The incidence of these infections has increased considerably over the last decade. Objectives: The aim of this study was to evaluate the incidence of fungal infections, to identify the most common fungal pathogens, and to determine the associated risk factors in solid organ recipients. Methods: One hundred twenty renal and 50 liver recipients were transplanted at the organ transplant unit of Nemazi Hospital in Shiraz, Iran, from September 2004 to August 2005 and were followed for fungal infections for at least 6 months. On admission to the hospital, all patients were evaluated for fungal colonization by mouth, vagina, urine, and rectal swabs cultured in Sabouraud Dextrose Agar. Samples of sputum, bronchoalveolar lavage, urine, cerebrospinal fluid (CSF), pleural tap, and tissue biopsy were evaluated by direct microscopic examination and were cultured for any clinical signs of fungal infections. Results: Fifty-four kidney recipients (45%) had Candida colonization in different sites of their bodies. Fungal infections presented in 13 of 120 recipients (10.8%). Five recipients had invasive fungal infections (3 had fungal pneumonitis and 2 had severe esophagitis), and 8 patients had cutaneous and mucocutaneous infections. All of the recipients with invasive fungal infections were colonized with Candida, and 2 of them died. Forty-two (84%) liver recipients had Candida colonization in different sites of their bodies. Fungal infections presented in 6 liver recipients. In 4 patients, invasive fungal infections occurred (2 fungal pneumonitis, 1 meningitis, and 1 severe esophagitis), 2 patients showed mucocutaneous infections. Three recipients with invasive fungal infections had Candida colonization. The mean time to diagnosis was 70 days after transplantation. The most common etiologic agent for fungal infections was Candida albicans. Conclusions: Renal and liver recipients with Candida colonization are at high risk for fungal infections and therefore, control of fungal colonization in liver and renal transplant candidates would reduce the risk of invasive fungal infections after transplantation.