Mycoses in the transplanted patient

The incidence of invasive fungal infection (IFI) has increased considerably over the past 20 years, and transplant recipients are at especially high r isk for fungal infections owing to their overall immunosuppressed condition . Organ transplantation procedures were incorporated as a therapeutic optio n for many patients who lacked the normal functions of organs such as the h eart, liver, kidney, lung, pancreas and small bowel. The prevalence of IFI in solid organ transplant (SOTR) patients ranges from 5 to 50% in kidney an d liver transplants, respectively. In bone marrow transplant (BMT) patients , IFI are major causes of morbidity and mortality due to the protracted neu tropenic period and graft-versus-host disease. Candida spp. and Aspergillus spp. account for > 80% of fungal episodes in both SOTR and BMT. The develo pment of new immunosuppressive agents, new prophylaxis strategies (as pre-e mptive therapy) and the improvement in surgical techniques led to increase survival of transplant recipients. In this session, a clear and concise upd ate of the recent advances in the laboratory diagnosis of candidiasis and a spergillosis in this kind of patients was presented. However, we still need to establish more rapid, sensitive and specific methods for IFI diagnosis. Representatives of the 'Subcomision de Infecciones en el Paciente Neutrope nico y Transplantado (SIPNYT)' de la Sociedad Argentina de Infectologia (SA DI), presented the results of an unusual multicenter study both retrospecti ve and descriptive studies of IFI in SOTR and BMT patients in Argentina. In addition, a study of IFI in 1861 SOTR patients from four centers and the a nalysis of IFI in 2066 BMT patients from all 12 BMT centers from Argentina was presented. From these studies it can be concluded that 'all transplant recipients are not the same' and that they should be stratified according t o their different risk degrees in order to determine the best prophylaxis a nd treatment strategies.