Epidemiology of invasive XXXX in lung transplant recipients on long-term azole antifungal prophylaxis.

@entity1 @entity2416 @entity364 @entity54 @entity358 @entity3
UNASSIGNED: Lung transplant recipients (LTR) at our institution receive prolonged and mostly lifelong azole antifungal (AF) prophylaxis. The impact of this prophylactic strategy on the epidemiology and outcome of invasive @entity364 (IFI) is unknown. This was a single-center, retrospective cohort study. We reviewed the medical records of all adult LTR from January 2002 to December 2011. Overall, 16.5% (15 of 91) of @entity1 who underwent lung transplantation during this time period developed IFI. Nineteen IFI episodes were identified (eight proven, 11 probable), 89% (17 of 19) of which developed during AF prophylaxis. LTR with @entity2416 were more likely to develop IFI (HR: 4.29; 95% CI: 1.15-15.91; p  =  0.03). A higher hazard of mortality was observed among those who developed IFI, although this was not statistically significant (hazard ratio [HR]: 1.71; 95% confidence interval [CI] [0.58-4.05]; p  =  0.27). @entity54 was the most common cause of IFI (45%), with @entity358 being the most common site of infection. None of our @entity1 developed disseminated @entity3 , @entity364 . IFI continue to occur in LTR, and the eradication of IFI appears to be challenging even with prolonged prophylaxis. Azole resistance is uncommon despite prolonged AF exposure.
