JI Xueª²Wen, L¦a Yi, MA Feng, YU Liang, LIU Chang, WU Zheng

    Department of Hepatobiliary Surgery, First Affiliated Hospital, Medical College, Xi¬ðan Jiaotong University, Xi¬ðan 710061, China

    ¡¾Abstract¡¿ AIM: To study the fungal spectrum and high risk factors associated with fungal infection in the intensive care unit (ICU) after orthotopic liver transplantation (OLTx). METHODS: One hundred and two consecutive OLTx in 100 recipients performed from November 2000 to January 2006 were included in the study. Their preª²surgical, surgical and postª²surgical variables were retrospectively evaluated using multivariate logistic regression model to identify the significant risk factors. RESULTS: The mean ICU stay was 11.0 d (7-23 d). Out of the 102 OLTx, 16 (16%) developed 29 positive cultures in our ICU and the mean time interval from transplantation to the deveª²lopment of fungal infection was 11.8 d (6-18 d). The most common pathogen was Candida albicans (75%) and the common primary sites were the lungs (73%) and blood (19%). The risk factors for fungal infections included preoperative UNOS status, postoperative detained central venous catheter and other infective complications. CONCLUSION: Fungal infections are a major complication in ICU following OLTx, with Candida albicans being the most common pathogen. Surveillance for the high risk factors and earlier antifungal prophylactic treatment is the key to decrease the incidence of postoperative fungal infections. ......