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Candida Infections in Solid Organ Transplantation

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Emerging Transplant Infections

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Abstract

Candida remains a common infectious complication in the setting of solid organ transplantation. The rates of invasive Candida infection vary among organ transplant, with small bowel accounting for the majority of cases. In this chapter, we review the epidemiology of Candida infections following organ transplantation. While C. albicans continues to be the most common fungal species isolated, more recent data show that non-albicans Candida species are on the rise, specifically drug-resistant C. glabrata. These non-albicans Candida species are associated with an increase in mortality compared to C. albicans. In addition, we examine the available tools for the diagnosis of invasive Candida infections, including traditional culture techniques, fungal cell wall markers, antibody serologies, and more efficient approaches using nucleic acid-based detection. A special section discusses the emergence of the highly drug-resistant fungal pandemic agent, C. auris. That said, improved surgical technique, patient-specific chemoprophylaxis, and early use of anti-fungal agents have resulted in decreased mortality due to Candida infection. Therapeutic drug monitoring of specific agents is reviewed. Finally, future consideration for more rapid diagnostics and a personalized approach to risk stratification and identification of those individuals who would benefit the most from pre-emptive strategies following transplantation are discussed.

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Authors and Affiliations

  1. Division of Infectious Diseases, Indiana University School of Medicine, Indianapolis, IN, USA

    Nicolas Barros

  2. Transplant Infectious Diseases and Immunocompromised Host Service, Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA, USA

    Michael K. Mansour

  3. Department of Medicine, Harvard Medical School, Boston, MA, USA

    Michael K. Mansour

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  1. Nicolas Barros
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  2. Michael K. Mansour
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Correspondence to Michael K. Mansour .

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Editors and Affiliations

  1. Miller School of Medicine, University of Miami, Miami, FL, USA

    Michele I. Morris

  2. Massachusetts General Hospital, Harvard University, Boston, MA, USA

    Camille Nelson Kotton

  3. Duke University, Durham, NC, USA

    Cameron Wolfe

Section Editor information

  1. Department of Medicine, Harvard Medical School, Boston, MA, USA

    Camille Nelson Kotton

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Barros, N., Mansour, M.K. (2020). Candida Infections in Solid Organ Transplantation. In: Morris, M.I., Kotton, C.N., Wolfe, C. (eds) Emerging Transplant Infections. Springer, Cham. https://doi.org/10.1007/978-3-030-01751-4_43-1

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