Abstract

The aim of the study was to elaborate diagnostic protocol scheme lowering the
risk of mycotic invasive infection in allotransplant recipients and to propose
introduction of pre-operative prophylaxis and/or empirical therapy.
Material/Methods: The following clinical samples were examined: blood samples, swabs taken from mouth lesions, throat swabs, rectal swabs, sputum, urine and faecal samples taken from a chosen group of kidney transplant recipients (KTx) and simultaneous pancreas and kidney transplantation (SPKTx) recipients highly predisposed to mycotic infections, which were treated in Hospital - Lindley'a Campus at Warsaw Medical University between 2003 and 2006. Conventional fungal laboratory diagnosis, enzymatic activity tests, serological tests, molecular diagnosis of samples taken from the sterile body sites and histopathological examinations were used.
Results: A group of 268 allograft recipients either with transient or constant yeast colonisation or with confirmed yeast infection was chosen. There were 7744 clinical samples analysed and among them 475 were positive for fungi. Microbiologic criteria of diagnosing systemic mycosis and principles of distinction between colonization and infection were established.
Conclusions: Prophylaxis and/or empirical therapy, culture-guided therapy was elaborated. To introduce this in clinical practice the quality and effectiveness were evaluated (including costs of diagnosis and treatment).

Keywords: fungal infections