Fungal Infections in Kidney Transplant Recipients: A Comprehensive Narrative Review
Background: Despite kidney transplantation being a life-saving procedure, patients experience a high risk of developing fungal infections (FIs), with an increased risk of both morbidity and mortality, especially during the first year after transplant. Methods: We herein conducted a narrative review...
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MDPI AG
2025-01-01
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| author | Maria Mazzitelli Federico Nalesso Alberto Enrico Maraolo Vincenzo Scaglione Lucrezia Furian Annamaria Cattelan |
| author_facet | Maria Mazzitelli Federico Nalesso Alberto Enrico Maraolo Vincenzo Scaglione Lucrezia Furian Annamaria Cattelan |
| author_sort | Maria Mazzitelli |
| collection | DOAJ |
| description | Background: Despite kidney transplantation being a life-saving procedure, patients experience a high risk of developing fungal infections (FIs), with an increased risk of both morbidity and mortality, especially during the first year after transplant. Methods: We herein conducted a narrative review of the most common FIs in kidney transplant recipients (KTRs), with a focus on prevalence, risk factors, mortality, and prevention strategies. Results: The most common fungal pathogens in KTRs include <i>Candida</i> species (up to 70% of the overall FIs), <i>Aspergillus</i> species, <i>Pneumocystis jiroveci</i>, and <i>Cryptococcus</i> species. Fungal colonization, diabetes mellitus, chronic liver disease, malnutrition, and pre-existing lung conditions should all be acknowledged as possible predisposing risk factors. The mortality rate can vary from 25 to 50% and according to different settings and the types of FIs. Preventive strategies are critical for reducing the incidence of FIs in this population. These include antifungal prophylaxis, environmental precautions, and infection control measures. The use of novel tools (such as PCR-based molecular assays and NGS) for rapid and accurate diagnosis may play an important role. Conclusions: Early recognition, the appropriate use of antifungal therapy, and preventive strategies are essential for improving graft loss and fatal outcomes in this vulnerable population. Future research is needed to optimize diagnostic tools, identify novel antifungal agents, and develop better prophylactic strategies for high-risk transplant recipients. |
| format | Article |
| id | doaj-art-d95e6212caa94febae7b1007517aa12f |
| institution | Kabale University |
| issn | 2076-2607 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | MDPI AG |
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| series | Microorganisms |
| spelling | doaj-art-d95e6212caa94febae7b1007517aa12f2025-01-24T13:43:03ZengMDPI AGMicroorganisms2076-26072025-01-0113120710.3390/microorganisms13010207Fungal Infections in Kidney Transplant Recipients: A Comprehensive Narrative ReviewMaria Mazzitelli0Federico Nalesso1Alberto Enrico Maraolo2Vincenzo Scaglione3Lucrezia Furian4Annamaria Cattelan5Infectious and Tropical Diseases Unit, Padua University Hospital, 35128 Padua, ItalyNephrology, Dialysis and Transplantation Unit, Department of Medicine, University of Padova, 35128 Padova, ItalySection of Infectious Diseases, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, 80131 Naples, ItalyInfectious and Tropical Diseases Unit, Padua University Hospital, 35128 Padua, ItalyKidney and Pancreas Transplantation Unit, Padua University Hospital, 35128 Padua, ItalyInfectious and Tropical Diseases Unit, Padua University Hospital, 35128 Padua, ItalyBackground: Despite kidney transplantation being a life-saving procedure, patients experience a high risk of developing fungal infections (FIs), with an increased risk of both morbidity and mortality, especially during the first year after transplant. Methods: We herein conducted a narrative review of the most common FIs in kidney transplant recipients (KTRs), with a focus on prevalence, risk factors, mortality, and prevention strategies. Results: The most common fungal pathogens in KTRs include <i>Candida</i> species (up to 70% of the overall FIs), <i>Aspergillus</i> species, <i>Pneumocystis jiroveci</i>, and <i>Cryptococcus</i> species. Fungal colonization, diabetes mellitus, chronic liver disease, malnutrition, and pre-existing lung conditions should all be acknowledged as possible predisposing risk factors. The mortality rate can vary from 25 to 50% and according to different settings and the types of FIs. Preventive strategies are critical for reducing the incidence of FIs in this population. These include antifungal prophylaxis, environmental precautions, and infection control measures. The use of novel tools (such as PCR-based molecular assays and NGS) for rapid and accurate diagnosis may play an important role. Conclusions: Early recognition, the appropriate use of antifungal therapy, and preventive strategies are essential for improving graft loss and fatal outcomes in this vulnerable population. Future research is needed to optimize diagnostic tools, identify novel antifungal agents, and develop better prophylactic strategies for high-risk transplant recipients.https://www.mdpi.com/2076-2607/13/1/207fungal infection<i>Candida</i><i>Aspergillus</i><i>Pneumocystis</i>kidney transplantkidney transplant recipients |
| spellingShingle | Maria Mazzitelli Federico Nalesso Alberto Enrico Maraolo Vincenzo Scaglione Lucrezia Furian Annamaria Cattelan Fungal Infections in Kidney Transplant Recipients: A Comprehensive Narrative Review Microorganisms fungal infection <i>Candida</i> <i>Aspergillus</i> <i>Pneumocystis</i> kidney transplant kidney transplant recipients |
| title | Fungal Infections in Kidney Transplant Recipients: A Comprehensive Narrative Review |
| title_full | Fungal Infections in Kidney Transplant Recipients: A Comprehensive Narrative Review |
| title_fullStr | Fungal Infections in Kidney Transplant Recipients: A Comprehensive Narrative Review |
| title_full_unstemmed | Fungal Infections in Kidney Transplant Recipients: A Comprehensive Narrative Review |
| title_short | Fungal Infections in Kidney Transplant Recipients: A Comprehensive Narrative Review |
| title_sort | fungal infections in kidney transplant recipients a comprehensive narrative review |
| topic | fungal infection <i>Candida</i> <i>Aspergillus</i> <i>Pneumocystis</i> kidney transplant kidney transplant recipients |
| url | https://www.mdpi.com/2076-2607/13/1/207 |
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