{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T02:56:29Z","timestamp":1792032989432,"version":"4.4.0"},"reference-count":19,"publisher":"American Society for Microbiology","issue":"3","license":[{"start":{"date-parts":[[2024,3,6]],"date-time":"2024-03-06T00:00:00Z","timestamp":1709683200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,3,6]],"date-time":"2024-03-06T00:00:00Z","timestamp":1709683200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"published-print":{"date-parts":[[2024,3,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:sec>\n            <jats:title\/>\n            <jats:p>\n              Invasive primary\n              <jats:italic>Candida<\/jats:italic>\n              surgical site infections (IP-SSIs) are a common complication of liver transplantation, and targeted antifungal prophylaxis is an efficient strategy to limit their occurrence. We performed a retrospective single-center cohort study among adult single liver transplant recipients at Duke University Hospital in the period between 1 January 2015 and 31 December 2020. The study aimed to determine the rate of\n              <jats:italic>Candida<\/jats:italic>\n              IP-SSI according to the peri-transplant antifungal prophylaxis received. Of 470 adult single liver transplant recipients, 53 (11.3%) received micafungin prophylaxis, 100 (21.3%) received fluconazole prophylaxis, and 317 (67.4%) did not receive systemic antifungal prophylaxis in the peri-transplant period. Ten\n              <jats:italic>Candida<\/jats:italic>\n              IP-SSIs occurred among 5 of 53 (9.4%) micafungin recipients, 1 of 100 (1.0%) fluconazole recipients, and 4 of 317 (1.3%) recipients who did not receive antifungal prophylaxis. Our study highlights the limitations of antifungal prophylaxis in preventing invasive\n              <jats:italic>Candida<\/jats:italic>\n              IP-SSI after liver transplant surgery. We hypothesize that pathogen, host, and pharmacokinetic-related factors contributed to the occurrence of\n              <jats:italic>Candida<\/jats:italic>\n              IP-SSI despite antifungal prophylaxis. Our study reinforces the need for a risk-based, multi-pronged approach to fungal prevention, including targeted antifungal administration in patients with risks for invasive candidiasis and close monitoring, especially among patients with surgically complex procedures, with timely control of surgical leaks.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1128\/aac.01279-23","type":"journal-article","created":{"date-parts":[[2024,2,1]],"date-time":"2024-02-01T14:01:18Z","timestamp":1706796078000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":8,"title":["Limitations of antifungal prophylaxis in preventing invasive\n            <i>Candida<\/i>\n            surgical site infections after liver transplant surgery"],"prefix":"10.1128","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3187-5905","authenticated-orcid":false,"given":"M.","family":"Carugati","sequence":"first","affiliation":[{"name":"Department of Medicine, Division of Infectious Diseases, Duke University, Durham, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Arif","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Infectious Diseases, Duke University, Durham, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. E.","family":"Yarrington","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Infectious Diseases, Duke University, Durham, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. Y.","family":"King","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Gastroenterology, Duke University, Durham, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Harris","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Duke University, Durham, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Evans","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Duke University, Durham, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. S.","family":"Barbas","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Abdominal Transplant Surgery, Duke University, Durham, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. L.","family":"Sudan","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Abdominal Transplant Surgery, Duke University, Durham, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. R.","family":"Perfect","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Infectious Diseases, Duke University, Durham, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. A.","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Infectious Diseases, Duke University, Durham, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B. D.","family":"Alexander","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Infectious Diseases, Duke University, Durham, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/tid.12613"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.13623"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciz156"},{"key":"e_1_3_2_5_2","unstructured":"Surgical site infection event. CDC-NHSN Website. Available from: https:\/\/www.cdc.gov\/nhsn\/pdfs\/pscmanual\/9pscssicurrent.pdf. Accessed 01 March 2021"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.17189"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.02390-09"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cit136"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/myc.12960"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0153247"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000001356"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00621-11"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10156-011-0240-3"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkv173"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01009-17"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.02326-17"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.12963"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1002\/lt.24391"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.3390\/jof9020272"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciu1128"}],"container-title":["Antimicrobial Agents and Chemotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/aac.01279-23","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/aac.01279-23","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,6]],"date-time":"2024-03-06T14:02:57Z","timestamp":1709733777000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.asm.org\/doi\/10.1128\/aac.01279-23"}},"subtitle":[],"editor":[{"given":"Andreas H.","family":"Groll","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2024,3,6]]},"references-count":19,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2024,3,6]]}},"alternative-id":["10.1128\/aac.01279-23"],"URL":"https:\/\/doi.org\/10.1128\/aac.01279-23","relation":{},"ISSN":["0066-4804","1098-6596"],"issn-type":[{"value":"0066-4804","type":"print"},{"value":"1098-6596","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,6]]},"assertion":[{"value":"2023-10-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-06","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-02-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e01279-23"}}