Invasive fungal infections among organ transplant recipients: results of the Transplant-Associated Infection Surveillance Network (TRANSNET).
By P. Pappas, B. Alexander, D. Andes, S. Hadley, C. Kauffman, A. Freifeld, E. Anaissie, L. Brumble, L. Herwaldt, J. Ito and 13 more. Clinical Infectious Diseases, 2010
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BACKGROUND Invasive fungal infections (IFIs) are a major cause of morbidity and mortality among organ transplant recipients. Multicenter prospective surveillance data to determine disease burden and secular trends are lacking. METHODS The Transplant-Associated Infection Surveillance Network (TRANSNET) is a consortium of 23 US transplant centers, including 15 that contributed to the organ transplant recipient dataset. We prospectively identified IFIs among organ transplant recipients from March, 2001 through March, 2006 at these sites. To explore trends, we calculated the 12-month cumulative incidence among 9 sequential cohorts. RESULTS During the surveillance period, 1208 IFIs were identified among 1063 organ transplant recipients. The most common IFIs were invasive candidiasis (53%), invasive aspergillosis (19%), cryptococcosis (8%), non-Aspergillus molds (8%), endemic fungi (5%), and zygomycosis (2%). Median time to onset of candidiasis, aspergillosis, and cryptococcosis was 103, 184, and 575 days, respectively. Among a cohort of 16,808 patients who underwent transplantation between March 2001 and September 2005 and were followed through March 2006, a total of 729 IFIs were reported among 633 persons. One-year cumulative incidences of the first IFI were 11.6%, 8.6%, 4.7%, 4.0%, 3.4%, and 1.3% for small bowel, lung, liver, heart, pancreas, and kidney transplant recipients, respectively. One-year incidence was highest for invasive candidiasis (1.95%) and aspergillosis (0.65%). Trend analysis showed a slight increase in cumulative incidence from 2002 to 2005. CONCLUSIONS We detected a slight increase in IFIs during the surveillance period. These data provide important insights into the timing and incidence of IFIs among organ transplant recipients, which can help to focus effective prevention and treatment strategies.
Subfields: Epidemiology, Infectious Diseases
View Paper: https://www.semanticscholar.org/paper/ca316030bdc0ea86734e97ec37e596325ced8e8a
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Citations in the corpus
- Global trends in the distribution of Candida species causing candidemia. (2014, neutral): “glabrata [32–34].”
- Aspergillus fumigatus and Aspergillosis in 2019 (2019, background): “IPA now predominantly manifests as a community-acquired pneumonia in nonneutropenic HSCT recipients late after engraftment (76), and it is associated with the use of corticosteroids and other immunosuppressive therapies for chronic graft-versus-host disease, metabolic abnormalities, acquired iron ov”
- Practice Guidelines for the Diagnosis and Management of Aspergillosis: 2016 Update by the Infectious Diseases Society of America. (2016, background): “Infections tend to occur both early after transplantation (first month) and late (mean approximately 184 days) [40, 43].”
- Zygomycosis in Europe: analysis of 230 cases accrued by the registry of the European Confederation of Medical Mycology (ECMM) Working Group on Zygomycosis between 2005 and 2007. (2011, background): “It mainly affects immunocompromized patients, such as those with haematological malignancies, recipients of haematopoietic stem cell (HSCT) [2] or solid organ transplants (SOT) [3], patients with diabetes mellitus and ketoacidosis [4,5], and infants with prematurity [6].”
- Infection in Organ Transplantation (2017, background): “Candida species Candidemia is most often an early posttransplant nosocomial infection associated with vascular access catheters, surgical drains, antimicrobial use, peripheral hyperalimentation, and diabetes (133).”