Epidemiology and outcome of invasive fungal infections in solid organ transplant recipients

• Published in: Transplant infectious disease 2010-06, Vol.12 (3), p.220-229
• Main Authors: Neofytos, D., Fishman, J.A., Horn, D., Anaissie, E., Chang, C.-H., Olyaei, A., Pfaller, M., Steinbach, W.J., Webster, K.M., Marr, K.A.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Antifungal Agents - administration & dosage; Antifungal Agents - therapeutic use; Aspergillosis - drug therapy; Aspergillosis - epidemiology; Aspergillosis - microbiology; Aspergillosis - mortality; Aspergillus; Aspergillus - drug effects; Aspergillus - isolation & purification; Candida; Candida - drug effects; Candida - isolation & purification; Candidiasis - drug therapy; Candidiasis - epidemiology; Candidiasis - microbiology; Candidiasis - mortality; Cryptococcosis - drug therapy; Cryptococcosis - epidemiology; Cryptococcosis - microbiology; Cryptococcosis - mortality; Cryptococcus - drug effects; Cryptococcus - isolation & purification; Epidemiology; Female; Horns; Humans; Infection; invasive aspergillosis; invasive candidiasis; invasive fungal infection; Male; Middle Aged; Mycoses - drug therapy; Mycoses - epidemiology; Mycoses - microbiology; Mycoses - mortality; Organ Transplantation - adverse effects; outcomes; solid organ transplant; Survival Rate; Time Factors; Treatment Outcome; United States - epidemiology; Young Adult
• ISSN: 1398-2273; 1399-3062
• DOI: 10.1111/j.1399-3062.2010.00492.x

D. Neofytos, J.A. Fishman, D. Horn, E. Anaissie, C.‐H. Chang, A. Olyaei, M. Pfaller, W.J. Steinbach, K.M. Webster, K.A. Marr. Epidemiology and outcome of invasive fungal infections in solid organ transplant recipients.
Transpl Infect Dis 2010: 12: 220–229. All rights reserved : Contemporary epidemiology and outcomes of invasive fungal infections (IFIs) in solid organ transplant (SOT) recipients are not well described. From March 2004 through September 2007, proven and probable IFIs were prospectively identified in 17 transplant centers in the United States. A total 429 adult SOT recipients with 515 IFIs were identified; 362 patients received a single and 67 patients received ≥2 organs. Most IFIs were caused by Candida species (59.0%), followed by Aspergillus species (24.8%), Cryptococcus species (7.0%), and other molds (5.8%). Invasive candidiasis (IC) was the most frequently observed IFI in all groups, except for lung recipients where invasive aspergillosis (IA) was the most common IFI (P1 year post transplant. Overall 12‐week mortality was 29.6%; liver recipients had the highest mortality (P=0.05). Organ damage, neutropenia, and administration of corticosteroids were predictors of death. These results extend our knowledge on the epidemiology of IFI in SOT recipients, emphasizing the occurrence of IC early after non‐lung transplant, and late complications with molds after lung transplant. Overall survival appears to have improved compared with historical reports.