Invasive Fungal Infections among Organ Transplant Recipients: Results of the Transplant-Associated Infection Surveillance Network (TRANSNET)

Loreen Herwaldt; Peter G Pappas; Barbara D Alexander; Thomas J Walsh; David R Andes; Susan Hadley; Carol A Kauffman; Alison Freifeld; Elias J Anaissie; Lisa M Brumble; James Ito; Dimitrios P Kontoyiannis; G. Marshall Lyon; Kieren A Marr; Vicki A Morrison; Benjamin J Park; Thomas F Patterson; Trish M Perl; Robert A Oster; Mindy G Schuster; Randall Walker; Kathleen A Wannemuehler; Tom M Chiller

doi:10.1086/651262

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Invasive Fungal Infections among Organ Transplant Recipients: Results of the Transplant-Associated Infection Surveillance Network (TRANSNET)

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Invasive Fungal Infections among Organ Transplant Recipients: Results of the Transplant-Associated Infection Surveillance Network (TRANSNET)

Loreen Herwaldt, Peter G Pappas, Barbara D Alexander, Thomas J Walsh, David R Andes, Susan Hadley, Carol A Kauffman, Alison Freifeld, Elias J Anaissie, Lisa M Brumble, …

Clinical infectious diseases, Vol.50(8), pp.1101-1111

04/15/2010

DOI: 10.1086/651262

PMID: 20218876

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Abstract

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.

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Title: Subtitle: Invasive Fungal Infections among Organ Transplant Recipients: Results of the Transplant-Associated Infection Surveillance Network (TRANSNET)
Creators: Loreen Herwaldt - University of Iowa Hospital, Iowa City
Peter G Pappas - Divisions of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham Medical Center, Birmingham
Barbara D Alexander - Duke University Medical Center, Durham, North Carolina
Thomas J Walsh - National Cancer Institute, National Institutes of Health, Bethesda, Maryland
David R Andes - University of Wisconsin, Madison
Susan Hadley - Tufts Medical Center, Boston, Massachusetts
Carol A Kauffman - University of Michigan and Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan
Alison Freifeld - University of Nebraska Medical Center, Omaha
Elias J Anaissie - University of Arkansas for Medical Sciences, Little Rock
Lisa M Brumble - Mayo Clinic, Jacksonville, Florida
James Ito - City of Hope National Medical Center, Duarte, California
Dimitrios P Kontoyiannis - MD Anderson Cancer Center, Houston
G. Marshall Lyon - Emory University School of Medicine, Atlanta, Georgia
Kieren A Marr - Johns Hopkins University Medical Center, Baltimore, Maryland
Vicki A Morrison - University of Minnesota and Veterans Affairs Medical Center, Minneapolis
Benjamin J Park - Mycotic Diseases Branch, Centers for Diseases Control and Prevention, Atlanta, Georgia
Thomas F Patterson - University of Texas Health Sciences Center, South Texas Veterans Healthcare System, San Antonio, Texas
Trish M Perl - Johns Hopkins University Medical Center, Baltimore, Maryland
Robert A Oster - Preventive Medicine, Department of Medicine, University of Alabama at Birmingham Medical Center, Birmingham
Mindy G Schuster - Hospital of the University of Pennsylvania, Philadelphia
Randall Walker - Mayo Clinic, Rochester, Minnesota
Kathleen A Wannemuehler - Mycotic Diseases Branch, Centers for Diseases Control and Prevention, Atlanta, Georgia
Tom M Chiller - Mycotic Diseases Branch, Centers for Diseases Control and Prevention, Atlanta, Georgia
Resource Type: Journal article
Publication Details: Clinical infectious diseases, Vol.50(8), pp.1101-1111
DOI: 10.1086/651262
PMID: 20218876
NLM abbreviation: Clin Infect Dis
ISSN: 1058-4838
eISSN: 1537-6591
Publisher: The University of Chicago Press
Language: English
Date published: 04/15/2010
Academic Unit: Infectious Diseases; Epidemiology; Internal Medicine
Record Identifier: 9984094622002771

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