Prospective Surveillance for Invasive Fungal Infections in Hematopoietic Stem Cell Transplant Recipients, 2001–2006: Overview of the Transplant-Associated Infection Surveillance Network (TRANSNET) Database

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

doi:10.1086/651263

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Prospective Surveillance for Invasive Fungal Infections in Hematopoietic Stem Cell Transplant Recipients, 2001–2006: Overview of the Transplant-Associated Infection Surveillance Network (TRANSNET) Database

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Prospective Surveillance for Invasive Fungal Infections in Hematopoietic Stem Cell Transplant Recipients, 2001–2006: Overview of the Transplant-Associated Infection Surveillance Network (TRANSNET) Database

Thomas J Walsh, Loreen A Herwaldt, Dimitrios P Kontoyiannis, Kieren A Marr, Benjamin J Park, Barbara D Alexander, Elias J Anaissie, James Ito, David R Andes, John W Baddley, …

Clinical infectious diseases, Vol.50(8), pp.1091-1100

04/15/2010

DOI: 10.1086/651263

PMID: 20218877

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Abstract

Background. The incidence and epidemiology of invasive fungal infections (IFIs), a leading cause of death among hematopoeitic stem cell transplant (HSCT) recipients, are derived mainly from single-institution retrospective studies. Methods. The Transplant Associated Infections Surveillance Network, a network of 23 US transplant centers, prospectively enrolled HSCT recipients with proven and probable IFIs occurring between March 2001 and March 2006. We collected denominator data on all HSCTs preformed at each site and clinical, diagnostic, and outcome information for each IFI case. To estimate trends in IFI, we calculated the 12-month cumulative incidence among 9 sequential subcohorts. Results. We identified 983 IFIs among 875 HSCT recipients. The median age of the patients was 49 years; 60% were male. Invasive aspergillosis (43%), invasive candidiasis (28%), and zygomycosis (8%) were the most common IFIs. Fifty-nine percent and 61% of IFIs were recognized within 60 days of neutropenia and graft-versushost disease, respectively. Median onset of candidiasis and aspergillosis after HSCT was 61 days and 99 days, respectively. Within a cohort of 16,200 HSCT recipients who received their first transplants between March 2001 and September 2005 and were followed up through March 2006, we identified 718 IFIs in 639 persons. Twelvemonth cumulative incidences, based on the first IFI, were 7.7 cases per 100 transplants for matched unrelated allogeneic, 8.1 cases per 100 transplants for mismatched-related allogeneic, 5.8 cases per 100 transplants for matchedrelated allogeneic, and 1.2 cases per 100 transplants for autologous HSCT. Conclusions. In this national prospective surveillance study of IFIs in HSCT recipients, the cumulative incidence was highest for aspergillosis, followed by candidiasis. Understanding the epidemiologic trends and burden of IFIs may lead to improved management strategies and study design.

Details

Title: Subtitle: Prospective Surveillance for Invasive Fungal Infections in Hematopoietic Stem Cell Transplant Recipients, 2001–2006: Overview of the Transplant-Associated Infection Surveillance Network (TRANSNET) Database
Creators: Thomas J Walsh - National Cancer Institute, NationalInstitutes of Health, Bethesda, Maryland
Loreen A Herwaldt - University of Iowa Carver College of Medicine, Iowa City
Dimitrios P Kontoyiannis - The University of Texas MD Anderson Cancer Center, Houston
Kieren A Marr - Fred Hutchinson Cancer Research Center, Seattle, Washington
Benjamin J Park - Mycotic Diseases Branch, Center for Diseases Control and Prevention, Atlanta, Georgia
Barbara D Alexander - Duke University Medical Center, Durham, North Carolina
Elias J Anaissie - The University of Arkansas for Medical Sciences, Little Rock
James Ito - City of Hope Hospital, Duarte
David R Andes - University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
John W Baddley - University of Alabama at Birmingham, Birmingham
Janice M Brown - Stanford University Medical Center, Palo Alto, California
Lisa M Brumble - Mayo Clinic, Jacksonville
Alison G Freifeld - University of Nebraska Medical Center, Omaha, Nebraska
Susan Hadley - Tufts Medical Center, Boston, Massachusetts
Carol A Kauffman - University of Michigan, Ann Arbor Veterans Affairs Health Care System, Ann Arbor
Katherine Knapp - St. Jude Children's Research Hospital, Memphis, Tennessee
G. Marshall Lyon - Emory University Medical Center, Atlanta, Georgia
Vicki A Morrison - University of Minnesota and Minneapolis Veterans Affairs Medical Center, Minneapolis, Minnesota
Genovefa Papanicolaou - Memorial Sloan Kettering Caner Center, New York, New York
Thomas F Patterson - University of Texas Health Science Center, San Antonio
Trish M Perl - Johns Hopkins University, Baltimore
Mindy G Schuster - University of Pennsylvania, Philadelphia
Randall Walker - Mayo Clinic and Mayo Clinic College of Medicine, Rochester
Kathleen A Wannemuehler - Mycotic Diseases Branch, Center for Diseases Control and Prevention, Atlanta, Georgia
John R Wingard - University of Florida, Gainesville, Florida
Tom M Chiller - Mycotic Diseases Branch, Center for Diseases Control and Prevention, Atlanta, Georgia
Peter G Pappas - University of Alabama at Birmingham, Birmingham
Resource Type: Journal article
Publication Details: Clinical infectious diseases, Vol.50(8), pp.1091-1100
DOI: 10.1086/651263
PMID: 20218877
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: 9984094745402771

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