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The epidemiology and outcomes of invasive Candida infections among organ transplant recipients in the United States: results of the Transplant‐Associated Infection Surveillance Network (TRANSNET)
Journal article   Open access   Peer reviewed

The epidemiology and outcomes of invasive Candida infections among organ transplant recipients in the United States: results of the Transplant‐Associated Infection Surveillance Network (TRANSNET)

David R Andes, Nasia Safdar, John W Baddley, Barbara Alexander, Lisa Brumble, Allison Freifeld, Susan Hadley, Loreen Herwaldt, Carol Kauffman, G. Marshall Lyon, …
Transplant infectious disease, Vol.18(6), pp.921-931
12/2016
DOI: 10.1111/tid.12613
PMID: 27643395
url
https://doi.org/10.1111/tid.12613View
Published (Version of record) Open Access

Abstract

Background Invasive candidiasis (IC) is a common cause of mortality in solid organ transplant recipients (OTRs), but knowledge of epidemiology in this population is limited. Method The present analysis describes data from 15 US centers that prospectively identified IC from nearly 17 000 OTRs. Analyses were undertaken to determine predictors of infection and mortality. Results A total of 639 cases of IC were identified. The most common species was Candida albicans (46.3%), followed by Candida glabrata (24.4%) and Candida parapsilosis (8.1%). In 68 cases >1 species was identified. The most common infection site was bloodstream (44%), followed by intra‐abdominal (14%). The most frequently affected allograft groups were liver (41.1%) and kidney (35.3%). All‐cause mortality at 90 days was 26.5% for all species and was highest for Candida tropicalis (44%) and C. parapsilosis (35.2%). Non‐white race and female gender were more commonly associated with non‐albicans species. A high rate of breakthrough IC was seen in patients receiving antifungal prophylaxis (39%). Factors associated with mortality include organ dysfunction, lung transplant, and treatment with a polyene antifungal. The only modifiable factor identified was choice of antifungal drug class based upon infecting Candida species. Conclusion These data highlight the common and distinct features of IC in OTRs.
Candida solid organ transplant

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