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Invasive fungal infections among organ transplant recipients: results of the Transplant-Associated Infection Surveillance Network (TRANSNET).

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Date
2010-04-15
Authors
Pappas, Peter G
Alexander, Barbara D
Andes, David R
Hadley, Susan
Kauffman, Carol A
Freifeld, Alison
Anaissie, Elias J
Brumble, Lisa M
Herwaldt, Loreen
Ito, James
Kontoyiannis, Dimitrios P
Lyon, G Marshall
Marr, Kieren A
Morrison, Vicki A
Park, Benjamin J
Patterson, Thomas F
Perl, Trish M
Oster, Robert A
Schuster, Mindy G
Walker, Randall
Walsh, Thomas J
Wannemuehler, Kathleen A
Chiller, Tom M
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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.
Type
Journal article
Subject
Adolescent
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
Cohort Studies
Female
Humans
Immunocompromised Host
Incidence
Infant
Male
Middle Aged
Mycoses
Prospective Studies
Sentinel Surveillance
Transplants
United States
Young Adult
Permalink
https://hdl.handle.net/10161/4144
Published Version (Please cite this version)
10.1086/651262
Publication Info
Pappas, Peter G; Alexander, Barbara D; Andes, David R; Hadley, Susan; Kauffman, Carol A; Freifeld, Alison; ... Chiller, Tom M (2010). Invasive fungal infections among organ transplant recipients: results of the Transplant-Associated Infection Surveillance Network (TRANSNET). Clin Infect Dis, 50(8). pp. 1101-1111. 10.1086/651262. Retrieved from https://hdl.handle.net/10161/4144.
This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.
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Scholars@Duke

Alexander

Barbara Dudley Alexander

Professor of Medicine
Clinical research related to infectious complications of solid organ and bone marrow transplantation, with a particular interest in the treatment and rapid diagnosis of fungal disease.
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