Invasive fungal infections among organ transplant recipients: results of the Transplant-Associated Infection Surveillance Network (TRANSNET).
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 articleSubject
AdolescentAdult
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
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https://hdl.handle.net/10161/4144Published Version (Please cite this version)
10.1086/651262Publication 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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Show full item recordScholars@Duke
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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