Endemic fungal infections in solid organ and hematopoietic cell transplant recipients enrolled in the Transplant-Associated Infection Surveillance Network (TRANSNET).

Abstract

BACKGROUND:

Invasive fungal infections are a major cause of morbidity and mortality among solid organ transplant (SOT) and hematopoietic cell transplant (HCT) recipients, but few data have been reported on the epidemiology of endemic fungal infections in these populations.

METHODS:

Fifteen institutions belonging to the Transplant-Associated Infection Surveillance Network prospectively enrolled SOT and HCT recipients with histoplasmosis, blastomycosis, or coccidioidomycosis occurring between March 2001 and March 2006.

RESULTS:

A total of 70 patients (64 SOT recipients and 6 HCT recipients) had infection with an endemic mycosis, including 52 with histoplasmosis, 9 with blastomycosis, and 9 with coccidioidomycosis. The 12-month cumulative incidence rate among SOT recipients for histoplasmosis was 0.102%. Occurrence of infection was bimodal; 28 (40%) infections occurred in the first 6 months post transplantation, and 24 (34%) occurred between 2 and 11 years post transplantation. Three patients were documented to have acquired infection from the donor organ. Seven SOT recipients with histoplasmosis and 3 with coccidioidomycosis died (16%); no HCT recipient died.

CONCLUSIONS:

This 5-year multicenter prospective surveillance study found that endemic mycoses occur uncommonly in SOT and HCT recipients, and that the period at risk extends for years after transplantation.

• Authors: C A Kauffman, A G Freifeld, D R Andes, J W Baddley, L Herwaldt, R C Walker, B D Alexander, E J Anaissie, K Benedict, J I Ito, K M Knapp, G M Lyon, K A Marr, V A Morrison, B J Park, T F Patterson, M G Schuster, T M Chiller, P G Pappas
• Journal: Transplant infectious disease : an official journal of the Transplantation Society (Transpl Infect Dis) Vol. 16 Issue 2 Pg. 213-24 (Apr 2014) ISSN: 1399-3062 [Electronic] Denmark
• PMID: 24589027 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)
• Copyright: © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Chemical References

• Antifungal Agents
• Itraconazole
• Amphotericin B

Topics

• Adolescent
• Adult
• Aged
• Amphotericin B (therapeutic use)
• Antifungal Agents (therapeutic use)
• Blastomycosis (drug therapy, epidemiology)
• Child
• Coccidioidomycosis (drug therapy, epidemiology)
• Coinfection (drug therapy, epidemiology)
• Comorbidity
• Endemic Diseases
• Female
• Hematopoietic Stem Cell Transplantation (adverse effects)
• Histoplasmosis (drug therapy, epidemiology)
• Humans
• Incidence
• Itraconazole (therapeutic use)
• Male
• Middle Aged
• Organ Transplantation (adverse effects)
• Prospective Studies
• Respiratory Tract Infections (epidemiology, microbiology)
• Time Factors
• United States (epidemiology)
• Young Adult