Invasive fungal infections among organ transplant recipients

results of the transplant-associated infection surveillance network (Transnet)

Peter G. Pappas, Barbara D. Alexander, David R. Andes, Susan Hadley, Carol A. Kauffman, Alison Gail Freifeld, Elias J. Anaissie, Lisa M. Brumble, Loreen Herwaldt, James Lto, Dimitrios P. Kontoyiannis, G. Marshall Lyon, Kieren A. Marr, Vicki A. Morrison, Benjamin J. Park, Thomas F. Patterson, Trish M. Perl, Robert A. Oster, Mindy G. Schuster, Randall Walker & 3 others Thomas J. Walsh, Kathleen A. Wannemuehler, Tom M. Chiller

Research output: Contribution to journalArticle

726 Citations (Scopus)

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%), nonAspergillus 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.

Original languageEnglish (US)
Pages (from-to)1101-1111
Number of pages11
JournalClinical Infectious Diseases
Volume50
Issue number8
DOIs
StatePublished - Apr 15 2010

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Transplants
Infection
Aspergillosis
Invasive Candidiasis
Incidence
Cryptococcosis
Fungi
Zygomycosis
Transplant Recipients
Invasive Fungal Infections
Candidiasis
Pancreas
Transplantation
Morbidity
Kidney
Lung
Mortality
Liver

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Cite this

Invasive fungal infections among organ transplant recipients : results of the transplant-associated infection surveillance network (Transnet). / Pappas, Peter G.; Alexander, Barbara D.; Andes, David R.; Hadley, Susan; Kauffman, Carol A.; Freifeld, Alison Gail; Anaissie, Elias J.; Brumble, Lisa M.; Herwaldt, Loreen; Lto, James; Kontoyiannis, Dimitrios P.; Marshall Lyon, G.; 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.

In: Clinical Infectious Diseases, Vol. 50, No. 8, 15.04.2010, p. 1101-1111.

Research output: Contribution to journalArticle

Pappas, PG, Alexander, BD, Andes, DR, Hadley, S, Kauffman, CA, Freifeld, AG, Anaissie, EJ, Brumble, LM, Herwaldt, L, Lto, J, Kontoyiannis, DP, Marshall Lyon, G, Marr, KA, Morrison, VA, Park, BJ, Patterson, TF, Perl, TM, Oster, RA, Schuster, MG, Walker, R, Walsh, TJ, Wannemuehler, KA & Chiller, TM 2010, 'Invasive fungal infections among organ transplant recipients: results of the transplant-associated infection surveillance network (Transnet)', Clinical Infectious Diseases, vol. 50, no. 8, pp. 1101-1111. https://doi.org/10.1086/651262
Pappas, Peter G. ; Alexander, Barbara D. ; Andes, David R. ; Hadley, Susan ; Kauffman, Carol A. ; Freifeld, Alison Gail ; Anaissie, Elias J. ; Brumble, Lisa M. ; Herwaldt, Loreen ; Lto, James ; Kontoyiannis, Dimitrios P. ; Marshall Lyon, G. ; 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. / Invasive fungal infections among organ transplant recipients : results of the transplant-associated infection surveillance network (Transnet). In: Clinical Infectious Diseases. 2010 ; Vol. 50, No. 8. pp. 1101-1111.
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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{\%}), nonAspergillus 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.",
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TY - JOUR

T1 - Invasive fungal infections among organ transplant recipients

T2 - results of the transplant-associated infection surveillance network (Transnet)

AU - Pappas, Peter G.

AU - Alexander, Barbara D.

AU - Andes, David R.

AU - Hadley, Susan

AU - Kauffman, Carol A.

AU - Freifeld, Alison Gail

AU - Anaissie, Elias J.

AU - Brumble, Lisa M.

AU - Herwaldt, Loreen

AU - Lto, James

AU - Kontoyiannis, Dimitrios P.

AU - Marshall Lyon, G.

AU - Marr, Kieren A.

AU - Morrison, Vicki A.

AU - Park, Benjamin J.

AU - Patterson, Thomas F.

AU - Perl, Trish M.

AU - Oster, Robert A.

AU - Schuster, Mindy G.

AU - Walker, Randall

AU - Walsh, Thomas J.

AU - Wannemuehler, Kathleen A.

AU - Chiller, Tom M.

PY - 2010/4/15

Y1 - 2010/4/15

N2 - 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%), nonAspergillus 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.

AB - 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%), nonAspergillus 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.

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