Citations 2
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)
Andes, David R. , Safdar, Nasia , Alexander, Barbara D. , Brumble, Lisa , Freifeld, Allison, Hadley, Susan , Herwaldt, Loreen A. , Kauffman, Carol A., Lyon, G. Marshall, Morrison, Vicki A., Perl, Trish M. , Walker, Randall C., Hess, Tim, Chiller, Tom , Pappas, Peter G. , Investigators, The TRANSNET, Walker, Randall, Baddley, John W. , Patterson, Thomas F. , Investigators, The TRANSNET
Transplant Infectious Disease | September 19, 2016 | Volume: 18 | Issue: 6 | Pages: 921-931
AbstractBackgroundInvasive candidiasis (IC) is a common cause of mortality in solid organ transplant recipients (OTRs), but knowledge of epidemiology in this population is limited.MethodThe 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.ResultsA 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.ConclusionThese data highlight the common and distinct features of IC in OTRs.
Comparison of In Vitro Susceptibility Characteristics of Candida Species from Cases of Invasive Candidiasis in Solid Organ and Stem Cell Transplant Recipients: Transplant-Associated Infections Surveillance Network (TRANSNET),
Wagner, Debra, Iqbal, Naureen, Pappas, Peter G. , Andes, David R. , Kauffman, Carol A., Brumble, Lisa , Hadley, Susan , Walker, Randall C., Ito, James I., Chiller, Tom , Park, Benjamin J., Lockhart, Shawn R. , Baddley, John W.
Journal of Clinical Microbiology | May 12, 2011 | Volume: 49 | Issue: 7 | Pages: 2404-2410
ABSTRACT Invasive fungal infections (IFI) are a major cause of morbidity and mortality among both solid organ transplant (SOT) and hematopoietic stem cell transplant (HSCT) recipients. Candida is the most common cause of IFI in SOT recipients and the second most common cause of IFI in HSCT recipients. We determined susceptibilities to fluconazole, voriconazole, itraconazole, posaconazole, amphotericin B, and caspofungin for 383 invasive Candida sp. isolates from SOT and HSCT recipients enrolled in the Transplant-Associated Infection Surveillance Network and correlated these results to clinical data. Fluconazole resistance in C. albicans , C. tropicalis , and C. parapsilosis isolates was low (1%), but the high percentage of C. glabrata and C. krusei isolates within this group of patients increased the overall percentage of fluconazole resistance to 16%. Voriconazole resistance was 3% overall but was 8% among C. glabrata isolates. On multivariable analysis, among HSCT recipients fluconazole nonsusceptibility was independently associated with C. glabrata , non-Hodgkin's lymphoma, cytomegalovirus (CMV) antigenemia, diabetes active at the time of the IFI, and any prior amphotericin B use; among SOT recipients, fluconazole nonsusceptibility was independently associated with any fluconazole use in the 3 months prior to the IFI, C. glabrata , ganciclovir use in the 3 months prior to the IFI, diabetes acquired since the transplant, and gender.