M-1195 Prospective Surveillance of Invasive Fungal Infections (IFIs) among Organ Transplant Recipients (OTRs) in the U.S. 2001-2006: Review of TRANSNET.

P. G. PAPPAS1, C. KAUFFMAN 2, B. ALEXANDER 3, D. ANDES 4, S. HADLEY 5, T. PATTERSON 6, R. WALKER 7, V. MORRISON 8, T. PERL 9, K. WANNEMUEHLER 10, T. CHILLER 10;

Author address: 

1Univ. of Alabama, Birmingham, AL, 2Univ. of Michigan, Ann Arbor, MI, 3DUMC, Durham, NC, 4Univ. of Wisconsin, Madison, WI, 5NEMC, Boston, MA, 6UTXSAMC, San Antonio, TX, 7Mayo Clinic, Rochester, MN, 8Univ. of Minnesota, Minneapolis, MN, 9Johns Hopkins

Abstract: 

Background: IFIs are a major cause of morbidity and mortality among OTRs, although multicenter prospective surveillance for these infections is generally lacking. A better understanding of the epidemiology of these infections could significantly improve the prevention and treatment of this important post-transplant complication. Methods: TRANSNET consists of 16 US transplant centers that have prospectively collected detailed data on all IFIs among their OTRs from 2001-2006. Total number of transplants performed at each site was also collected. Results: From March 2001 through October 2006, a total of 1037 incident IFIs were reported; consisting of invasive candidiasis (IC) (53%), invasive aspergillosis (IA) (20%), cryptococcosis (9%), zygomycosis (ZM) (2%), other moulds (7%), endemic fungi (EF)(5%), and PCP (1%). Median days to onset of IC was 81, IA 186, crypto 598, and EF 366. All cause mortality at 3 mo was 25% for IC, 35% for IA, 21% for crypto, 14% for EF, and 14% for other moulds. From March 01-Oct 05, 17226 SOTs were performed at TRANSNET sites, including 8811 kidney, 759 kidney /pancreas, 4358 liver, 1138 heart, 1179 lung and 19 small bowel. Among this population, 1 year cumulative incidence per 1000 OTRs was 100 for lung, 57 for liver and 14 for kidney. Conclusions: TRANSNET is the most detailed prospective assessment of IFI’s following organ transplantation. Insights from these data will be valuable in understanding the incidence and risk factors for IFI in populations at greatest risk, and designing comprehensive preventive and other interventional strategies to improve outcomes among these pts.
2007

abstract No: 

M-1195

Full conference title: 

47th Interscience Conference on Antimicrobial agents and Chemotherapy
    • ICAAC 47th