title: 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.affiliation: University of Michigan and Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan, USA.
authors.forename: C A
authors.initials: CA
authors.lastname: Kauffman
authors.forename: A G
authors.initials: AG
authors.lastname: Freifeld
authors.forename: D R
authors.initials: DR
authors.lastname: Andes
authors.forename: J W
authors.initials: JW
authors.lastname: Baddley
authors.forename: L
authors.initials: L
authors.lastname: Herwaldt
authors.forename: R C
authors.initials: RC
authors.lastname: Walker
authors.forename: B D
authors.initials: BD
authors.lastname: Alexander
authors.forename: E J
authors.initials: EJ
authors.lastname: Anaissie
authors.forename: K
authors.initials: K
authors.lastname: Benedict
authors.forename: J I
authors.initials: JI
authors.lastname: Ito
authors.forename: K M
authors.initials: KM
authors.lastname: Knapp
authors.forename: G M
authors.initials: GM
authors.lastname: Lyon
authors.forename: K A
authors.initials: KA
authors.lastname: Marr
authors.forename: V A
authors.initials: VA
authors.lastname: Morrison
authors.forename: B J
authors.initials: BJ
authors.lastname: Park
authors.forename: T F
authors.initials: TF
authors.lastname: Patterson
authors.forename: M G
authors.initials: MG
authors.lastname: Schuster
authors.forename: T M
authors.initials: TM
authors.lastname: Chiller
authors.forename: P G
authors.initials: PG
authors.lastname: Pappas
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D001759:Blastomycosis / Q000188:drug therapy / Q000453:epidemiology*; D002648:Child; D003047:Coccidioidomycosis / Q000188:drug therapy / Q000453:epidemiology*; D060085:Coinfection / Q000188:drug therapy / Q000453:epidemiology; D015897:Comorbidity; D019353:Endemic Diseases; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006660:Histoplasmosis / Q000188:drug therapy / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D017964:Itraconazole / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D016377:Organ Transplantation / Q000009:adverse effects*; D011446:Prospective Studies; D012141:Respiratory Tract Infections / Q000453:epidemiology / Q000382:microbiology; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000935:Antifungal Agents; D017964:Itraconazole; D000666:Amphotericin B
keywords: blastomycosis; coccidioidomycosis; hematopoietic cell transplant; histoplasmosis; solid organ transplant