title: Epidemiological features of invasive mold infections among solid organ transplant recipients: PATH Alliance® registry analysis.
abstract: Epidemiological characteristics of 333 proven and probable invasive mould infections (IMIs) among solid organ transplant recipients (SOTRs) identified between 2004 and 2008 from the Prospective Antifungal Therapy Alliance (PATH) registry are presented. Liver transplant recipients (LTRs) had the lowest median time to IMIs (109 days; interquartile range [IQR] 24-611 days), the highest rate of disseminated disease (n/N = 18/33; 55%), and highest mortality (n/N = 21/33; 64%). Lung transplant recipients had highest median time to IMIs (486 days; IQR 117-1358 days) and lowest mortality (n/N = 31/184; 17%). Complete or partial response at week 12 in patients with invasive aspergillosis (IA) was 67% (n/N = 189/281), and 41% (n/N = 9/22) in mucormycosis patients. In the composite outcome of death or no response to therapy, LTRs had the worst outcome. Higher suspicion of mold infection and institution of appropriate antifungal prophylactic strategies are warranted, especially in high risk LTRs.
authors.affiliation: Multi-organ Transplant Program, Infectious Diseases Division, University Health Network, University of Toronto, 11 PMB 138, 585 University Avenue, Toronto, ON, M5G 2N2, Canada.
authors.forename: Shahid
authors.initials: S
authors.lastname: Husain
authors.affiliation: Division of Infectious Diseases, University of Pittsburgh, Falk Medical Building, 3601 Fifth Avenue Suite 3A, Pittsburgh, PA, 15213, USA.
authors.forename: Fernanda P
authors.initials: FP
authors.lastname: Silveira
authors.affiliation: Astellas Pharma Global Development Inc., 1 Astellas Way, Northbrook, IL, 60062, USA.
authors.forename: Nkechi
authors.initials: N
authors.lastname: Azie
authors.affiliation: Astellas Pharma Global Development Inc., 1 Astellas Way, Northbrook, IL, 60062, USA.
authors.forename: Billy
authors.initials: B
authors.lastname: Franks
authors.affiliation: David Horn, LLC, Doylestown, PA, 18902, USA.
authors.forename: David
authors.initials: D
authors.lastname: Horn
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000935:Antifungal Agents / Q000627:therapeutic use; D018890:Chemoprevention / Q000379:methods; D002648:Child; D005260:Female; D005658:Fungi / Q000145:classification* / Q000302:isolation & purification*; D006801:Humans; D000072742:Invasive Fungal Infections / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality; D008297:Male; D008875:Middle Aged; D016377:Organ Transplantation / Q000009:adverse effects*; D011446:Prospective Studies; D016019:Survival Analysis; D066027:Transplant Recipients; D055815:Young Adult
chemical_list: D000935:Antifungal Agents
keywords: Invasive mould infections; PATH Alliance® registry; liver transplant; solid organ transplant