Investigation and control of aspergillosis and other filamentous fungal infections in solid organ transplant recipients

Jan E Patterson, Jay I Peters, John H Calhoon, Stephanie M Levine, Antonio R Anzueto, H. Al-Abdely, R. Sanchez, Thomas F Patterson, M. Rech, J. H. Jorgensen, M. G. Rinaldi, Edward Y Sako, Scott B Johnson, Kermit V Speeg, Glenn A Halff, J. K. Trinkle

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Abstract

Filamentous fungal infections are associated with high morbidity and mortality in solid organ transplant patients, and prevention is warranted whenever possible. An increase in invasive aspergillosis was detected among solid organ transplant recipients in our institution during 1991-92. Rates of Aspergillus infection (18.2%) and infection or colonization (42%) were particularly high among lung transplant recipients. Epidemiologic investigation revealed cases to be both nosocomial and community-acquired, and preventative efforts were directed at both sources. Environmental controls were implemented in the hospital, and itraconazole prophylaxis was given in the early period after lung transplantation. The rate of Aspergillus infection in solid organ transplant recipients decreased from 9.4% to 1.5%, and mortality associated with this disease decreased from 8.2% to 1.8%. The rate of Aspergillus infection or colonization among lung transplant recipients decreased from 42% to 22.5%; nosocomial Aspergillus infection decreased from 9% to 3.2%. Cases of aspergillosis in lung transplant recipients were more likely to be early infections in the pre-intervention period. Early mortality in lung transplant recipients decreased from 15% to 3.2%. Two cases of dematiaceous fungal infection were detected, and no further cases occurred after environmental controls. The use of environmental measures that resulted in a decrease in airborne fungal spores, as well as antifungal prophylaxis, was associated with a decrease in aspergillosis and associated mortality in these patients. Ongoing surveillance and continuing intervention is needed for prevention of infection in high-risk solid organ transplant patients.

Original languageEnglish (US)
Pages (from-to)22-28
Number of pages7
JournalTransplant Infectious Disease
Volume2
Issue number1
DOIs
StatePublished - Mar 2000

Fingerprint

Aspergillosis
Mycoses
Aspergillus
Transplants
Infection
Mortality
Lung
Pulmonary Aspergillosis
Itraconazole
Fungal Spores
Lung Transplantation
Cross Infection
Transplant Recipients
Morbidity

Keywords

  • Aspergillosis
  • Filamentous fungal infections
  • Solid organ transplant

ASJC Scopus subject areas

  • Transplantation
  • Microbiology (medical)
  • Immunology

Cite this

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title = "Investigation and control of aspergillosis and other filamentous fungal infections in solid organ transplant recipients",
abstract = "Filamentous fungal infections are associated with high morbidity and mortality in solid organ transplant patients, and prevention is warranted whenever possible. An increase in invasive aspergillosis was detected among solid organ transplant recipients in our institution during 1991-92. Rates of Aspergillus infection (18.2{\%}) and infection or colonization (42{\%}) were particularly high among lung transplant recipients. Epidemiologic investigation revealed cases to be both nosocomial and community-acquired, and preventative efforts were directed at both sources. Environmental controls were implemented in the hospital, and itraconazole prophylaxis was given in the early period after lung transplantation. The rate of Aspergillus infection in solid organ transplant recipients decreased from 9.4{\%} to 1.5{\%}, and mortality associated with this disease decreased from 8.2{\%} to 1.8{\%}. The rate of Aspergillus infection or colonization among lung transplant recipients decreased from 42{\%} to 22.5{\%}; nosocomial Aspergillus infection decreased from 9{\%} to 3.2{\%}. Cases of aspergillosis in lung transplant recipients were more likely to be early infections in the pre-intervention period. Early mortality in lung transplant recipients decreased from 15{\%} to 3.2{\%}. Two cases of dematiaceous fungal infection were detected, and no further cases occurred after environmental controls. The use of environmental measures that resulted in a decrease in airborne fungal spores, as well as antifungal prophylaxis, was associated with a decrease in aspergillosis and associated mortality in these patients. Ongoing surveillance and continuing intervention is needed for prevention of infection in high-risk solid organ transplant patients.",
keywords = "Aspergillosis, Filamentous fungal infections, Solid organ transplant",
author = "Patterson, {Jan E} and Peters, {Jay I} and Calhoon, {John H} and Levine, {Stephanie M} and Anzueto, {Antonio R} and H. Al-Abdely and R. Sanchez and Patterson, {Thomas F} and M. Rech and Jorgensen, {J. H.} and Rinaldi, {M. G.} and Sako, {Edward Y} and Johnson, {Scott B} and Speeg, {Kermit V} and Halff, {Glenn A} and Trinkle, {J. K.}",
year = "2000",
month = "3",
doi = "10.1034/j.1399-3062.2000.020105.x",
language = "English (US)",
volume = "2",
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TY - JOUR

T1 - Investigation and control of aspergillosis and other filamentous fungal infections in solid organ transplant recipients

AU - Patterson, Jan E

AU - Peters, Jay I

AU - Calhoon, John H

AU - Levine, Stephanie M

AU - Anzueto, Antonio R

AU - Al-Abdely, H.

AU - Sanchez, R.

AU - Patterson, Thomas F

AU - Rech, M.

AU - Jorgensen, J. H.

AU - Rinaldi, M. G.

AU - Sako, Edward Y

AU - Johnson, Scott B

AU - Speeg, Kermit V

AU - Halff, Glenn A

AU - Trinkle, J. K.

PY - 2000/3

Y1 - 2000/3

N2 - Filamentous fungal infections are associated with high morbidity and mortality in solid organ transplant patients, and prevention is warranted whenever possible. An increase in invasive aspergillosis was detected among solid organ transplant recipients in our institution during 1991-92. Rates of Aspergillus infection (18.2%) and infection or colonization (42%) were particularly high among lung transplant recipients. Epidemiologic investigation revealed cases to be both nosocomial and community-acquired, and preventative efforts were directed at both sources. Environmental controls were implemented in the hospital, and itraconazole prophylaxis was given in the early period after lung transplantation. The rate of Aspergillus infection in solid organ transplant recipients decreased from 9.4% to 1.5%, and mortality associated with this disease decreased from 8.2% to 1.8%. The rate of Aspergillus infection or colonization among lung transplant recipients decreased from 42% to 22.5%; nosocomial Aspergillus infection decreased from 9% to 3.2%. Cases of aspergillosis in lung transplant recipients were more likely to be early infections in the pre-intervention period. Early mortality in lung transplant recipients decreased from 15% to 3.2%. Two cases of dematiaceous fungal infection were detected, and no further cases occurred after environmental controls. The use of environmental measures that resulted in a decrease in airborne fungal spores, as well as antifungal prophylaxis, was associated with a decrease in aspergillosis and associated mortality in these patients. Ongoing surveillance and continuing intervention is needed for prevention of infection in high-risk solid organ transplant patients.

AB - Filamentous fungal infections are associated with high morbidity and mortality in solid organ transplant patients, and prevention is warranted whenever possible. An increase in invasive aspergillosis was detected among solid organ transplant recipients in our institution during 1991-92. Rates of Aspergillus infection (18.2%) and infection or colonization (42%) were particularly high among lung transplant recipients. Epidemiologic investigation revealed cases to be both nosocomial and community-acquired, and preventative efforts were directed at both sources. Environmental controls were implemented in the hospital, and itraconazole prophylaxis was given in the early period after lung transplantation. The rate of Aspergillus infection in solid organ transplant recipients decreased from 9.4% to 1.5%, and mortality associated with this disease decreased from 8.2% to 1.8%. The rate of Aspergillus infection or colonization among lung transplant recipients decreased from 42% to 22.5%; nosocomial Aspergillus infection decreased from 9% to 3.2%. Cases of aspergillosis in lung transplant recipients were more likely to be early infections in the pre-intervention period. Early mortality in lung transplant recipients decreased from 15% to 3.2%. Two cases of dematiaceous fungal infection were detected, and no further cases occurred after environmental controls. The use of environmental measures that resulted in a decrease in airborne fungal spores, as well as antifungal prophylaxis, was associated with a decrease in aspergillosis and associated mortality in these patients. Ongoing surveillance and continuing intervention is needed for prevention of infection in high-risk solid organ transplant patients.

KW - Aspergillosis

KW - Filamentous fungal infections

KW - Solid organ transplant

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