Endemic fungal infections in solid organ and hematopoietic cell transplant recipients enrolled in the Transplant-Associated Infection Surveillance Network (TRANSNET).

Endemic fungal infections in solid organ and hematopoietic cell transplant recipients enrolled in the Transplant-Associated Infection Surveillance Network (TRANSNET).
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DOI:
10.1111/tid.12186
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发表时间:
2014-04
期刊:
Transplant infectious disease : an official journal of the Transplantation Society
影响因子:
--
通讯作者:
Pappas PG
Pappas PG
中科院分区:
其他
文献类型:
--
作者:
Kauffman CA;Freifeld AG;Andes DR;Baddley JW;Herwaldt L;Walker RC;Alexander BD;Anaissie EJ;Benedict K;Ito JI;Knapp KM;Lyon GM;Marr KA;Morrison VA;Park BJ;Patterson TF;Schuster MG;Chiller TM;Pappas PG

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侵袭性真菌感染是实体器官移植(SOT)和造血细胞移植(HCT)受者发病和死亡的主要原因,但很少有关于这些人群中地方性真菌感染流行病学的报道。15家属于移植相关感染监测网络的机构前瞻性招募了2001年3月至2006年3月期间发生组织胞浆菌病、芽生菌病或球孢子菌病的SOT和HCT受者。共有70例患者(64例SOT接受者和6例HCT接受者)感染了地方性真菌病,其中52例为组织胞浆菌病,9例为芽生菌病,9例为球孢子菌病。SOT受者12个月组织胞浆菌病累积发病率为0.102%。感染的发生是双峰的; 28例(40%)感染发生在移植后的前6个月,24例(34%)发生在移植后2 - 11年。三名患者被记录为从供体器官获得性感染。7例SOT受者组织胞浆菌病和3例球孢子菌病死亡(16%);无HCT受者死亡。这项为期5年的多中心前瞻性监测研究发现,地方性真菌病在SOT和HCT受者中并不常见,并且移植后的风险期延长了数年。
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. 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. 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. 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.
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