Transplant Associated Infection Surveillance Network

描述（由申请人提供）：移植后感染是实体器官移植和造血干细胞移植受者发病和死亡的主要原因。在过去的3年里，我们参与了一个前瞻性的25个中心监测网络（TRANSNET），筛选了18,000多名移植受者，并确定了1200多例确诊和可能的侵袭性真菌感染（IFI）病例。这些数据提高了对美国疾病负担的了解，并突出了移植组之间的一些主要差异。该小组对重要危险因素进行病例对照试验的能力有限。美国疾病控制和预防中心发起的“器官移植感染检测和预防计划”是评估与ifi发展相关的危险因素的及时和必要的下一步，并开始对重要的非真菌病原体进行前瞻性监测。我们建议实现以下目标：1)在美国3个移植中心（UAB、密歇根大学和宾夕法尼亚大学）对已证实和可能的ifi的otr和hsctr进行前瞻性监测，并开发可出口的监测方法；2)在侵袭性霉菌感染高危患者中开展病例对照研究，确定重要的院内和门诊危险因素，并提出预防建议；3)制定对选定的非真菌病原体（即西尼罗病毒、呼吸道病毒和选定的多重耐药细菌）进行前瞻性监测的方法；4)建立菌类和临床标本库。这些目标的实现将为了解与国际金融机构发展相关的关键可改变风险因素提供至关重要的见解。此外，在多个地点建立标准监测方法将显著提高重要病原体数据收集的质量和便利性。最后，建立一个数据库对于开发和验证新的诊断分析方法将是非常宝贵的。

Description (provided by applicant): Infections in the post-transplant period are a leading cause of morbidity and mortality among solid organ transplant recipients and hematopoietic stem cell transplant recipient. In the last 3 years we have been involved in a prospective 25 center surveillance network (TRANSNET), screening over 18,000 transplant recipients and identifying over 1,200 proven and probable cases of invasive fungal infection (IFI). This data has led to improved understanding of the disease burden in the U.S. and has highlighted some of the major differences among transplant groups. The group has had limited ability to perform case-control trials of Important risk factors. The CDC-sponsored initiative "Organ Transplant Infection Detection and Prevention Program" is a timely and necessary next step toward the assessment of risk factors associated with the Development of IFIs, and to initiate prospective surveillance for important non-fungal pathogens. We propose to achieve the following aims:1) to perform prospective surveillance among OTRs and HSCTRs for proven and probable IFIs at 3 US transplant centers (UAB, University of Michigan, and University of Pennsylvania), and to develop exportable surveillance methodology;2) to perform case-control studies among patients at high risk for invasive mould infections to identify significant nosocomial and outpatient risk factors and to establish recommendations for prevention;3) to develop methodologies for conducting prospective surveillance for selected non-fungal pathogens (i.e. West Nile virus, respiratory viruses, and selected multiresistant bacteria); and 4) to establish a bank for fungi and clinical specimens. The achievement of these goals will provide critically important insights into the key modifiable risk factors associated with the development of IFIs. Moreover, the establishment of standard surveillance methodology across multiple sites will significantly improve the quality and ease of data collection for important pathogens. Finally, the establishment of a bank will be invaluable in the development and validation of newer diagnostic assays.