The epidemiology and outcomes of invasive Candida infections among organ transplant recipients in the United States: results of the Transplant-Associated Infection Surveillance Network (TRANSNET).

Published

Journal Article

BACKGROUND: Invasive candidiasis (IC) is a common cause of mortality in solid organ transplant recipients (OTRs), but knowledge of epidemiology in this population is limited. METHOD: The present analysis describes data from 15 US centers that prospectively identified IC from nearly 17 000 OTRs. Analyses were undertaken to determine predictors of infection and mortality. RESULTS: A total of 639 cases of IC were identified. The most common species was Candida albicans (46.3%), followed by Candida glabrata (24.4%) and Candida parapsilosis (8.1%). In 68 cases >1 species was identified. The most common infection site was bloodstream (44%), followed by intra-abdominal (14%). The most frequently affected allograft groups were liver (41.1%) and kidney (35.3%). All-cause mortality at 90 days was 26.5% for all species and was highest for Candida tropicalis (44%) and C. parapsilosis (35.2%). Non-white race and female gender were more commonly associated with non-albicans species. A high rate of breakthrough IC was seen in patients receiving antifungal prophylaxis (39%). Factors associated with mortality include organ dysfunction, lung transplant, and treatment with a polyene antifungal. The only modifiable factor identified was choice of antifungal drug class based upon infecting Candida species. CONCLUSION: These data highlight the common and distinct features of IC in OTRs.

Full Text

Duke Authors

Cited Authors

  • Andes, DR; Safdar, N; Baddley, JW; Alexander, B; Brumble, L; Freifeld, A; Hadley, S; Herwaldt, L; Kauffman, C; Lyon, GM; Morrison, V; Patterson, T; Perl, T; Walker, R; Hess, T; Chiller, T; Pappas, PG; TRANSNET Investigators,

Published Date

  • December 2016

Published In

Volume / Issue

  • 18 / 6

Start / End Page

  • 921 - 931

PubMed ID

  • 27643395

Pubmed Central ID

  • 27643395

Electronic International Standard Serial Number (EISSN)

  • 1399-3062

Digital Object Identifier (DOI)

  • 10.1111/tid.12613

Language

  • eng

Conference Location

  • Denmark