D Neofytos1, O Chatzis1,2, D Nasioudis1, E Boely Janke1, T Doco Lecompte1, C Garzoni3,4, C Berger5, A Cussini3, K Boggian6, N Khanna7, O Manuel8, N J Mueller9, C van Delden1. 1. Transplant Infectious Diseases Unit, University Hospitals of Geneva, Geneva, Switzerland. 2. Division of Pediatric Infectious Diseases, University Hospital of St Luc, Brussels, Belgium. 3. Department of Infectious Diseases, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland. 4. Departments of Internal Medicine and Infectious Disease, Clinica Luganese, Lugano, Switzerland. 5. Division of Infectious Diseases and Hospital Epidemiology, University Children's Hospital Zürich, Zürich, Switzerland. 6. Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St Gallen, St Gallen, Switzerland. 7. Division of Infectious Diseases and Hospital Epidemiology, University and University Hospital of Basel, Basel, Switzerland. 8. Service of Infectious Diseases and Transplantation Center, University Hospital of Lausanne, Lausanne, Switzerland. 9. Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Zurich, Zurich, Switzerland.
Abstract
BACKGROUND: There is lack of recent multicenter epidemiological data on invasive aspergillosis (IA) among solid organ transplant recipient (SOTr) in the mold-acting antifungal era. We describe the epidemiology and outcomes of IA in a contemporary cohort of SOTr using the Swiss Transplant Cohort Study. METHODS: All consecutive SOTr with proven or probable IA between 01.05.2008 and 31.12.2014 were included. A case-control study to identify IA predictors was performed: 1-case was matched with 3-controls based on SOT type, transplant center, and time post-SOT. RESULTS: Among 2868 SOTr, 70 (2.4%) patients were diagnosed with proven (N: 30/70, 42.9%) or probable (N: 40/70, 57.1%) IA. The incidence of IA was 8.3%, 7.1%, 2.6%, 1.3%, and 1.2% in lung, heart, combined, kidney, and liver transplant recipients, respectively, Galactomannan immunoassay was positive in 1/3 of patients tested. Only 33/63 (52.4%) of patients presented with typical pulmonary radiographic findings. Predictors of IA included: renal insufficiency, re-operation, and bacterial and viral infections. 12-week mortality was higher in liver (85.7%, 6/7) compared to other (15.9%, 10/63; P < .001) SOTr. CONCLUSIONS: Invasive aspergillosis remains a rare complication post-SOT, with atypical radiographic presentations and low positivity rates of biomarkers posing significant diagnostic challenges. Although overall mortality has decreased in SOTr, it remains high in liver SOTr.
BACKGROUND: There is lack of recent multicenter epidemiological data on invasive aspergillosis (IA) among solid organ transplant recipient (SOTr) in the mold-acting antifungal era. We describe the epidemiology and outcomes of IA in a contemporary cohort of SOTr using the Swiss Transplant Cohort Study. METHODS: All consecutive SOTr with proven or probable IA between 01.05.2008 and 31.12.2014 were included. A case-control study to identify IA predictors was performed: 1-case was matched with 3-controls based on SOT type, transplant center, and time post-SOT. RESULTS: Among 2868 SOTr, 70 (2.4%) patients were diagnosed with proven (N: 30/70, 42.9%) or probable (N: 40/70, 57.1%) IA. The incidence of IA was 8.3%, 7.1%, 2.6%, 1.3%, and 1.2% in lung, heart, combined, kidney, and liver transplant recipients, respectively, Galactomannan immunoassay was positive in 1/3 of patients tested. Only 33/63 (52.4%) of patients presented with typical pulmonary radiographic findings. Predictors of IA included: renal insufficiency, re-operation, and bacterial and viral infections. 12-week mortality was higher in liver (85.7%, 6/7) compared to other (15.9%, 10/63; P < .001) SOTr. CONCLUSIONS:Invasive aspergillosis remains a rare complication post-SOT, with atypical radiographic presentations and low positivity rates of biomarkers posing significant diagnostic challenges. Although overall mortality has decreased in SOTr, it remains high in liver SOTr.
Authors: Pablo González-García; Montserrat Alonso-Sardón; Beatriz Rodríguez-Alonso; Hugo Almeida; Ángela Romero-Alegría; Víctor-José Vega-Rodríguez; Amparo López-Bernús; Juan Luis Muñoz-Bellido; Antonio Muro; Javier Pardo-Lledías; Moncef Belhassen-García Journal: J Fungi (Basel) Date: 2022-05-27
Authors: Christian van Delden; Susanne Stampf; Hans H Hirsch; Oriol Manuel; Pascal Meylan; Alexia Cusini; Cédric Hirzel; Nina Khanna; Maja Weisser; Christian Garzoni; Katja Boggian; Christoph Berger; David Nadal; Michael Koller; Ramon Saccilotto; Nicolas J Mueller Journal: Clin Infect Dis Date: 2020-10-23 Impact factor: 9.079
Authors: Shareef K Shaheen; Praveen R Juvvadi; John Allen; E Keats Shwab; D Christopher Cole; Yohannes G Asfaw; Mili Kapoor; Karen Joy Shaw; William J Steinbach Journal: Antimicrob Agents Chemother Date: 2021-07-26 Impact factor: 5.191