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      Invasive Non- Aspergillus Mold Infections in Transplant Recipients, United States, 2001–2006

      research-article
      , , , , , , , , , , , , , , , , , , , , , , , ,
      Emerging Infectious Diseases
      Centers for Disease Control and Prevention
      Mucorales, Fusarium, Scedosporium, mucormycosis, non-Aspergillus, fungi, organ transplant, epidemiology, invasive mold infections, zygomycosis, fusariosis, surveillance, United States, research

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          Abstract

          Recent reports describe increasing incidence of non-Aspergillus mold infections in hematopoietic cell transplant (HCT) and solid organ transplant (SOT) recipients. To investigate the epidemiology of infections with Mucorales, Fusarium spp., and Scedosporium spp. molds, we analyzed data from the Transplant-Associated Infection Surveillance Network, 23 transplant centers that conducted prospective surveillance for invasive fungal infections during 2001–2006. We identified 169 infections (105 Mucorales, 37 Fusarium spp., and 27 Scedosporium spp.) in 169 patients; 124 (73.4%) were in HCT recipients, and 45 (26.6%) were in SOT recipients. The crude 90-day mortality rate was 56.6%. The 12-month mucormycosis cumulative incidence was 0.29% for HCT and 0.07% for SOT. Mucormycosis incidence among HCT recipients varied widely, from 0.08% to 0.69%, with higher incidence in cohorts receiving transplants during 2003 and 2004. Non-Aspergillus mold infections continue to be associated with high mortality rates. The incidence of mucormycosis in HCT recipients increased substantially during the surveillance period.

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          Author and article information

          Journal
          Emerg Infect Dis
          Emerging Infect. Dis
          EID
          Emerging Infectious Diseases
          Centers for Disease Control and Prevention
          1080-6040
          1080-6059
          October 2011
          : 17
          : 10
          : 1855-1864
          Affiliations
          [-1-1]Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA (B.J. Park, K.A. Wannemuehler);
          [-1-2]University of Alabama at Birmingham Medical Center, Birmingham, Alabama, USA (P.G. Pappas, J.W. Baddley);
          [-1-3]Duke University Medical Center, Durham, North Carolina, USA (B.D. Alexander);
          [-1-4]University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA (E.J. Anaissie);
          [-1-5]University of Wisconsin–Madison, Madison, Wisconsin, USA (D.R. Andes);
          [-1-6]Stanford University School of Medicine, Stanford, California, USA (J.M. Brown);
          [-1-7]Mayo Clinic, Jacksonville, Florida, USA (L.M. Brumble);
          [-1-8]University of Nebraska Medical Center, Omaha, Nebraska, USA (A.G. Freifeld);
          [-1-9]Tufts Medical Center, Boston, Massachusetts, USA (S. Hadley);
          [-1-10]University of Iowa Hospital, Iowa City, Iowa, USA (L. Herwaldt);
          [-1-11]City of Hope National Medical Center, Duarte, California, USA (J.I. Ito);
          [-1-12]University of Michigan, Ann Arbor, Michigan, USA (C.A. Kauffman);
          [-1-13]Veterans Affairs Ann Arbor Healthcare System–Medicine, Ann Arbor (C.A. Kauffman);
          [-1-14]Emory University School of Medicine, Atlanta (G.M. Lyon);
          [-1-15]Johns Hopkins Medical Institutions, Baltimore, Maryland, USA (K.A. Marr, T.M. Perl);
          [-1-16]Fred Hutchinson Cancer Research Center, Seattle, Washington, USA (K.A. Marr);
          [-1-17]University of Minnesota, Minneapolis, Minnesota, USA (V.A. Morrison);
          [-1-18]Veterans Affairs Medical Center, Minneapolis (V.A. Morrison);
          [-1-19]Memorial Sloan Kettering Cancer Center, New York, New York, USA (G. Papanicolaou);
          [-1-20]University of Texas Health Sciences Center, San Antonio, Texas, USA (T.F. Patterson);
          [-1-21]South Texas Veterans Healthcare System, San Antonio (T.F. Patterson);
          [-1-22]Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA (M.G. Schuster);
          [-1-23]Mayo Clinic, Rochester, Minnesota, USA (R. Walker);
          [-1-24]University of Florida, Gainesville, Florida, USA (J.R. Wingard);
          [-1-25]National Institutes of Health, Bethesda, Maryland, USA (T.J. Walsh);
          [-1-26]MD Anderson Cancer Center, Houston, Texas, USA (D.P. Kontoyiannis)
          [-2-1]Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA (B.J. Park, K.A. Wannemuehler);
          [-2-2]University of Alabama at Birmingham Medical Center, Birmingham, Alabama, USA (P.G. Pappas, J.W. Baddley);
          [-2-3]Duke University Medical Center, Durham, North Carolina, USA (B.D. Alexander);
          [-2-4]University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA (E.J. Anaissie);
          [-2-5]University of Wisconsin–Madison, Madison, Wisconsin, USA (D.R. Andes);
          [-2-6]Stanford University School of Medicine, Stanford, California, USA (J.M. Brown);
          [-2-7]Mayo Clinic, Jacksonville, Florida, USA (L.M. Brumble);
          [-2-8]University of Nebraska Medical Center, Omaha, Nebraska, USA (A.G. Freifeld);
          [-2-9]Tufts Medical Center, Boston, Massachusetts, USA (S. Hadley);
          [-2-10]University of Iowa Hospital, Iowa City, Iowa, USA (L. Herwaldt);
          [-2-11]City of Hope National Medical Center, Duarte, California, USA (J.I. Ito);
          [-2-12]University of Michigan, Ann Arbor, Michigan, USA (C.A. Kauffman);
          [-2-13]Veterans Affairs Ann Arbor Healthcare System–Medicine, Ann Arbor (C.A. Kauffman);
          [-2-14]Emory University School of Medicine, Atlanta (G.M. Lyon);
          [-2-15]Johns Hopkins Medical Institutions, Baltimore, Maryland, USA (K.A. Marr, T.M. Perl);
          [-2-16]Fred Hutchinson Cancer Research Center, Seattle, Washington, USA (K.A. Marr);
          [-2-17]University of Minnesota, Minneapolis, Minnesota, USA (V.A. Morrison);
          [-2-18]Veterans Affairs Medical Center, Minneapolis (V.A. Morrison);
          [-2-19]Memorial Sloan Kettering Cancer Center, New York, New York, USA (G. Papanicolaou);
          [-2-20]University of Texas Health Sciences Center, San Antonio, Texas, USA (T.F. Patterson);
          [-2-21]South Texas Veterans Healthcare System, San Antonio (T.F. Patterson);
          [-2-22]Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA (M.G. Schuster);
          [-2-23]Mayo Clinic, Rochester, Minnesota, USA (R. Walker);
          [-2-24]University of Florida, Gainesville, Florida, USA (J.R. Wingard);
          [-2-25]National Institutes of Health, Bethesda, Maryland, USA (T.J. Walsh);
          [-2-26]MD Anderson Cancer Center, Houston, Texas, USA (D.P. Kontoyiannis)
          [-3-1]Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA (B.J. Park, K.A. Wannemuehler);
          [-3-2]University of Alabama at Birmingham Medical Center, Birmingham, Alabama, USA (P.G. Pappas, J.W. Baddley);
          [-3-3]Duke University Medical Center, Durham, North Carolina, USA (B.D. Alexander);
          [-3-4]University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA (E.J. Anaissie);
          [-3-5]University of Wisconsin–Madison, Madison, Wisconsin, USA (D.R. Andes);
          [-3-6]Stanford University School of Medicine, Stanford, California, USA (J.M. Brown);
          [-3-7]Mayo Clinic, Jacksonville, Florida, USA (L.M. Brumble);
          [-3-8]University of Nebraska Medical Center, Omaha, Nebraska, USA (A.G. Freifeld);
          [-3-9]Tufts Medical Center, Boston, Massachusetts, USA (S. Hadley);
          [-3-10]University of Iowa Hospital, Iowa City, Iowa, USA (L. Herwaldt);
          [-3-11]City of Hope National Medical Center, Duarte, California, USA (J.I. Ito);
          [-3-12]University of Michigan, Ann Arbor, Michigan, USA (C.A. Kauffman);
          [-3-13]Veterans Affairs Ann Arbor Healthcare System–Medicine, Ann Arbor (C.A. Kauffman);
          [-3-14]Emory University School of Medicine, Atlanta (G.M. Lyon);
          [-3-15]Johns Hopkins Medical Institutions, Baltimore, Maryland, USA (K.A. Marr, T.M. Perl);
          [-3-16]Fred Hutchinson Cancer Research Center, Seattle, Washington, USA (K.A. Marr);
          [-3-17]University of Minnesota, Minneapolis, Minnesota, USA (V.A. Morrison);
          [-3-18]Veterans Affairs Medical Center, Minneapolis (V.A. Morrison);
          [-3-19]Memorial Sloan Kettering Cancer Center, New York, New York, USA (G. Papanicolaou);
          [-3-20]University of Texas Health Sciences Center, San Antonio, Texas, USA (T.F. Patterson);
          [-3-21]South Texas Veterans Healthcare System, San Antonio (T.F. Patterson);
          [-3-22]Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA (M.G. Schuster);
          [-3-23]Mayo Clinic, Rochester, Minnesota, USA (R. Walker);
          [-3-24]University of Florida, Gainesville, Florida, USA (J.R. Wingard);
          [-3-25]National Institutes of Health, Bethesda, Maryland, USA (T.J. Walsh);
          [-3-26]MD Anderson Cancer Center, Houston, Texas, USA (D.P. Kontoyiannis)
          Author notes
          Address for correspondence: Benjamin J. Park, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Mailstop C09, Atlanta, GA 30333, USA; email: bpark1@ 123456cdc.gov
          Article
          11-0087
          10.3201/eid1710.110087
          3311117
          22000355
          10a68e31-ec9c-4448-8466-0161f85c94a8
          History
          Categories
          CME
          Research
          Research

          Infectious disease & Microbiology
          scedosporium,mucormycosis,united states,research,fusariosis,fusarium,epidemiology,invasive mold infections,zygomycosis,organ transplant,mucorales,non-aspergillus,surveillance,fungi

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