TY - JOUR
T1 - Opportunistic mycelial fungal infections in organ transplant recipients
T2 - Emerging importance of non-Aspergillus mycelial fungi
AU - Husain, Shahid
AU - Alexander, Barbara D.
AU - Munoz, Patricia
AU - Avery, Robin K.
AU - Houston, Sally
AU - Pruett, Timothy
AU - Jacobs, Richard
AU - Dominguez, Edward A.
AU - Tollemar, Jan G.
AU - Baumgarten, Katherine
AU - Yu, Chen M.
AU - Wagener, Marilyn M.
AU - Linden, Peter
AU - Kusne, Shimon
AU - Singh, Nina
N1 - Funding Information:
Financial support: Educational grant from Enzon Pharmaceuticals, Pfizer, and a Medical School grant from Merck.
PY - 2003/7/15
Y1 - 2003/7/15
N2 - To determine the spectrum and impact of mycelial fungal infections, particularly those due to non-Aspergillus molds, 53 liver and heart transplant recipients with invasive mycelial infections were prospectively identified in a multicenter study. Invasive mycelial infections were due to Aspergillus species in 69.8% of patients, to non-Aspergillus hyalohyphomycetes in 9.4%, to phaeohyphomycetes in 9.4%, to zygomycetes in 5.7%, and to other causes in 5.7%. Infections due to mycelial fungi other than Aspergillus species were significantly more likely to be associated with disseminated (P = .005) and central nervous system (P = .07) infection than were those due to Aspergillus species. Overall mortality at 90 days was 54.7%. The associated mortality rate was 100% for zygomycosis, 80% for non-Aspergillus hyalohyphomycosis, 54% for aspergillosis, and 20% for phaeohyphomycosis. Thus, non-Aspergillus molds have emerged as significant pathogens in organ transplant recipients. These molds are more likely to be associated with disseminated infections and to be associated with poorer outcomes than is aspergillosis.
AB - To determine the spectrum and impact of mycelial fungal infections, particularly those due to non-Aspergillus molds, 53 liver and heart transplant recipients with invasive mycelial infections were prospectively identified in a multicenter study. Invasive mycelial infections were due to Aspergillus species in 69.8% of patients, to non-Aspergillus hyalohyphomycetes in 9.4%, to phaeohyphomycetes in 9.4%, to zygomycetes in 5.7%, and to other causes in 5.7%. Infections due to mycelial fungi other than Aspergillus species were significantly more likely to be associated with disseminated (P = .005) and central nervous system (P = .07) infection than were those due to Aspergillus species. Overall mortality at 90 days was 54.7%. The associated mortality rate was 100% for zygomycosis, 80% for non-Aspergillus hyalohyphomycosis, 54% for aspergillosis, and 20% for phaeohyphomycosis. Thus, non-Aspergillus molds have emerged as significant pathogens in organ transplant recipients. These molds are more likely to be associated with disseminated infections and to be associated with poorer outcomes than is aspergillosis.
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U2 - 10.1086/375822
DO - 10.1086/375822
M3 - Article
C2 - 12856215
AN - SCOPUS:0041766322
SN - 1058-4838
VL - 37
SP - 221
EP - 229
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
IS - 2
ER -