Invasive Fungal Disease in Solid Organ and Hematopoietic Cell Transplant Recipients, United States.

Details

• Alternative Title:
  Transplant Infectious Disease: An Official Journal of the Transplantation Society, 2025, v. 27, no. 5: Invasive Fungal Disease in Solid Organ and Hematopoietic Cell Transplant Recipients, United States.
• Journal Article:
  Transplant Infectious Disease: An Official Journal of the Transplantation Society
• Personal Author:
  Gold, Jeremy A. W. ; Benedict, Kaitlin ; Sajewski, Elizabeth ; Chiller, Tom ; Lyman, Meghan ; Toda, Mitsuru ; Little, Jessica S. ; Ostrosky-Zeichner, Luis
• Description:
  Updated benchmark data on invasive fungal disease (IFD) in solid organ transplantation (SOT) and hematopoietic cell transplantation (HCT) recipients are necessary to increase clinical recognition and inform treatment and prevention strategies. We estimated IFD incidence and potential risk factors in transplant recipients in a large US commercial health insurance database.
  
  We observed patients who received SOT or HCT during 2018-2022 until IFD development, disenrollment, or database end date (July 31, 2023). We calculated incidence (per 1000 person-years) and time to IFD development, comparing demographic features and underlying conditions for IFD versus non-IFD patients.
  
  Overall, 9143 patients received an SOT (5667 kidney, 2025 liver, 759 heart, 650 lung, 39 pancreas, 3 intestine), and 5693 patients received an HCT (3519 autologous, 2114 allogeneic, 60 unspecified type). Among SOT patients, 360 developed an IFD (incidence: 21.0 per 1000 person-years). Mold infections had the highest incidence (7.1), followed by unspecified mycoses (3.9) and endemic mycoses (3.3). Among HCT patients, 292 developed an IFD (incidence: 28.5), with higher incidence among allogeneic (58.4) versus autologous (12.8) HCT recipients; among all HCT recipients, unspecified mycoses had the highest incidence (8.3), then pneumocystosis (7.6), and mold infections (6.7). Median time to IFD was 173.5 days for SOT recipients and 197.5 days for HCT recipients. IFD risk varied substantially by transplant type, region, and certain underlying conditions.
  
  Our results suggest that IFDs remain an important cause of infection among SOT and HCT recipients, particularly later in the posttransplant period, and highlight the need for prevention strategies.
• Content Notes:
  Author manuscript
• Subjects:
  • Hematopoietic Stem Cell Transplantation
  • Humans
  • Male
  • Female
  • Adult
  • Middle Aged
  • Invasive Fungal Infections
  • Organ Transplantation
  • Databases, Factual
  • Risk Factors
  More +
• Keywords:
  • aspergillosis
  • candidiasis
  • cryptococcosis
  • invasive fungal disease
  • pneumocystosis
  • solid organ transplantation
  • stem cell transplantation
• Source:
  Transplant Infectious Disease: An Official Journal of the Transplantation Society, 2025, v. 27, no. 5
• DOI:
  https://doi.org/10.1111/tid.70077
• ISSN:
  1398-2273 ; 1399-3062
• Pubmed ID:
  40625116
• Pubmed Central ID:
  PMC12289323
• Document Type:
  Text
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/ ; U01 CK000692/CK/NCEZID CDC HHSUnited States/ ; U01CK000692/ACL/ACL HHSUnited States/ ; UL1 TR003167/TR/NCATS NIH HHSUnited States/
• Genre:
  Journal Article
• Place as Subject:
  United States
• Pages in Document:
  e70077 (18 pdf pages)
• Volume:
  27
• Issue:
  5
• Download URL:
  https://stacks.cdc.gov/view/cdc/261277/cdc_261277_DS1.pdf
• File Type:
  [PDF - 615.94 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:1bf0225acc419ec40a0243b853fe413a5357ba260d777b853e3b3587681ecc6819e5232499d22cbc9e593d12484f38a76b1e799a2ba3be3f02d30362e6897901