Epidemiology, risk factors and outcomes of invasive aspergillosis in solid organ transplant recipients in the Swiss Transplant Cohort Study. Issue 4 (10th May 2018)

• Record Type: Journal Article
• Authors: Neofytos, D.; Chatzis, O.; Nasioudis, D.; Boely Janke, E.; Doco Lecompte, T.; Garzoni, C.; Berger, C.; Cussini, A.; Boggian, K.; Khanna, N.; Manuel, O.; Mueller, N.J.; van Delden, C.
• Other Names: Amico Patrizia investigator.; Aubert John‐David investigator.; Banz Vanessa investigator.; Beldi Guido investigator.; Benden Christian investigator.; Binet Isabelle investigator.; Bochud Pierre‐Yves investigator.; Boëly Elsa investigator.; Bucher Heiner investigator.; Carell Thierry investigator.; Catana Emmanuelle investigator.; Chalandon Yves investigator.; de Geest Sabina investigator.; de Rougemont Olivier investigator.; Dickenmann Michael investigator.; Duchosal Michel investigator.; Elkrief Laure investigator.; Fehr Thomas investigator.; Ferrari‐Lacraz Sylvie investigator.; Gasche Soccal Paola investigator.; Gasche Soccal Paola investigator.; Gaudet Christophe investigator.; Giostra Emiliano investigator.; Golshayan Déla investigator.; Hadaya Karine investigator.; Halter Jörg investigator.; Heim Dominik investigator.; Hess Christoph investigator.; Hillinger Sven investigator.; Hirsch Hans H investigator.; Hofbauer Günther investigator.; Huynh‐Do Uyen investigator.; Immer Franz investigator.; Klaghofer Richard investigator.; Koller Michael investigator.; Laesser Bettina investigator.; Lehmann Roger investigator.; Lovis Christian investigator.; Majno Pietro investigator.; Marti Hans‐Peter investigator.; Martin Pierre Yves investigator.; Meylan Pascal investigator.; Mohacsi Paul investigator.; Morel Philippe investigator.; Mueller Ulrike investigator.; Mueller‐McKenna Helen investigator.; Müller Antonia investigator.; Müller Thomas investigator.; Müllhaupt Beat investigator.; Pascual Manuel investigator.; Passweg Jakob investigator.; Posfay‐Barbe Klara investigator.; Rick Juliane investigator.; Roosnek Eddy investigator.; Rosselet Anne investigator.; Rothlin Silvia investigator.; Ruschitzka Frank investigator.; Schanz Urs investigator.; Schaub Stefan investigator.; Schnyder Aurelia investigator.; Seiler Christian investigator.; Sprachta Jan investigator.; Stampf Susanne investigator.; Steiger Jürg investigator.; Stirnimann Guido investigator.; Toso Christian investigator.; Venetz Jean‐Pierre investigator.; Villard Jean investigator.; Wick Madeleine investigator.; Wilhelm Markus investigator.; Yerly Patrick investigator.;
• Is Part Of: Transplant infectious disease. Volume 20:Issue 4(2018)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2018-05-10
• Subjects: epidemiology -- invasive aspergillosis -- solid organ transplant recipients; Transplantation of organs, tissues, etc -- Complications -- Periodicals; Communicable diseases -- Periodicals; Infection -- Periodicals; 617.01
• DOI: 10.1111/tid.12898
• Languages: English
• ISSNs: 1398-2273

Abstract

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.