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

Benjamin J. Park, Peter G. Pappas, Kathleen A. Wannemuehler and 22 more

Emerging Infectious Diseases · 2011

doi:10.3201/eid1710.110087

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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From PubMed Central, U.S. National Library of Medicine, as current on Oct 19, 2026. Paragraph numbers are ours, so an answer can point at one.

Medscape CME

Medscape, LLC is pleased to provide online continuing medical education (CME) for this journal article, allowing clinicians the opportunity to earn CME credit.

This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Medscape, LLC and Emerging Infectious Diseases. Medscape, LLC is accredited by the ACCME to provide continuing medical education for physicians.

Medscape, LLC designates this Journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit(s)TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

All other clinicians completing this activity will be issued a certificate of participation. To participate in this journal CME activity: (1) review the learning objectives and author disclosures; (2) study the education content; (3) take the post-test with a 70% minimum passing score and complete the evaluation at www.medscape.org/journal/eid; (4) view/print certificate.

Release date: September 23, 2011; Expiration date: September 23, 2012

Learning Objectives

Upon completion of this activity, participants will be able to:

Distinguish the type of fungal infection most common in the current case series

Evaluate patient characteristics associated with fungal infection after transplant

Assess other factors associated with fungal infection after transplant

Analyze the epidemiology of mucormycosis in the current case series

Editor

Karen L. Foster, Technical Writer/Editor, Emerging Infectious Diseases. Disclosure: Karen L. Foster has disclosed no relevant financial relationships.

CME Author

Charles P. Vega, MD, Associate Professor; Residency Director, Department of Family Medicine, University of California, Irvine. Disclosure: Charles P. Vega, MD, has disclosed no relevant financial relationships.

Authors

Disclosures: Benjamin J. Park, MD; Kathleen A. Wannemuehler, MSc; Janice M. Brown, MD; Lisa M. Brumble, MD; G. Marshall Lyon, MD, MMSc; Randall Walker, MD; Thomas J. Walsh, MD; and Dimitrios P. Kontoyiannis, MD, have disclosed no relevant financial relationships. Peter G. Pappas, MD, has disclosed the following relevant financial relationships: served as an advisor or consultant for Pfizer Inc., Merck & Co., Inc., Astellas Pharma, Inc.; received grants for clinical research from Pfizer Inc., Merck & Co., Inc., Astellas Pharma, Inc. Barbara D. Alexander, MD, has disclosed the following relevant financial relationships: served as an advisor or consultant for bioMerieux, Bristol-Myers Squibb Company, Becton-Dickinson; received grants for clinical research from Pfizer Inc., Astellas Pharma, Inc., Charles River Laboratories. Elias J. Anaissie, MD, has disclosed the following relevant financial relationships: received grants for clinical research from Astellas Pharma, Inc., Millenium, Pfizer Inc. David R. Andes, MD, has disclosed the following relevant financial relationships: served as an advisor or consultant for Pfizer Inc., Merck & Co., Inc., Astellas; received grants for clinical research from Merck, Astellas Pharma, Inc. John W. Baddley, MD, MSPH, has disclosed the following relevant financial relationships: served as an advisor or consultant for Pfizer Inc., Merck & Co., Inc., Abbott; received grants for clinical research from Pfizer Inc. Alison G. Freifeld, MD, has disclosed the following relevant financial relationships: received grants for clinical research from Streck Inc., Chimerix. Susan Hadley, MD, has disclosed the following relevant financial relationships: served as an advisor or consultant for Merck & Co., Inc.; DSMB member. Loreen Herwaldt, MD, has disclosed the following relevant financial relationships: received grants for clinical research from 3M. James I. Ito, MD, has disclosed the following relevant financial relationships: served as an advisor or consultant for Sigma Tau; served as a speaker or a member of a speakers bureau for Astellas Pharma, Inc., Merck & Co., Inc., Pfizer Inc. Carol A. Kauffman, MD, has disclosed the following relevant financial relationships: received grants for clinical research from Merck & Co., Inc.; chair for the Data Adjudication Committee for Phase IV anidulafungin trial (Pfizer Inc.). Kieren A. Marr, MD, has disclosed the following relevant financial relationships: served as an advisor or consultant for Pfizer Inc., Merck & Co., Inc., Astellas Pharma, Inc.; received grants for clinical research from Merck & Co., Inc., Astellas Pharma, Inc. Vicki A. Morrison, MD, has disclosed the following relevant financial relationships: served as an advisor or consultant for Amgen Inc., Celgene Corporation; served as a speaker or a member of a speakers bureau for Amgen Inc., Celgene Corporation, Genentech Inc., Pfizer Inc. Genovefa Papanicolaou, MD, has disclosed the following relevant financial relationships: served as an advisor or consultant for Chimerix Inc., Merck & Co., Inc. Thomas F. Patterson, MD, has disclosed the following relevant financial relationships: served as an advisor or consultant for Pfizer Inc., Merck & Co., Inc., Astellas Pharma, Inc., Basilea & Toyon; served as a speaker for Pfizer Inc.; received grants for clinical research from Pfizer Inc., Merck & Co., Inc., Astellas Pharma, Inc., Basilea, Schering-Plough Corporation. Trish M. Perl, MD, has disclosed the following relevant financial relationships: served as an advisor or consultant for Hospira, BioMerieux, Pfizer Inc.; received grants for clinical research from Merck & Co., Inc., Sage. Mindy G. Schuster, MD, has disclosed the following relevant financial relationships: received grants for clinical research from Merck & Co., Inc. John R. Wingard, MD, has disclosed the following relevant financial relationships: served as an advisor or consultant for Merck & Co., Inc.; served as a speaker or a member of a speakers bureau for Pfizer Inc.

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