Epidemiology of Aspergillus Infections in a Large Cohort of Patients Undergoing Bone Marrow Transplantation
Abstract
To investigate the incidence, risk factors, and outcome of Aspergillus infections among marrow transplant recipients, records from 2496 patients were reviewed, and 214 patients had Aspergillus organisms identified. Of these, 158 had invasive aspergillosis, 44 were colonized, and 12 had contaminated cultures. The incidence of invasive aspergillosis increased from 5.7% to 11.2% during the study. The onset of infection was bimodal, peaking 16 and 96 days after transplant. For patients within 40 days after transplant, underlying disease, donor type, season, and transplant outside of laminar air flow rooms were associated with significant risk for invasive aspergillosis. For patients >40 days after transplant, age, underlying disease, donor type, graft-versus-host disease, neutropenia, and corticosteroid use were associated with increased risk of aspergillosis. Only 31% of infected patients were neutropenic at the time of diagnosis. The risk factors for aspergillosis depend on the time after marrow transplant and include both host and environmental characteristics.
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Among patients with documented MRSA infections, delays of > 24-48 hours until antibiotic administration are associated with increased mortality in some studies, but not in others.
“Among patients with documented MRSA infections, delays of > 24-48 hours until antibiotic administration are associated with increased mortality in some studies (143-147), but not in others (148-154).”
From Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. (2021) · cites this paper as [144]
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- Authors
- Wald, A., Leisenring, W., van Burik, J., & Bowden, R. A.
- Affiliations
- University of Washington (US)
- Venue
- The Journal of Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 1997-06
- Volume
- 175
- Issue
- 6
- Pages
- 1459-1466
- ISSN
- 0022-1899 (ISSN-L)
- 1537-6613
- OpenAlex
- W2149288225
- Cited by
- 742
- References
- 0
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 7 · 2023: 8 · 2022: 9 · 2021: 11 · 2020: 7 · 2019: 12 · 2018: 6 · 2017: 8 · 2016: 19 · 2015: 24 · 2014: 21 · 2013: 13 · 2012: 25
- FWCI
- 23.62
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Infectious Diseases (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Heart, Lung, and Blood Institute (HL-36444, P01HL036444)
- National Cancer Institute (CA18029, P01CA018029)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
- Health Sciences › Medicine › Oncology › Neutropenia and Cancer Infections
- Life Sciences › Immunology and Microbiology › Immunology › Immunodeficiency and Autoimmune Disorders
- Keywords
- aspergillosis, invasive aspergillosis, bone marrow transplantation, risk factors, incidence, fungal colonization, graft-versus-host disease, neutropenia, corticosteroid use, donor type, environmental risk factors, post-transplant infection
- MeSH terms
- Adolescent, Adult, Aspergillosis, Aspergillus, Female, Humans, Male, Neutropenia, Opportunistic Infections, Organ Specificity, Retrospective Studies, Risk Factors, Seasons, Transplantation, Autologous, Transplantation, Homologous, Cohort Studies, Incidence, Proportional Hazards Models, Bone Marrow Transplantation
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