TABLE 3 ∣.
Characteristics of patients with invasive fungal disease (IFD) development among solid organ transplant recipients, United States, 2018–2022a.
| Kidney | Liver | Heart | Lung | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
|
|
|
|
|
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| Characteristics | All (N = 5667) |
IFD (n = 138) |
No IFD (n = 5529) |
p value | All (N = 2025) |
IFD (n = 67) |
No IFD (n = 1958) |
p value | All (N = 759) |
IFD (n = 35) |
No IFD (n = 724) |
p value | All (N = 650) |
IFD (n = 117) |
No IFD (n = 533) |
p value |
| Demographic features | ||||||||||||||||
| Median age in years (IQR) | 52.7 (42.4–60.5) | 54.9 (47.1–62.0) | 52.6 (42.4–60.5) | 0.031 | 55.1 (45.3–61.1) | 57.9 (48.7–63.1) | 54.9 (45.2–61.1) | 0.093 | 53.9 (41.3–61.0) | 57.9 (53.4–62.5) | 53.6 (41.1–60.9) | 0.046 | 57.9 (52.2–63.9) | 59.9 (53.3–63.8) | 59.7 (52.2–63.9) | 0.922 |
| Age group (years) | 0.084 | 0.647 | 0.080 | 0.460 | ||||||||||||
| 0–17 | 144 (2.5) | 1 (0.7) | 143 (2.6) | 81 (4.0) | 2 (3.0) | 79 (4.0) | 71 (9.4) | 3 (8.6) | 68 (9.4) | 13 (2.0) | 1 (0.9) | 12 (2.3) | ||||
| 18–44 | 1545 (27.3) | 29 (21.0) | 1516 (27.4) | 415 (20.5) | 10 (14.9) | 405 (20.7) | 147 (19.4) | 1 (2.9) | 146 (20.2) | 84 (12.9) | 19 (16.2) | 65 (12.2) | ||||
| 45–64 | 3362 (59.3) | 87 (63.0) | 3275 (59.2) | 1351 (66.7) | 49 (73.1) | 1302 (66.5) | 467 (61.5) | 27 (77.1) | 440 (60.8) | 429 (66.0) | 73 (62.4) | 356 (66.8) | ||||
| ≥ 65 | 616 (10.9) | 21 (15.2) | 595 (10.8) | 178 (8.8) | 6 (9.0) | 172 (8.8) | 74 (9.7) | 4 (11.4) | 70 (9.7) | 124 (19.1) | 24 (20.5) | 100 (18.8) | ||||
| Female | 2139 (37.7) | 49 (35.5) | 2090 (37.8) | 0.583 | 744 (36.7) | 26 (38.8) | 718 (36.7) | 0.721 | 212 (27.9) | 9 (25.7) | 203 (28.0) | 0.765 | 219 (33.7) | 36 (30.8) | 183 (34.3) | 0.460 |
| US census regionb | 0.993 | 0.215 | 0.927 | 0.186 | ||||||||||||
| Northeast | 890 (16.4) | 21 (15.8) | 869 (16.4) | 265 (13.6) | 8 (12.7) | 257 (13.6) | 120 (16.6) | 6 (19.4) | 114 (16.5) | 101 (16.4) | 21 (18.9) | 80 (15.9) | ||||
| South | 2548 (47.0) | 62 (46.6) | 2486 (47.0) | 981 (50.4) | 27 (42.9) | 954 (50.6) | 333 (46.0) | 13 (41.9) | 320 (46.2) | 260 (42.3) | 41 (36.9) | 219 (43.5) | ||||
| Midwest | 1247 (23.0) | 31 (23.3) | 1216 (23.0) | 415 (21.3) | 13 (20.6) | 402 (21.3) | 165 (22.8) | 8 (25.8) | 157 (22.7) | 165 (26.8) | 37 (33.3) | 128 (25.4) | ||||
| West | 737 (13.6) | 19 (14.3) | 718 (13.6) | 286 (14.7) | 15 (23.8) | 271 (14.4) | 106 (14.6) | 4 (12.9) | 102 (14.7) | 89 (14.5) | 12 (10.8) | 77 (15.3) | ||||
| Underlying medical conditions during 0–180 days before transplantc | ||||||||||||||||
| Asthma | 347 (6.1) | 9 (6.5) | 338 (6.1) | 0.843 | 156 (7.7) | 6 (9.0) | 150 (7.7) | 0.696 | 71 (9.4) | 4 (11.4) | 67 (9.3) | 0.560 | 97 (14.9) | 21 (17.9) | 76 (14.3) | 0.310 |
| Bronchiectasis | 22 (0.4) | 1 (0.7) | 21 (0.4) | 0.419 | 21 (1.0) | 2 (3.0) | 19 (1.0) | 0.152 | 10 (1.3) | 1 (2.9) | 9 (1.2) | 0.378 | 177 (27.2) | 43 (36.8) | 134 (25.1) | 0.011 |
| Chronic obstructive pulmonary disease | 172 (3.0) | 6 (4.3) | 166 (3.0) | 0.314 | 147 (7.3) | 12 (17.9) | 135 (6.9) | 0.003 | 89 (11.7) | 2 (5.7) | 87 (12.0) | 0.417 | 306 (47.1) | 61 (52.1) | 245 (46.0) | 0.226 |
| Dialysis | 4467 (78.8) | 115 (83.3) | 4342 (78.5) | 0.174 | 209 (10.3) | 13 (19.4) | 196 (10.0) | 0.024 | 43 (5.7) | 3 (8.6) | 40 (5.5) | 0.442 | 15 (2.3) | 3 (2.6) | 12 (2.3) | 0.741 |
| Interstitial lung disease | 92 (1.6) | 0 (0.0) | 92 (1.7) | 0.175 | 109 (5.4) | 7 (10.4) | 102 (5.2) | 0.088 | 62 (8.2) | 6 (17.1) | 56 (7.7) | 0.058 | 428 (65.8) | 90 (76.9) | 338 (63.4) | 0.005 |
| Pulmonary hypertension | 266 (4.7) | 14 (10.1) | 252 (4.6) | 0.002 | 243 (12.0) | 10 (14.9) | 233 (11.9) | 0.454 | 381 (50.2) | 18 (51.4) | 363 (50.1) | 0.882 | 331 (50.9) | 64 (54.7) | 267 (50.1) | 0.367 |
| Diabetes mellitus | 2376 (41.9) | 78 (56.5) | 2298 (41.6) | < 0.001 | 713 (35.2) | 36 (53.7) | 677 (34.6) | 0.001 | 296 (39.0) | 20 (57.1) | 276 (38.1) | 0.024 | 229 (35.2) | 41 (35.0) | 188 (35.3) | 0.963 |
| Hematologic malignancy | 171 (3.0) | 4 (2.9) | 167 (3.0) | > 0.999 | 52 (2.6) | 1 (1.5) | 51 (2.6) | > 0.999 | 32 (4.2) | 0 (0.0) | 32 (4.4) | 0.392 | 13 (2.0) | 5 (4.3) | 8 (1.5) | 0.066 |
| HIV infection | 57 (1.0) | 3 (2.2) | 54 (1.0) | 0.161 | 11 (0.5) | 2 (3.0) | 9 (0.5) | 0.489 | 1 (0.1) | 1 (2.9) | 0 (0.0) | 0.046 | 5 (0.8) | 0 (0.0) | 5 (0.9) | 0.591 |
| Solid malignancy | 309 (5.5) | 10 (7.2) | 299 (5.4) | 0.347 | 581 (28.7) | 18 (26.9) | 563 (28.8) | 0.737 | 48 (6.3) | 3 (8.6) | 45 (6.2) | 0.480 | 43 (6.6) | 7 (6.0) | 36 (6.8) | 0.761 |
| Other conditionsc,d | ||||||||||||||||
| Graft-versus-host disease | 8 (0.1) | 0 (0.0) | 8 (0.1) | > 0.999 | 11 (0.5) | 1 (1.5) | 10 (0.5) | 0.310 | 3 (0.4) | 0 (0.0) | 3 (0.4) | > 0.999 | 9 (1.4) | 3 (2.6) | 6 (1.1) | 0.209 |
| Cytomegalovirus | 1264 (22.3) | 25 (18.1) | 1239 (22.4) | 0.231 | 451 (22.3) | 12 (17.9) | 439 (22.4) | 0.383 | 230 (30.3) | 10 (28.6) | 220 (30.4) | 0.820 | 141 (21.7) | 32 (27.4) | 109 (20.5) | 0.101 |
| Neutropenia | 879 (15.5) | 23 (16.7) | 856 (15.5) | 0.704 | 333 (16.4) | 9 (13.4) | 324 (16.5) | 0.499 | 119 (15.7) | 1 (2.9) | 118 (16.3) | 0.033 | 102 (15.7) | 14 (12) | 88 (16.5) | 0.221 |
| Transplant rejection | 1060 (18.7) | 35 (25.4) | 1025 (18.5) | 0.042 | 455 (22.5) | 16 (23.9) | 439 (22.4) | 0.778 | 597 (78.7) | 29 (82.9) | 568 (78.5) | 0.535 | 276 (42.5) | 54 (46.2) | 222 (41.7) | 0.372 |
| Median follow-up time (IQR) | 597 (296.0–1035.0) | 724 (393.0–1241.0) | 593 (295.0–1029.0) | 0.001 | 521 (261.0–926.0) | 735 (445.0–1094.0) | 514 (260.0–917.0) | 0.003 | 532 (281.0–999.0) | 650 (347.0–1115.0) | 523 (277.0–996.0) | 0.437 | 507.5 (268.0–906.0) | 665 (458.0–966.0) | 459 (245.0–856.0) | < 0.001 |
Abbreviation: IQR, interquartile range.
a
p values were calculated using chi-square or Fisher’s exact tests (for small cell sizes) for proportions.
b
US census region of primary beneficiary’s residence. Map of US census regions: https://www2.census.gov/geo/pdfs/maps-data/maps/reference/us_regdiv.pdf.
c
Patients could have more than condition.
d
These conditions were either present between transplant date and date of incident IFD diagnosis or between the transplant date until the date of last follow-up, whichever occurred earliest.