Table 2.
Risk Factors for Noninfluenza Invasive Pulmonary Aspergillosis
| Risk Factor | NI-IPA (n = 11) | No IPAa (n = 213) | Univariate Analysis P Value | Multivariate Analysis P Value | Odds Ratio (95% CI) |
|---|---|---|---|---|---|
| Median age at time of NI-RVI (IQR), y | 48 (34–63) | 57 (45–65) | .3 | ||
| Median number of months from transplant to NI-RVI (IQR) | 10.8 (8.4–42.4) | 19.0 (5.1–37.8) | .9 | ||
| Organ transplanted | |||||
| Lung or heart-lung | 82 (9) | 75 (157) | .31 | ||
| Kidney | 0 | 6 (13) | |||
| Liver | 0 | 6 (13) | |||
| Heart | 0 | 6 (13) | |||
| Small bowel/multivisceral | 10 (1) | 1 (2) | |||
| Kidney-pancreas | 0 | 1 (2) | |||
| Multi-organb | 10 (1) | 5 (10) | |||
| Immunosuppression | |||||
| Cumulative dose of prednisone equivalent within 7 d of NI-RVP, mg | 96 (35–140) | 35 (25–70) | .02 | ||
| Cumulative dose >140mg of prednisone equivalent within 7 d of NI-RVP | 45 (5) | 5 (11) | <.0001 | <.0001 | 22.6 (4.5–112) |
| Alemtuzumab, thymoglobulin, or rituximab | 20 (2) | 9 (20) | .26 | ||
| Basiliximab | 18 (2) | 3 (6) | .052 | ||
| Tacrolimus | 70 (7) | 76 (160) | .71 | ||
| Cyclosporine A | 20 (2) | 23 (48) | 1 | ||
| Sirolimus/everolimus | 10 (1) | 17 (37) | 1 | ||
| Mycophenolate | 60 (6) | 65 (137) | .74 | ||
| Azathioprine | 10 (1) | 10 (22) | 1 | ||
| Belatacept | 10 (1) | 2 (5) | .25 | ||
| Renal replacement therapy | 0 | 11 (24) | .61 | ||
| Respiratory viruses | .048 | .053 | |||
| Adenovirus | 27 (3) | 15 (32) | |||
| Parainfluenza virus | 64 (7) | 41 (87) | |||
| RSV | 9 (1) | 44 (94) | |||
| Lung involvement (pneumonia) | 64 (7) | 25 (54) | .01 | .009 | 7.2 (1.6–31.7) |
| CMV viremia | 18 (2) | 6 (13) | .16 | ||
| Steroid therapy added within 30 d after RVI diagnosis | 82 (9) | 61 (130) | .22 | ||
| Length of stay, median (IQR), d | 11 (6–22) | 8 (4–24) | .48 | ||
Data are presented as % (No.) unless otherwise indicated. There was no difference in NI-RVI manifestations (asymptomatic vs symptomatic [either URI or pneumonia]) and receipt of NI-RVI treatment between patients with or without NI-IPA.
Abbreviations: CMV, cytomegalovirus; IQR, interquartile range; IPA, invasive pulmonary aspergillosis; NI-IPA, noninfluenza invasive pulmonary aspergillosis; NI-RVIs, noninfluenza respiratory virus infections; RSV, respiratory syncytial virus; RVI, respiratory viral infection.
Thirty-one patients with presumed IPA or Aspergillus colonization were excluded from the analysis.
One patient underwent combined heart-lung and kidney transplant.