TABLE 2.
Fungal infection and treatmenta
| Fungal infection | Description |
|---|---|
| Median (range) time (mo) from transplant to infection | 5.7 (1.7–40.2) |
| Identified fungal species | 53 species in 44 SOTR |
| Aspergillus spp | 43 (81.1) |
| Alternaria alternata | 1 (1.9) |
| Diaporthe spp. | 1 (1.9) |
| Lomentospora prolificans | 1 (1.9) |
| Purpureocillium lilacinus | 1 (1.9) |
| Unidentified new mold species (28) | 1 (1.9) |
| Mucormycosis | 1 (1.9) |
| Trichosporon asahii | 2 (3.8) |
| Candida albicans | 1 (1.9) |
| Saccharomyces cerevisiae | 1 (1.9) |
| No fungal isolate | 9 SOTR |
| Type of FIb | 54 infections in 53 SOTRc |
| Tracheobronchitis | 25 (46.3) |
| Fungal pneumonia | 7 (13) |
| Bronchial anastomotic infection | 2 (3.7) |
| Other | |
| Micetoma | 6 (11.1) |
| Cutaneous infection | 3 (5.6) |
| Disseminated FI | 2 (3.7) |
| Osteomyelitis | 1 (1.9) |
| Chronic otitis media | 1 (1.9) |
| Isolation in donor | 1 (1.9) |
| No proven or probable FI | 6 (11.1) |
| Previous antifungal treatments | 17 (32.1) |
| Voriconazole | 7 (13.2) |
| Nebulized amphotericin B | 5 (9.4) |
| Systemic echinocandin (micafungin or anidulafungin) | 5 (9.4) |
| Duration of previous treatment (days). Mean (IQR) | 13 (4–37) |
| Reason to stop previous treatment (n = 17) | |
| Intravenous-to-oral switch and avoiding interactions | 6 (35.3) |
| No previous clinical benefit | 5 (29.4) |
| Switch according to antifungal susceptibility | 3 (17.6) |
| Adverse events with previous treatment | 3 (17.6) |
a
Data are expressed as numbers (%) unless otherwise indicated. EORTC/MSGERC, European Organization for Research and Treatment of Cancer and the Mycoses Study Group Education and Research Consortium; FI, fungal infection; IQR, interquartile range; ISA, isavuconazole; ISHLT, International Society for Heart and Lung Transplantation; SOTR, solid organ transplant recipient.
b
All cases were definite or probable fungal infection according to ISHLT and EORTC/MSGERC criteria except when indicated.
c
One patient was treated for fungal tracheobronchitis and subcutaneous infection at the same time.