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Updated: May 1, 2026
Author Spotlight: Investigating the Key Factors of Obliterative Bronchiolitis After Lung Transplantation
Published on: November 10, 2023
Epidemiology of invasive mold infections in lung transplant recipients
C T Doligalski1, K Benedict, A A Cleveland
1Department of Pharmacy, Tampa General Hospital, Tampa, FL.
Abstract:
Invasive mold infections (IMIs) are a major source of morbidity and mortality among lung transplant recipients (LTRs), yet information regarding the epidemiology of IMI in this population is limited. From 2001 to 2006, multicenter prospective surveillance for IMIs among LTR was conducted by the Transplant-Associated Infection Surveillance Network. The epidemiology of IMI among all LTRs in the cohort is reported. Twelve percent (143/1173) of LTRs under surveillance at 15 US centers developed IMI infections. The 12-month cumulative incidence of IMIs was 5.5%; 3-month all-cause mortality was 21.7%. Aspergillus caused the majority (72.7%)of IMIs; non-Aspergillus infections (39, 27.3%) included Scedosporium (5, 3.5%), mucormycosis (3, 2.1%) and "unspecified" or "other" mold infections (31, 21.7%). Late-onset IMI was common: 52% occurred within 1 year posttransplant (median 11 months, range 0-162 months). IMIs are common late-onset complications with substantial mortality in LTRs. LTRs should be monitored for late-onset IMIs and prophylactic agents should be optimized based on likely pathogen.
Insights
Invasive mold infections (IMIs) are common in lung transplant recipients (LTRs), often occurring late after transplant. Early monitoring and optimized prophylaxis are crucial due to substantial associated mortality.
Area of Science:
- Medical Mycology
- Transplant Infectious Diseases
- Epidemiology
Background:
- Invasive mold infections (IMIs) pose significant risks for lung transplant recipients (LTRs).
- Limited data exists on the epidemiology of IMIs specifically within the LTR population.
- IMIs contribute to substantial morbidity and mortality in LTRs.
Purpose of the Study:
- To report the epidemiology of invasive mold infections in lung transplant recipients.
- To determine the incidence, timing, and causative agents of IMIs in LTRs.
- To assess the mortality associated with IMIs in this patient group.
Main Methods:
- Multicenter prospective surveillance conducted from 2001 to 2006.
- Involved 15 US centers and 1173 lung transplant recipients.
- Data collected on IMI development and outcomes.
Main Results:
- 12% of LTRs developed IMIs, with a 12-month cumulative incidence of 5.5%.
- Aspergillus species were the most common cause (72.7%), followed by non-Aspergillus molds.
- 52% of IMIs were late-onset (occurring >1 year post-transplant), with a 3-month mortality of 21.7%.
Conclusions:
- Invasive mold infections are frequent, late-onset complications in lung transplant recipients.
- Significant mortality is associated with IMIs in LTRs.
- Continuous surveillance and optimized prophylactic strategies are recommended for LTRs.
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