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Updated: May 22, 2026
Investigating the Immunological Mechanisms Underlying Organ Transplant Rejection
Published on: August 20, 2007
Invasive mold infections among transplant recipients: A single-center observational study
Sukanya Sudhaharan1, Umabala Pamidimukkala1, Shivani Bojja1
1Department of Microbiology, ICMR-Advanced Mycology Diagnostic and Research Centre, Nizam's Institute of Medical Sciences, Panjagutta, Hyderabad-500082, Telangana, India.
Introduction:
Patients undergoing solid organ and hematopoietic stem cell transplants are at an increased risk for invasive fungal infections (IFI), which constitute the primary cause of mortality in this population. The epidemiology and risk factors for invasive fungal infections differ according to the type of transplant. There are limited studies from India concerning the spectrum of invasive mold infections (IMI) in transplant recipients. This study aims to elucidate the clinical microbiological spectrum of mold infections in transplant recipients.
Materials And Methods:
This study was a retrospective analysis of solid organ transplant (SOT) and hematopoietic stem cell transplant patients (HSCT) with mold infections from January 2023 to December 2025 at a tertiary care center in southern India. Patients with IMI were included in the study according to the EORTC/MSG criteria. Clinical and microbiological data were extracted from records and analyzed.
Results:
During the study period, a total of 3.6% IMI was observed. Of these, 3.8% were from renal transplants, 2.4% from hematopoietic stem cell transplants (HSCT), and 33.3% from lung transplant recipients. Among the IMI cases, 37.5% were proven, whereas 62.5% were classified as probable IMI cases. The male population was predominant, with a median age of 37 years. The lungs were the most frequently affected site, followed by subcutaneous infections. The predominant mold infection was mucormycosis in 43.7% cases, followed by aspergillosis in 31.25%. The majority of infections occurred within the initial six months post-transplantation.
Conclusion:
In the current study, Mucorales is the predominant mold isolated, accompanied by rare molds. Clinicians must recognize invasive mold infections (IMI), including the uncommon molds responsible for transplant-related infections, to enable rapid and appropriate treatment, crucial for survival.
Insights
Invasive mold infections (IMI) are a significant risk for transplant recipients in India. Mucormycosis and aspergillosis were the most common IMI, often affecting the lungs within six months post-transplant.
Area of Science:
- Medical Mycology
- Transplant Infectious Diseases
- Clinical Microbiology
Background:
- Transplant recipients face high mortality from invasive fungal infections (IFI).
- Epidemiology of IFI varies by transplant type, with limited Indian data on invasive mold infections (IMI).
Purpose of the Study:
- To determine the clinical and microbiological spectrum of mold infections in solid organ and hematopoietic stem cell transplant recipients in India.
Main Methods:
- Retrospective analysis of SOT and HSCT patients with IMI from January 2023 to December 2025.
- Inclusion based on EORTC/MSG criteria; data extracted and analyzed.
Main Results:
- 3.6% overall IMI incidence; highest in lung (33.3%) and renal (3.8%) transplants.
- Mucormycosis (43.7%) and aspergillosis (31.25%) were predominant; lungs most affected.
- Most infections occurred within six months post-transplant; males predominated (median age 37).
Conclusions:
- Mucorales species are the primary cause of IMI in Indian transplant recipients.
- Early recognition of IMI, including rare molds, is critical for timely treatment and improved survival.
