Aspergillus mould infections in lung transplant patients

epidemiology lung transplantation Aspergillus fumigatus

dr. E.A.M. Verschuuren
dr. D.F. Postma

Nature of the research:
Observational cohort study

Fields of study:
epidemiology pulmonology internal medicine

Background / introduction
Invasive fungal infections, such as invasive aspergillosis, are a major concern in solid organ transplant (SOT) recipients. Lung transplant recipients (LTR) are especially prone to invasive fungal disease. A multicenter study performed in the US on transplant recipients identified an incidence of invasive fungal infection of 8.6% during the first year after lung transplantation. Risk factors were numerous, prominent ones being pre-transplant fungal colonization of airways, surgical complications such as bronchial anastomosis ischemia, intensity of immunosuppression, and direct environmental exposure to moulds. Data on the incidence, diagnosis, outcomes, and treatment in the current era of fungal diagnostics and treatment are limited.
Research question / problem definition
- What is the incidence of pulmonary colonization with Aspergillus or invasive pulmonary aspergillosis in lung transplant recipients per patient follow up year?
- What are the most important risk factors for colonization with Aspergillus or invasive pulmonary aspergillosis in lung transplant recipients?
- What is the duration and nature of antifungal therapy given for invasive aspergilus infections?
- What is the extent of antifungal stewardship provided by supportive disciplines? What is the compliance with antifungal stewardship advice?
This is a project for a medical student in the final Master phase for the full period of 20 weeks. One to two weeks will be used for familiarizing with the team and background information. Twelve weeks will be spent on data acquisition and writing of the analysis plan, the next four weeks will be spent on analysis. The final four weeks of the project will be used for writing and presentation of the results.
1. Pappas, P. G. et al. Invasive Fungal Infections among Organ Transplant Recipients: Results of the Transplant-Associated Infection Surveillance Network (TRANSNET). Clin Infect Dis 50, 1101–1111 (2010).

2. Husain, S. & Camargo, J. F. Invasive Aspergillosis in solid-organ transplant recipients: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice. Clinical Transplantation 0, e13544 (2019).

3. Doligalski, C. T. et al. Epidemiology of Invasive Mold Infections in Lung Transplant Recipients. American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons 14, 1328 (2014).
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