Paper of the Month - March, 2011

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Factors associated with mortality in transplant patients with invasive aspergillosis

Baddley JW, Andes DR, Marr KA et al.; Transplant Associated Infection Surveillance Network.
The purpose of this study was to evaluate factors associated with mortality among patients who developed invasive aspergillosis (IA) following hematopoietic stem cell transplantation (HSCT) and solid-organ transplantation (SOT). Among HSCT recipients, factors independently associated with death included neutropenia, renal insufficiency, hepatic insufficiency, early-onset IA, proven IA, and methylprednisolone use. Conversely, white race was associated with a reduced risk of death. Among recipients of SOT, hepatic impairment, malnutrition, and involvement of the central nervous system were indicators of poor outcomes. The use of an amphotericin B formulation as part of initial therapy was associated with an increased risk of death in both patient groups. Knowledge of patient factors that influence the outcome of IA may allow clinicians to optimize patient therapy and reduce death.


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