Invasive Fungal Infections in Lung Transplant Recipients Not Receiving Routine Systemic Antifungal Prophylaxis: 12-Year Experience at a University Lung Transplant Center

Study Objective. To determine the rate of invasive fungal infection among the lung transplant population at a center that does not provide routine systemic antifungal prophylaxis, and to compare that rate with rates currently reported in the literature. Design. Retrospective medical record review. Setting. University-affiliated lung transplant center. Patients. Two hundred forty-two adults without cystic fibrosis who underwent lung transplantation between March 1, 1994, and June 30, 2006. Measurements and Main Results. Patients were followed by the adult lung transplant service. Twenty-three cases of invasive fungal infections were identified in 22 patients, resulting in a 9.1% overall invasive fungal infection rate in our study population. Aspergillus infections were the most common type of fungal infection identified, occurring in 11(47.8%) of the 23 cases, with an overall rate of 4.5% (11/242 patients). Invasive fungal infections in lung transplant recipients have been reported in the literature at a rate 15-35%, with rates of Aspergillus infections reported as 3-15%. Conclusion. Despite the absence of routine systemic antifungal prophylaxis, the overall invasive fungal infection rate and the Aspergillus infection rate in these lung transplant recipients do not appear to be higher than the rates reported in the literature.