The epidemiology and choice of therapy for candidemia are rapidly changing. Additional study is warranted to differentiate host factors and differences in virulence among Candida species and to determine the best therapeutic regimen.

IA remains the most commonly identified IFI among HSCT recipients, but rates of survival in persons with IA appear to have improved, compared with previously reported data. Invasive candidiasis and IFI due to molds other than Aspergillus species remain a significant problem in HSCT recipients.

Contemporary epidemiology and outcomes of invasive fungal infections (IFIs) in solid organ transplant (SOT) recipients are not well described. From March 2004 through September 2007, proven and probable IFIs were prospectively identified in 17 transplant centers in the United States. A total 429 adult SOT recipients with 515 IFIs were identified; 362 patients received a single and 67 patients received >or=2 organs. Most IFIs were caused by Candida species (59.0%), followed by Aspergillus species (24.8%), Cryptococcus species (7.0%), and other molds (5.8%). Invasive candidiasis (IC) was the most frequently observed IFI in all groups, except for lung recipients where invasive aspergillosis (IA) was the most common IFI (P<0.0001). Almost half of IC cases in liver, heart, and lung transplant recipients occurred during the first 100 days post transplant. Over half of IA cases in lung recipients occurred >1 year post transplant. Overall 12-week mortality was 29.6%; liver recipients had the highest mortality (P=0.05). Organ damage, neutropenia, and administration of corticosteroids were predictors of death. These results extend our knowledge on the epidemiology of IFI in SOT recipients, emphasizing the occurrence of IC early after non-lung transplant, and late complications with molds after lung transplant. Overall survival appears to have improved compared with historical reports.

Abstract. Nearly a century of fire suppression has changed fundamental aspects of the structure and functioning of fire-adapted forests throughout the western U.S. Prescribed fire is increasingly used to restore forest structure and reduce surface fuels with limited consideration of its consequences for biological diversity. In this study, we used more than two decades of data from permanent plots in mixedconifer forests of Sequoia and Kings Canyon National Parks, California, to explore changes in plant diversity and abundance following reintroduction and repeated use of fire. Data on stand structure, fuel loading, fire severity and heterogeneity, and the richness and abundance of major growth forms were collected on 51 plots representing one of three treatments: control, first-entry burn, and second-entry burn. Understories showed distinct compositional changes over time in first-and second-entry burns. Burned plots supported more than twice as many species as controls 10 yr after treatment; first-entry plots showed a nearly threefold increase in richness by year 20. Burned plots supported four to five times as many shrub species as controls 5-10 yr after burning. Total plant cover (dominated by perennial forbs and shrubs) increased in first-entry plots, but did not differ from controls until 20 yr after treatment. Following secondentry, cover did not change through final sampling (year 10). Nonnative species were rare, occurring in only three plots at low abundance. Higher severity fires led to greater numbers of species and to greater plant cover. Species richness was not correlated with burn heterogeneity. Long-term observations suggest that reintroduction of fire in previously unmanaged forests can gradually enhance the diversity and abundance of understory species. Repeated burning-necessary to achieve structural and fuel-reduction objectives-does not appear to have a detrimental effect on plant diversity and may enhance the distributions of species that are adversely affected by fire exclusion. If fire is to play an important role in restoration, however, it will need to be maintained as a frequent and spatially dynamic process on the landscape.