Epidemiology of Invasive Fungal Infections in Solid Organ Transplant Recipients: an Indian Perspective

Abstract

Purpose of Review This review summarizes the available Indian data on epidemiology of invasive fungal infections (IFI) in recipients of solid organ transplants (SOT). The epidemiology is further compared with studies from other parts of the world for each SOT type. Recent Findings The available studies on Indian epidemiology of IFI in SOT are scarce, though the number of SOTs performed in India have increased tremendously in recent years. The limited data from India present a distinct spectrum of infection in transplant recipients with high incidence of mucormycosis. During COVID-19 outbreak, IFI rate increased and renal transplant recipients acquired mucormycosis earlier than previous studies. Summary Maximum data on IFI was available from renal transplant recipients, wherein mucormycosis was the predominant IFI in Indian patients in contrast to invasive candidiasis in majority countries. The other IFIs had varied spectrum. With the increasing number of SOTs being performed and the already persisting high burden of IFI in India, there is an urgent need of larger prospective studies on epidemiology of IFI in transplant recipients.

The epidemiology of invasive fungal infections in transplant recipients

“…Indeed, while Candida albicans and Aspergillus spp. remain the most important pathogens in SOT and HSCT, a rising emergence of non- C. albicans and non- Aspergillus infection has recently been noted [ 12 ]. The Transplant-associated infection Surveillance Network (TRANSNET), a global repository of data on transplant patients followed-up prospectively over a six-year period (from 2001 to 2006), found that the risk of IFIs in SOT varied with the organ type, being highest in small bowel (11.6%), followed by lung (8.6%), liver (4.7%), heart (4%), pancreas (3.4%), and kidney (1.3%) [ 5 ].…”

“…The primary mode of acquiring mold infections is inhalation of fungal airborne spores. The resulting IFIs are predominantly observed in lung transplant recipients and are associated with higher mortality due to the frequent multiresistance of these fungi [ 12 ].…”

Invasive Candidiasis: Prevalence, Species Distribution and Trends in Antifungal Susceptibility in an Egyptian University Hospital

“…During the last few decades, the rate of fungal infections have been rising tremendously (Sharma et al, 2022). The estimated global rate of invasive fungal infections is 1.5 million yearly, this rising frequency may be attributed to the wide use of broad-spectrum antibiotics as well as the increased number of immunocompromised individuals due to organ transplantation, HIV infections or cancer patients on chemotherapy (Bajpai et al, 2019).…”