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Transpl Infect Dis DOI:10.1111/tid.12935

Genomic characterization of recurrent mold infections in thoracic transplant recipients.

Publication TypeJournal Article
Year of Publication2018
AuthorsMessina, JA, Wolfe, CR, Hemmersbach-Miller, M, Milano, C, Todd, JL, Reynolds, J, Alexander, BD, Schell, WA, Cuomo, CA, Perfect, JR
JournalTranspl Infect Dis
Date Published2018 Oct
KeywordsAged, Antifungal Agents, Aspergillus fumigatus, Biopsy, DNA, Fungal, Fatal Outcome, Heart Transplantation, Humans, Invasive Fungal Infections, Lung Transplantation, Male, Middle Aged, Recurrence, Saccharomycetales, Transplant Recipients, Whole Genome Sequencing

Invasive mold disease in thoracic organ transplant recipients is a well-recognized complication, but the long-term persistence of molds within the human body and evasion of host defenses has not been well-described. We present 2 cases of invasive mold disease (Verruconis gallopava and Aspergillus fumigatus) in thoracic transplant recipients who had the same mold cultured years prior to the invasive disease presentation. The paired isolates from the index and recurrent infections in both patients were compared using whole-genome sequencing to determine if the same strain of mold caused both the index and recurrent infections. In Case 1, the isolates were found to be of the same strain indicating that the initial colonizing isolate identified pre-transplant eventually caused invasive mold disease post-transplant while in Case 2, the 2 isolates were not of the same strain. These results demonstrate the distinct possibility of molds both persisting within the human body for years prior to invasive mold disease or the long-term risk of recurrent, persistent infection with more than one strain. Further studies of long-term molecular epidemiology of IMD and risk factors for mold persistence in transplant recipients are encouraged.


Alternate JournalTranspl Infect Dis
PubMed ID29851203
PubMed Central IDPMC6175610
Grant ListR01 AI073896 / AI / NIAID NIH HHS / United States
R01 AI093257 / AI / NIAID NIH HHS / United States
U19AI110818 / / National Institute of Allergy and Infectious Diseases /
5T32AI100851 / / National Institute of Allergy and Infectious Diseases /
R01A73896 / / National Institute of Allergy and Infectious Diseases /
R01AI93257 / / National Institute of Allergy and Infectious Diseases /
T32 AI100851 / AI / NIAID NIH HHS / United States
S10 OD018164 / OD / NIH HHS / United States
U19 AI110818 / AI / NIAID NIH HHS / United States