TY - JOUR
T1 - Geoclimatic influences on invasive aspergillosis after hematopoietic stem cell transplantation
AU - Panackal, Anil A.
AU - Li, Hong
AU - Kontoyiannis, Dimitrios P.
AU - Mori, Motomi
AU - Perego, Cheryl A.
AU - Boeckh, Michael
AU - Marr, Kieren A.
N1 - Funding Information:
Financial support. National Institutes of Health (grants AI51468, AI54736, CA 18029, and CA15704; and UL1 RR024140 to the Oregon Clinical and Translational Research Institute, Portland); Knight Cancer Institute, Oregon Health & Science University, Portland (grant P30CA069533).
PY - 2010/6/15
Y1 - 2010/6/15
N2 - Background. Aspergillus species are ubiquitous. We hypothesized that climatic variables that affect airborne mold counts affect the incidence of invasive aspergillosis (IA). Methods. Patients who received hematopoietic stem cell transplants (HSCTs) in geographically and climatically diverse regions (Seattle, WA, and Houston, TX) were examined. Cumulative incidence function, Kaplan-Meier analysis, and Cox proportional hazards regression were performed to examine the association between IA and season. Poisson regression analysis was performed to evaluate the seasonal patterns in IA rates and association with spore counts and climate. Results. In Seattle, the 3-month incidence of IA was 4.6% (5.7% in allograft recipients and 0.8% in autograft recipients). During the 10-year study period, there was a decrease in the incidence of IA among allogeneic HSCT recipients, corresponding to decreased risks during the nonsummer months; receipt of HSCTs during the summer months was associated with an increased hazard for IA (hazard ratio, 1.87; 95% confidence interval, 1.25-2.81) after adjustment for other known risks. The person-month IA rate in Seattle was positively associated with environmental spore counts, which increased with high temperature and low precipitation. No seasonal effect on IA was observed in Houston, where total spore counts were lower and not variable by climate. Conclusions. Climatic variables differentially affect airborne spore counts and IA risk in geographically disparate centers.
AB - Background. Aspergillus species are ubiquitous. We hypothesized that climatic variables that affect airborne mold counts affect the incidence of invasive aspergillosis (IA). Methods. Patients who received hematopoietic stem cell transplants (HSCTs) in geographically and climatically diverse regions (Seattle, WA, and Houston, TX) were examined. Cumulative incidence function, Kaplan-Meier analysis, and Cox proportional hazards regression were performed to examine the association between IA and season. Poisson regression analysis was performed to evaluate the seasonal patterns in IA rates and association with spore counts and climate. Results. In Seattle, the 3-month incidence of IA was 4.6% (5.7% in allograft recipients and 0.8% in autograft recipients). During the 10-year study period, there was a decrease in the incidence of IA among allogeneic HSCT recipients, corresponding to decreased risks during the nonsummer months; receipt of HSCTs during the summer months was associated with an increased hazard for IA (hazard ratio, 1.87; 95% confidence interval, 1.25-2.81) after adjustment for other known risks. The person-month IA rate in Seattle was positively associated with environmental spore counts, which increased with high temperature and low precipitation. No seasonal effect on IA was observed in Houston, where total spore counts were lower and not variable by climate. Conclusions. Climatic variables differentially affect airborne spore counts and IA risk in geographically disparate centers.
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U2 - 10.1086/652761
DO - 10.1086/652761
M3 - Article
C2 - 20450414
AN - SCOPUS:77953004089
SN - 1058-4838
VL - 50
SP - 1588
EP - 1597
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
IS - 12
ER -