Invasive fungal infections among organ transplant recipients: results of the Transplant-Associated Infection Surveillance Network (TRANSNET).

BACKGROUND: Invasive fungal infections (IFIs) are a major cause of morbidity and mortality among organ transplant recipients. Multicenter prospective surveillance data to determine disease burden and secular trends are lacking. METHODS: The Transplant-Associated Infection Surveillance Network (TRANSNET) is a consortium of 23 US transplant centers, including 15 that contributed to the organ transplant recipient dataset. We prospectively identified IFIs among organ transplant recipients from March, 2001 through March, 2006 at these sites. To explore trends, we calculated the 12-month cumulative incidence among 9 sequential cohorts. RESULTS: During the surveillance period, 1208 IFIs were identified among 1063 organ transplant recipients. The most common IFIs were invasive candidiasis (53%), invasive aspergillosis (19%), cryptococcosis (8%), non-Aspergillus molds (8%), endemic fungi (5%), and zygomycosis (2%). Median time to onset of candidiasis, aspergillosis, and cryptococcosis was 103, 184, and 575 days, respectively. Among a cohort of 16,808 patients who underwent transplantation between March 2001 and September 2005 and were followed through March 2006, a total of 729 IFIs were reported among 633 persons. One-year cumulative incidences of the first IFI were 11.6%, 8.6%, 4.7%, 4.0%, 3.4%, and 1.3% for small bowel, lung, liver, heart, pancreas, and kidney transplant recipients, respectively. One-year incidence was highest for invasive candidiasis (1.95%) and aspergillosis (0.65%). Trend analysis showed a slight increase in cumulative incidence from 2002 to 2005. CONCLUSIONS: We detected a slight increase in IFIs during the surveillance period. These data provide important insights into the timing and incidence of IFIs among organ transplant recipients, which can help to focus effective prevention and treatment strategies.

Telescoping is not time compression: a model of the dating of autobiographical events.

A model of telescoping is proposed that assumes no systematic errors in dating. Rather, the overestimation of recent occurrences of events is based on the combination of three factors: (1) Retention is greater for recent events; (2) errors in dating, though unbiased, increase linearly with the time since the dated event; and (3) intrusions often occur from events outside the period being asked about, but such intrusions do not come from events that have not yet occurred. In Experiment 1, we found that recall for colloquia fell markedly over a 2-year interval, the magnitude of errors in psychologists' dating of the colloquia increased at a rate of .4 days per day of delay, and the direction of the dating error was toward the middle of the interval. In Experiment 2, the model used the retention function and dating errors from the first study to predict the distribution of the actual dates of colloquia recalled as being within a 5-month period. In Experiment 3, the findings of the first study were replicated with colloquia given by, instead of for, the subjects.