Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2010 Jun 15;50(12):1588-97.
doi: 10.1086/652761.

Geoclimatic influences on invasive aspergillosis after hematopoietic stem cell transplantation

Anil A Panackal  1 , Hong Li, Dimitrios P Kontoyiannis, Motomi Mori, Cheryl A Perego, Michael Boeckh, Kieren A Marr
Affiliations

Geoclimatic influences on invasive aspergillosis after hematopoietic stem cell transplantation

Anil A Panackal et al. Clin Infect Dis. .

Abstract

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.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Estimated cumulative incidence of invasive aspergillosis in allogeneic and autologous hematopoietic stem cell transplant (HSCT) recipients at the Fred Hutchinson Cancer Research Center (1992–2003).
Figure 2
Figure 2
Hazard of invasive aspergillosis (IA) in the first 3 months after hematopoietic stem cell transplantation (HSCT) at the Fred Hutchinson Cancer Research Center (1992–2003) according to month of transplantation (1 indicates January and 12 indicates December).
Figure 3
Figure 3
Estimated cumulative incidence (CumInc) of invasive aspergillosis (IA) by season and year of hematopoietic stem cell transplantation (HSCT) in allogeneic HSCT recipients at the Fred Hutchinson Cancer Research Center. CI, confidence interval.
Figure 4
Figure 4
Person-time invasive aspergillosis (IA) count and total spore count according to season and precipitation in Seattle, Washington (A), and Houston, Texas (B). NS, not significant.
See this image and copyright information in PMC

Comment in

References

    1. Marr K, Carter R, Crippa F, Wald A, Corey L. Epidemiology and outcome of mould infections in hematopoietic stem cell transplant recipients. Clin Infect Dis. 2002;34:909–917. - PubMed
    1. Marr KA, Carter RA, Boeckh M, Martin P, Corey L. Invasive aspergillosis in allogeneic stem cell transplant recipients: changes in epidemiology and risk factors. Blood. 2002;100:4358–4366. - PubMed
    1. Wald A, Leisenring W, van Burik JA, Bowden RA. Epidemiology of Aspergillus infections in a large cohort of patients undergoing bone marrow transplantation. J Infect Dis. 1997;175:1459–1466. - PubMed
    1. Grow W, Moreb J, Roque D, et al. Late onset of invasive Aspergillus infection in bone marrow transplant patients at a university hospital. Bone Marrow Transplant. 2002;29:15–19. - PubMed
    1. Fukuda T, Boeckh M, Carter RA, et al. Risks and outcomes of invasive fungal infections in recipients of allogeneic hematopoietic stem cell transplants after nonmyeloablative conditioning. Blood. 2003;102:827–833. - PubMed

Publication types