{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T06:17:10Z","timestamp":1780381030565,"version":"3.54.1"},"reference-count":26,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T00:00:00Z","timestamp":1755734400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Introduction<\/jats:title>\n<jats:p>Lung transplant recipients (LTRs) are susceptible to invasive candidiasis (IC). This study aimed to assess the incidence, risk factors, and impact of IC on mortality in LTRs using a national insurance claims cohort.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We conducted a retrospective cohort study using administrative claims data from the OptumLabs\u00ae Data Warehouse. We identified LTRs from January 1, 2005, to December 31, 2023, using procedural codes. Exclusion criteria included re-transplantations and pre-transplant IC. We employed multivariable logistic regression to identify risk factors for IC and Cox Proportional Hazard models to assess the impact of IC on mortality.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Among 1279 LTRs, 131 (10.2%) developed IC, primarily during the initial hospitalization for lung transplantation (index hospitalization). The median time to IC diagnosis was 32.0 days following transplant. Post-transplant extra-corporeal membrane oxygenation (ECMO) for more than 8 days was associated with IC (OR: 2.34; 95% CI 1.03 to 5.34). Mortality was higher in LTRs with IC (HR: 2.31; 95% CI: 1.45 to 3.67; p\u2009&lt;\u20090.001). LTRs with IC also had longer hospital stays (median 26.0 days vs. 20.0 days; p\u2009&lt;\u20090.001) and more re-operations (36.7% vs. 27.3%; p\u2009=\u20090.003) compared to those without IC.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Invasive candidiasis affects approximately 10% of lung transplant recipients, most often during the initial hospitalization. It is associated with increased mortality, prolonged hospital stays, and a greater need for surgical re-intervention. These findings highlight the importance of early identification and targeted preventive strategies to improve outcomes in this high-risk population.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0330162","type":"journal-article","created":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T17:29:26Z","timestamp":1755797366000},"page":"e0330162","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Invasive candidiasis following lung transplant: An Assessment of impact utilizing a national insurance claims cohort"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1187-5059","authenticated-orcid":true,"given":"Kelly 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G.","family":"Peters","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4945-1035","authenticated-orcid":true,"given":"Patricio","family":"Escalante","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Che","family":"Ngufor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymund R.","family":"Razonable","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cassie C.","family":"Kennedy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,8,21]]},"reference":[{"issue":"3","key":"pone.0330162.ref001","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1111\/j.1399-0012.2009.01076.x","article-title":"The impact of invasive fungal diseases on survival 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