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Transplant Infectious Disease: An Official Journal of the Transplantation Society

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https://www.readbyqxmd.com/read/28815897/multidrug-resistant-enterobacteriaceae-pseudomonas-aeruginosa-and-vancomycin-resistant-enterococci-three-major-threats-to-hematopoietic-stem-cell-transplant-recipients
#1
REVIEW
Michael J Satlin, Thomas J Walsh
Hematopoietic stem cell transplant (HSCT) recipients are uniquely threatened by the emergence of multidrug-resistant (MDR) bacteria because these patients rely on immediate active antimicrobial therapy to combat bacterial infections. This review describes the epidemiology and treatment considerations for three challenging MDR bacterial pathogens in HSCT recipients: MDR Enterobacteriaceae, including extended-spectrum β-lactamase (ESBL)-producing and carbapenem-resistant Enterobacteriaceae (CRE), Pseudomonas aeruginosa, and vancomycin-resistant Enterococcus (VRE)...
August 16, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28805990/absence-of-jc-polyomavirus-jcpyv-in-early-post-transplant-jcpyv-nephropathy-a-case-report
#2
Chitimaporn Janphram, Suchin Worawichawong, Sinee Disthabanchong, Vasant Sumethkul, Porpon Rotjanapan
JC polyomavirus (JCPyV)-associated nephropathy (JCPyVAN) occurs in < 3% of PVAN cases after renal transplantation. We report the first confirmed case to our knowledge of JCPyVAN diagnosed by kidney biopsy in the early 6 months post transplant in Thailand. In this case report, recovery of renal allograft function was not observed after reduction of immunosuppressive agents and administration of intravenous immunoglobulin and cidofovir. Despite persistent JCPyV viruria, no significant further decline in allograft function was documented at 15 months post transplant...
August 14, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28803455/effect-of-positive-perioperative-donor-and-recipient-respiratory-bacterial-cultures-on-early-post-transplant-outcomes-in-lung-transplant-recipients
#3
Crystal K Howell, Christopher A Paciullo, Marshall G Lyon, David Neujahr, Peter Lyu, George Cotsonis, Michael Hurtik
BACKGROUND: It is standard practice to administer prophylactic antibiotics post lung transplantation. However, no studies have evaluated the impact of culture positivity. The purpose of this study was to evaluate early post-transplant outcomes of culture-positive and culture-negative lung transplant (LT) recipients and the appropriateness of the empiric regimens used. METHODS: Adult patients who received an LT at Emory University Hospital between January 1, 2010 and August 31, 2015 were reviewed and stratified into three groups: (i) culture-positive appropriate empiric treatment, (ii) culture-positive inappropriate empiric treatment, and (iii) culture-negative...
August 13, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28803446/urinary-tract-infections-due-to-esbl-producing-enterobacteriaceae-in-renal-transplant-recipients-a-systematic-review-and-meta-analysis
#4
Michail Alevizakos, Dimitrios Nasioudis, Eleftherios Mylonakis
BACKGROUND: Urinary tract infections (UTIs) are the most common infectious complications among renal transplant recipients (RTR). UTIs caused by extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae (ESBL-PE) have been associated with inferior clinical outcomes and increased financial burden. METHODS: We performed a systematic review and meta-analysis by searching through the PubMed and EMBASE databases (to May 20, 2016) and identifying studies that reported data on the number of RTR who developed an ESBL-PE UTI...
August 13, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28796929/safe-and-effective-administration-of-bcg-for-bladder-carcinoma-in-situ-after-umbilical-cord-blood-stem-cell-transplantation
#5
Toshihiro Magaribuchi, Shusuke Akamatsu, Takashi Kobayashi, Hiroshi Kawabata, Toshinari Yamasaki, Takahiro Inoue, Osamu Ogawa
Although intravesical Bacillus Calmette-Guérin (BCG) instillation is the standard treatment for carcinoma in situ of the bladder, it is generally contraindicated in immunocompromised patients. Here we report the first case, to our knowledge, of BCG treatment for a bladder cancer patient who had received umbilical cord blood stem cell transplantation (UCBSCT). BCG can be given safely and effectively in select cases where reconstitution of the immune system has been achieved at least 2 years after UCBSCT. This article is protected by copyright...
August 10, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28796391/impact-of-carbapenem-resistant-klebsiella-pneumoniae-cr-kp-infections-in-kidney-transplantation
#6
Giovanni Varotti, Ferdinando Dodi, Alessia Terulla, Gregorio Santori, Gabriele Mariottini, Massimo Bertocchi, Anna Marchese, Iris Fontana
BACKGROUND: Carbapenem-resistant Klebsiella pneumoniae (CR-KP) infections in solid organ transplant patients are progressively increasing and are associated with worse outcomes, although potential risk factors and therapeutic strategies are still not well defined. METHODS: We conducted a retrospective matched-pair analysis in which we compared 26 recipients CR-KP-positive after kidney transplantation (KT) with 52 CR-KP-negative patients transplanted in the same period, during a CR-KP outbreak occurred in our hospital...
August 10, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28746781/human-herpesvirus-6-encephalitis-following-chemotherapy-induction-for-acute-myelogenous-leukemia
#7
John W Frey, Joseph N Cherabie, Maha A Assi
We report a case of human herpesvirus-6 (HHV-6) encephalitis in a neutropenic patient who had undergone chemotherapy induction for acute myelogenous leukemia while on broad-spectrum antimicrobial therapy. The patient displayed symptoms of confusion, amnesia, and lethargy. Diagnosis was made via polymerase chain reaction analysis of cerebrospinal fluid. Electroencephalogram and magnetic resonance imaging of the brain were unremarkable. Following diagnosis, the patient was successfully treated with ganciclovir...
July 26, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28741797/risk-factors-and-long-term-outcomes-of-parvovirus-b19-infection-in-kidney-transplant-patients
#8
Chung Hee Baek, Hyosang Kim, Won Soek Yang, Duck Jong Han, Su-Kil Park
BACKGROUND: Parvovirus B19 is a small, non-enveloped, single-stranded DNA virus with a special affinity for the erythroid progenitor cells of the bone marrow. The first case of parvovirus B19 infection in a kidney transplant recipient (KTR) was reported in 1986. Data on the risk factors and specific clinical characteristics of parvovirus B19 infection remain insufficient. METHODS: We screened 602 KTRs for parvovirus B19 infection using parvovirus B19 polymerase chain reaction (PCR) from January 1990 to April 2016, and the clinical characteristics of patients with positive results were compared to those of age- and gender-matched patients with negative PCR results...
July 25, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28741746/skin-lesion-in-a-patient-after-hematopoietic-stem-cell-transplant
#9
Erica E Kaufman West, Mudresh Mehta, Vinit Patel, Robin Chamberland
We present a case of a 61-year-old Caucasian woman who was hospitalized with fevers on day 176 after a matched unrelated stem cell transplant for acute myelogenous leukemia. She developed hemorrhagic bullae on the skin of her right thigh, and blood cultures and skin biopsy both confirmed Fusarium proliferatum. Despite antifungal therapy, her condition worsened and she died while on comfort-only measures. This article is protected by copyright. All rights reserved.
July 25, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28741738/aspergillus-calidoustus-case-series-and-review-of-the-literature
#10
Justin Seroy, Philip Antiporta, Shellee A Grim, Laurie A Proia, Kamaljit Singh, Nina M Clark
Aspergillus calidoustus, previously classified as Aspergillus ustus, is an emerging pathogen in immunocompromised persons. We describe four recent cases of A. calidoustus and review 37 additional cases of A. calidoustus (n=16) or A. ustus (n=25) published through June 2016. Twenty (49%) cases occurred in patients with hematologic malignancy and/or receipt of hematopoietic cell transplantation, and 13 (32%) occurred in solid organ transplant recipients. Antifungal susceptibility was reported in 49% of cases and in 42% treatment failed...
July 25, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28727230/urothelial-cell-carcinoma-after-bk-polyomavirus-infection-in-kidney-transplant-recipients-a-cohort-study-of-veterans
#11
Ralph Rogers, Reginald Gohh, Amanda Noska
BACKGROUND: BK polyomavirus (BKPyV) reactivation is a common clinical occurrence in kidney transplant recipients (KTR). Several other polyomaviruses have been implicated as pathogens with a direct role in the development of malignancies, raising the question of whether BKPyV might also be oncogenic. METHODS: This study is the first retrospective, multicenter cohort study evaluating the relative risk for urothelial cell carcinoma (UCC) associated with BKPyV infection among KTR, and was conducted among veterans who underwent transplantation between 2000 and 2009...
July 20, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28722255/drug-drug-interactions-between-triazole-antifungal-agents-used-to-treat-invasive-aspergillosis-and-immunosuppressants-metabolized-by-cytochrome-p450-3a4
#12
REVIEW
Andreas H Groll, Robert Townsend, Amit Desai, Nkechi Azie, Mark Jones, Marc Engelhardt, Anne-Hortense Schmitt-Hoffman, Robert J Brüggemann
Patients undergoing treatment with immunosuppressant drugs following solid organ or hematopoietic stem cell transplantation are at particular risk for development of serious infections such as invasive aspergillosis. Four triazole antifungal drugs, voriconazole, posaconazole, itraconazole, and isavuconazole, are approved to treat invasive aspergillosis either as first- or second-line therapy. All of these agents are inhibitors of cytochrome P450 3A4, which plays a key role in metabolizing immunosuppressant drugs such as cyclosporine, tacrolimus, and sirolimus...
July 19, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28714235/tuberculosis-after-kidney-transplantation-is-associated-with-significantly-impaired-allograft-function
#13
Silvana Daher Costa, Tainá Veras de Sandes-Freitas, Camilla Neves Jacinto, Lorena Vasconcelos Mesquita Martiniano, Yago Sucupira Amaral, Fernando José Villar Nogueira Paes, Maria Luiza de Mattos Brito Oliveira Sales, Ronaldo de Matos Esmeraldo, Elizabeth de Francesco Daher
BACKGROUND: This study aimed to evaluate renal function before, during and after the course of tuberculosis (TB) disease in kidney transplant recipients; and assess the risk factors for non-recovery of baseline renal function. METHODS: We performed a retrospective, single-center cohort study, including all patients with confirmed or presumed TB diagnosis after kidney transplant (n=34, 2.1%). Renal function was assessed by serum creatinine (Cr) and glomerular filtration rate (GFR) adjusted for deaths and graft losses...
July 17, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28714222/barriers-to-vaccination-in-renal-transplant-recipients
#14
Angela Q Maldonado, David Johnson, Jennifer Trofe-Clark
Vaccine-preventable diseases remain at the forefront of challenges in the long-term care of renal transplant recipients (RTR). Although global vaccination campaigns targeting patients with end-stage renal disease or RTR are standard, rates of vaccination among renal transplant candidates and RTRs remain suboptimal. We highlight the multifactorial barriers leading to low vaccination rates in this vulnerable population. This article is protected by copyright. All rights reserved.
July 17, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28708266/belatacept-conversion-in-an-hiv-positive-kidney-transplant-recipient-following-anti-thymocyte-globulin-induction
#15
Samatha A Kuten, Samir J Patel, Ashvin Baru, A Osama Gaber, Rustin D Crutchley, Venkataraman Ramanathan, Richard J Knight
Herein, we describe a case of early belatacept conversion in a human immunodeficiency virus (HIV)-positive kidney transplant recipient in an effort to improve suboptimal graft function and avoid drug interactions following anti-thymocyte globulin (ATG) administration. We observed improvement in renal function without HIV disease progression or opportunistic infections. Donor-specific antibodies appeared shortly after conversion but cleared without intervention. This case highlights belatacept as a means to improve renal function and avoid significant drug interactions even following ATG induction...
July 14, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28708253/cytomegalovirus-appendicitis-after-hematopoietic-stem-cell-transplantation
#16
Atul Kothari, Kari D Caradine, Juan Carlos Crescencio Rico, Appalanaidu Sasapu, Muthu K Veeraputhiran, Yogesh Jethava, Mary J Burgess
We present the case of a young man with acute lymphoblastic leukemia who developed cytomegalovirus (CMV) appendicitis after receiving alemtuzumab for acute refractory graft-versus-host disease after allogeneic hematopoietic stem cell transplantation (HSCT). CMV appendicitis is a rare complication; and we are reporting the first case to our knowledge of CMV appendicitis following HSCT. Our case highlights the importance of recognition of CMV viral reactivation following the use of alemtuzumab. Using a preemptive strategy of checking CMV PCR, with initiation of early effective treatment on detection of CMV replication, may be appropriate following use of alemtuzumab in hematologic malignancies in patients after HSCT...
July 14, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28699274/transplant-center-support-for-infectious-diseases
#17
Joanna M Schaenman, Deepali Kumar, Camille N Kotton, Lara Danziger-Isakov, Michele I Morris
BACKGROUND: Transplant Infectious Diseases (TID) is a rapidly growing subspecialty, which has contributed significantly to improving patient outcomes after transplantation. Obtaining institutional support to implement programs that promote excellence in patient care remains a challenge for many non-surgical transplant-related specialties. METHOD: We surveyed the membership of the American Society of Transplantation Infectious Diseases Community of Practice to assess characteristics of individual transplant programs and delineate current patterns of institutional support of TID, with a goal of facilitating the exchange of innovative funding ideas between transplant programs...
July 12, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28696077/legionnaires-disease-in-transplant-recipients-a-15-year-retrospective-study-in-a-tertiary-referral-center
#18
Shobini Sivagnanam, Sara Podczervinski, Susan M Butler-Wu, Vivian Hawkins, Zach Stednick, Lois A Helbert, William A Glover, Estella Whimbey, Jeffrey Duchin, Guang-Shing Cheng, Steven A Pergam
Legionnaires' disease (LD) can be fatal among high-risk transplant recipients. To understand the epidemiology of LD, we reviewed 15-year, longitudinal data from a center in Seattle, Washington that cares for both solid organ transplant (SOT) and hematopoietic cell transplant (HCT) recipients. We identified all laboratory-confirmed LD and extracted data on species, diagnostic modalities, clinical presentation, management, and outcomes from medical records. Among 32 patients with LD, transplant recipients made up the majority of diagnoses (22, 69%; SOT 10, HCT 12)...
July 11, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28695649/single-center-experience-of-antifungal-prophylaxis-for-coccidioidomycosis-in-heart-transplant-recipients-within-an-endemic-area
#19
Graham M Lohrmann, Darko Vucicevic, Romy Lawrence, D Eric Steidley, Robert L Scott, Shimon Kusne, Janis E Blair
In endemic regions, coccidioidomycosis causes substantial morbidity and mortality for patients receiving solid organ transplants. We aimed to demonstrate the effect of antifungal coccidioidal prophylaxis in heart transplant (HT) recipients. We retrospectively reviewed the electronic health records of all patients who received HTs between October 19, 2005, and December 13, 2014. We collected information regarding antifungal regimens and determined whether patients subsequently developed infections. Our 174-person cohort all received antifungal prophylaxis for at least 6 months (mean follow-up, 53...
July 11, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28691772/successful-liver-transplantation-despite-donor-transmitted-esbl-producing-klebsiella-pneumoniae-infection-case-report-and-review-of-the-literature
#20
Laura Escolà-Vergé, Ibal Los-Arcos, Junajo González, Mayli Lung, Itxarone Bilbao, Mercè Farré, Teresa Pont, Alberto Sandiumenge, Joan Gavalda, Oscar Len
Donor-derived bacterial infection is a recognized complication of solid organ transplantation. Patients admitted to the intensive care unit are increasingly exposed to infection with multidrug-resistant microorganisms. However, no specific recommendations are available about their suitability as donors. We report a case of donor-transmitted extended-spectrum beta-lactamase-producing Klebsiella pneumoniae infection in a liver recipient, and review the related literature. This article is protected by copyright...
July 10, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
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