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Transplant Infectious Disease: An Official Journal of the Transplantation Society

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https://www.readbyqxmd.com/read/29446866/tacrolimus-concentration-to-dose-ratio-in-solid-organ-transplant-patients-treated-with-fecal-microbiota-transplantation-for-recurrent-clostridium-difficile-infection
#1
Michael H Woodworth, Colleen S Kraft, Erika J Meredith, Aneesh K Mehta, Tiffany Wang, Yafet T Mamo, Tanvi Dhere, Kaitlin L Sitchenko, Rachel E Patzer, Rachel J Friedman-Moraco
Fecal microbiota transplantation (FMT) is increasingly being performed for Clostridium difficile infection in solid organ transplant patients; however, little is known about the potential pharmacokinetic or pharmacomicrobial effects this may have on tacrolimus levels. We reviewed the medical records of 10 solid organ transplant patients from September 2012 - December 2016 who were taking tacrolimus at time of FMT for recurrent Clostridium difficile infection. We compared the differences in tacrolimus concentration / dose ratio (C/D ratio) three months prior to FMT vs three months after FMT...
February 15, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29427406/risk-factors-for-clostridium-difficile-infection-in-intestinal-transplant-recipients-during-the-first-year-post-transplant
#2
Luis Guzman, Fang Qiu, Andre C Kalil, David F Mercer, Alan Langnas, Diana F Florescu
BACKGROUND: C. difficile is the most common cause of healthcare-associated infectious diarrhea. Risk factors for C. difficile infections (CDI) in intestinal transplant recipients (ITR) are not well defined. The aim of our study was to assess specific risk factors for CDI in ITR. METHODS: This is a 1:3 case-control study that included 29 ITR who developed CDI (cases) and 87 ITR without CDI (controls) observed during the first year post transplantation. Wilcoxon rank sum and Fisher's exact tests were used to compare variables...
February 10, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29427394/a-simplified-regimen-of-targeted-antifungal-prophylaxis-in-liver-transplant-recipients-a-single-center-experience
#3
Bruna Lavezzo, Damiano Patrono, Francesco Tandoi, Silvia Martini, Fabrizio Fop, Valentina Ballerini, Chiara Stratta, Stefano Skurzak, Francesco Lupo, Paolo Strignano, Pier Paolo Donadio, Mauro Salizzoni, Renato Romagnoli, Francesco Giuseppe De Rosa
Invasive fungal infection (IFI) is a severe complication of liver transplantation burdened by high mortality. Guidelines recommend targeted rather than universal antifungal prophylaxis based on tiers of risk METHODS: We aimed to evaluate IFI incidence, risk factors and outcome after implementation of a simplified two-tiered targeted prophylaxis regimen based on a single broad-spectrum antifungal drug (amphotericin B). Patients presenting one or more risk factors according to literature were administered prophylaxis...
February 10, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29427356/epidemiology-and-outcomes-of-clostridium-difficile-infection-in-allogeneic-hematopoietic-cell-and-lung-transplant-recipients
#4
Erik R Dubberke, Kimberly A Reske, Margaret A Olsen, Kerry Bommarito, Angela A Cleveland, Fernanda P Silveira, Mindy G Schuster, Carol A Kauffman, Robin K Avery, Peter G Pappas, Tom M Chiller
BACKGROUND: Clostridium difficile infection (CDI) is a common complication of lung and allogeneic hematopoietic cell (HCT) transplant, but the epidemiology and outcomes of CDI after transplant are poorly described. METHODS: We performed a prospective, multicenter study of CDI within 365 days post-allogeneic HCT or lung transplantation. Data were collected via patient interviews and medical chart review. Participants were followed weekly in the 12 weeks post-transplant and while hospitalized and contacted monthly up to 18 months post-transplantation...
February 10, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29427352/a-rare-case-of-epstein-barr-virus-associated-hepatosplenic-smooth-muscle-tumors-after-kidney-transplantation
#5
Christoph Pircher, Stefan Schneeberger, Claudia Boesmueller, Abbas Agaimy, Heinz Zoller, Reto Bale, Benjamin Henninger, Gert Mayer, Hannes Neuwirt
A 27-year old caucasian male was diagnosed 2.7 years after kidney transplantation with Epstein-Barr virus (EBV)-associated smooth muscle tumors in liver and spleen. The reduction of immunosuppression and conversion from tacrolimus to sirolimus did not lead to a regression of the tumors. Additionally, the patient developed a cellular rejection of his renal allograft, which was successfully treated. A combined approach with stereotactic radiofrequency ablation (SRFA) and surgical resection was effective in the treatment of the tumors...
February 10, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29427322/comparison-of-risk-factors-and-outcomes-of-daptomycin-susceptible-and-nonsusceptible-vancomycin-resistant-enterococcus-faecium-infections-in-liver-transplant-recipients
#6
Jessica D Lewis, Andrew J Barros, Costi D Sifri
BACKGROUND: Vancomycin-resistant Enterococcus faecium (VRE) infections are common in liver transplant recipients (LTRs). Daptomycin (DAP) is an important treatment for such infections; however, DAP-nonsusceptible VRE (DNS-VRE) are increasingly frequent. The purpose of this study was to compare clinical characteristics and outcomes of LTRs with infections due to DNS-VRE and DAP-susceptible VRE (DS-VRE). METHODS: A single center, retrospective review of patients who underwent liver transplantation between 1/1/2010 and 12/31/15 and developed infections due to DS-VRE or DNS-VRE post-transplant was performed...
February 10, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29423923/stewardship-opportunities-in-viral-pneumonia-why-not-the-immunocompromised
#7
N J Mercuro, R M Kenney, L Samuel, R J Tibbetts, G J Alangaden, S L Davis
Antimicrobial management of viral pneumonia has proven to be a challenge in hospitalized immunocompromised patients. A host of factors contribute to the dilemma, such as diagnostic uncertainty, lack of organism identification, and clinical status of the patient. Respiratory virus panel (RVP) use was compared between 131 immunocompromised patients who received send-out (n=56) versus in-house (n=75) testing. Antimicrobial optimization interventions consisted of antiviral addition/discontinuation, antibiotic discontinuation/de-escalation, or modification of immunosuppressive regimen...
February 8, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29380479/safety-and-efficacy-of-foscarnet-for-the-management-of-ganciclovir-resistant-or-refractory-cytomegalovirus-infections-a-single-center-study
#8
Brett Pierce, Chad L Richardson, Lisa Lacloche, Anne Allen, Michael G Ison
BACKGROUND: Infection with cytomegalovirus is an important cause of morbidity and mortality following solid organ transplantation. Resistance to ganciclovir can rarely develop via mutations in UL97 or UL54. There are limited published studies assessing the safety and efficacy of foscarnet for the management of ganciclovir-resistant or refractory cytomegalovirus infection and many centers are reluctant to utilize this important therapy because of concerns about toxicity. METHODS: Solid organ recipients transplanted between 1/1/06 and 12/31/14 who received at least one dose of foscarnet were retrospectively reviewed to assess treatment outcomes, tolerability, and safety of foscarnet...
January 30, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29377402/infection-transmission-among-lung-transplant-couples
#9
Jessica Rademacher, Jan Fuge, Tobias Welte, Jens Gottlieb, Hendrik Suhling
BACKGROUND: The risk of transmission of infections in partnerships between two transplant recipients is unknown. The aim of this study was to evaluate transmission in such couples. METHODS: In this single centre study, lung transplant (LTx) couples were identified among outpatients between 1988 and 2016. Infection rates per year and survival were compared to matched LTx-recipients not living in a transplant partnership. RESULTS: Twelve transplant couples were analysed with cumulative 65 years of relationship...
January 29, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29360277/comparative-effectiveness-of-aerosolized-versus-oral-ribavirin-for-the-treatment-of-respiratory-syncytial-virus-infections-a-single-center-retrospective-cohort-study-and-review-of-the-literature
#10
Tracy P Trang, Meghan Whalen, Alexandra Hilts-Horeczko, Sarah B Doernberg, Catherine Liu
BACKGROUND: Respiratory syncytial virus (RSV) is a leading cause of viral infections in immunocompromised hosts and is associated with significant morbidity and mortality. In January 2015, our institution switched from aerosolized to oral ribavirin (RBV) for primary treatment of RSV infection among high risk immunocompromised adult patients. The objective of the study was to evaluate the clinical and economic outcomes associated with this switch. METHODS: Retrospective cohort analysis of adult patients diagnosed with RSV infection and treated with RBV between January 1, 2013 and May 31, 2016...
January 23, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29360250/impact-of-electronic-health-record-based-pharmacist-driven-valganciclovir-dose-optimization-in-solid-organ-transplant-recipients
#11
David Hensler, Chad L Richardson, Joslyn Brown, Christine Tseng, Phyllis J DeCamp, Amy Yang, Anna Pawlowski, Bing Ho, Michael G Ison
BACKGROUND: Prophylaxis with valganciclovir reduces the incidence of cytomegalovirus (CMV) infection following solid organ transplant (SOT). Under-dosing of valganciclovir is associated with an increased risk of CMV infection and development of ganciclovir-resistant CMV. METHODS: An automated electronic health record (EHR)-based, pharmacist-driven program was developed to optimize dosing of valganciclovir in solid organ transplant recipients at a large transplant center...
January 23, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29360195/reduction-of-late-onset-cytomegalovirus-primary-disease-after-discontinuation-of-antiviral-prophylaxis-in-kidney-transplant-recipients-treated-with-de-novo-everolimus
#12
Arnaud Devresse, Marianne Leruez-Ville, Anne Scemla, VĂ©ronique Avettand-Fenoel, Lise Morin, Xavier Lebreton, Claire Tinel, Lucile Amrouche, Lionel Lamhaut, Marc Olivier Timsit, Julien Zuber, Christophe Legendre, Dany Anglicheau
BACKGROUND: donor (D)+/recipient (R)- serostatus is closely associated with a higher risk of cytomegalovirus (CMV) infection and disease. Antiviral prophylaxis is conventionally used in such patients, but late-onset CMV infection/disease still occurs after the discontinuation of prophylaxis. METHODS: we retrospectively analyzed the data of 215 low immunological risk patients who received kidney transplantation in our center between 2011 and 2016. RESULTS: ninety-seven patients received a combination of everolimus (EVL)/reduced doses of calcineurin inhibitors (CNI) (EVL group) de novo, and 118 received a combination of mycophenolic acid (MPA)/standard doses of CNI (MPA group) de novo...
January 23, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29359876/a-successful-aggressive-surgical-and-medical-approach-to-pulmonary-artery-obstruction-due-to-mycobacterium-abscessus-infection-post-lung-transplantation
#13
Sakhee Kotecha, Olivia C Smibert, Atsuo Doi, Julian Gooi, Orla Morrissey, Miranda Paraskeva, Greg I Snell, David McGiffin
Mycobacterium abscessus infection following lung transplantation has historically been associated with poor outcomes. We report a case of bilateral lung retransplantation complicated by obstruction of the right pulmonary artery secondary to M. abscessus mycotic aneurysm. Aggressive surgical management, including reconstruction of the right pulmonary artery was undertaken with prolonged antimicrobial therapy. 36 months later, antibiotics have been discontinued and the patient has stable soft tissue chest wall disease with good graft function...
January 23, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29359872/mycobacterium-abscessus-infections-in-lung-transplant-recipients-15-year-experience-from-a-single-institution
#14
Morsal Osmani, David Sotello, Salvador Alvarez, John A Odell, Matthew Thomas
PURPOSE: To evaluate our institutional experience with Mycobacterium abscessus infections occurring in lung transplant recipients (LTR). METHODS: We retrospectively reviewed our prospectively collected institutional adult lung transplant database from 2001 to 2015 to identify patients with M. abscessus or Mycobacterium chelonae/abscessus infection before or after transplantation. Untreated, colonized patients were excluded from the study. Electronic health records of 9 out of 516 lung recipients (1...
January 23, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29359871/association-between-the-time-after-transplantation-and-different-immunosuppressive-medications-with-dental-and-periodontal-treatment-need-in-patients-after-solid-organ-transplantation
#15
Gerhard Schmalz, Horst Wendorff, Lisa Berisha, Anja Meisel, Florian Widmer, Anna Marcinkowski, Helmut Teschler, Urte Sommerwerck, Rainer Haak, Otto Kollmar, Dirk Ziebolz
OBJECTIVE: Aim of this study was to investigate the association of time after transplantation and different immunosuppressive medications with dental and periodontal treatment needs in patients after solid organ transplantation (SOT). METHODS: After lung, liver or kidney transplantation, patients were included and divided into subgroups based on the time after SOT (0-1, 1-3, 3-6, 6-10 and >10 years) and immunosuppression (Tacrolimus, Cyclosporine, Mycophenolate, Glucocorticoids, Sirolimus and monotherapy vs...
January 23, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29359870/breakthrough-exophiala-dermatitidis-infection-during-prophylactic-administration-of-micafungin-during-second-umbilical-cord-blood-transplantation-after-graft-failure
#16
Naoki Watanabe, Akihiko Gotoh, Shuichi Shirane, Yasuharu Hamano, Yuji Hirai, Maika Shimizu, Ayako Nakamura, Kana Matsumoto, Kunihiko Morita, Takeshi Mori, Akimichi Ohsaka, Norio Komatsu
Exophiala dermatitidis infections in patients with hematological malignancies are very rare. Our patient had a blood stream infection caused by E. dermatitidis following the second umbilical cord blood transplantation (UCBT) after graft failure during the first UCBT. To our knowledge, this is the first report describing a breakthrough fungal infection caused by E. dermatitidis during the prophylactic administration of micafungin (MCFG). Therefore, MCFG-treated patients should be monitored for breakthrough E...
January 23, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29359867/early-infections-in-the-intensive-care-unit-after-liver-transplantation-etiology-and-risk-factors-a-single-center-experience
#17
Cristiana Laici, Lorenzo Gamberini, Tommaso Bardi, Antonio Siniscalchi, Maria Letizia Bacchi Reggiani, Strefano Faenza
BACKGROUND: Infectious complications represent one of the main causes of perioperative morbidity and mortality of liver transplant recipients. The primary objective of this retrospective observational study was to evaluate incidence and etiology of early (within 1 month from surgery and occurring in the intensive care unit [ICU]) postoperative infections as well as donor and recipient related risk factors. METHODS: The data of 280 patients undergoing 299 consecutive liver transplant procedures from January 2012 to December 2015 were extracted from the Italian ICU registry database and hospital registries...
January 23, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29359847/successful-resolution-of-hyperammonemia-following-hematopoietic-cell-transplantation-with-directed-treatment-of-ureaplasma-parvum-infection
#18
Riley Graetz, Robyn Meyer, Kareem Shehab, Emmanuel Katsanis
Hyperammonemia following hematopoietic cell transplantation (HCT) has been characterized as idiopathic and is associated with a very high mortality. A causal relationship between Ureaplasma infection and hyperammonemia in immunocompromised lung transplant recipients has recently been described. We document the first case of hyperammonemia following HCT associated with Ureaplasma parvum. The initiation of appropriate antibiotics resulted in rapid resolution of hyperammonemic encephalopathy and eradication of the implicating organism...
January 23, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29359846/progressive-multifocal-leukoencephalopathy-after-t-cell-replete-hla-haploidentical-transplantation-with-post-transplantation-cyclophosphamide-graft-versus-host-disease-prophylaxis
#19
Shuntaro Ikegawa, Nobuharu Fujii, Koh Tadokoro, Kota Sato, Miki Iwamoto, Masayuki Matsuda, Tomoko Inomata, Hiroyuki Sugiura, Takeru Asano, Shohei Yoshida, Hisakazu Nishimori, Ken-Ichi Matsuoka, Yoshinobu Maeda
A 52-year-old male suffered from progressive multifocal leukoencephalopathy (PML) after human leukocyte antigen (HLA)-haploidentical transplantation with post-transplantation cyclophosphamide (PTCY). Mirtazepam, mefloquine, and cytarabine failed to improve his symptoms and he finally died 4.5 months after PML onset. This is the first case report of a patient with PML after HLA-haploidentical transplantation with PTCY. Although T-cell replete HLA-haploidentical transplantation with PTCY has enabled early immune reconstitution, PML should be considered if a patient's mental condition deteriorates...
January 23, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29359845/acanthamoeba-endophthalmitis-during-treatment-for-cutaneous-disease-in-a-renal-transplant-patient
#20
Allison Kutner, Margaret Aldrich, Sarju Patel, Joann J Kang, Bijal Amin, Ranon Mann, Ibne Karim M Ali, Roosecelis Brasil Martines, Jennifer Rittenhouse Cope, Graciela O De Boccardo, Yoram A Puius
Acanthamoeba infections are difficult to diagnose and treat. We present a renal transplant patient who developed Acanthamoeba endophthalmitis on therapy with posaconazole and miltefosine for cutaneous acanthamobiasis. The patient was maintained on intracameral voriconazole injections, and oral azithromycin, fluconazole, and flucytosine. This case highlights novel presentations and treatments for acanthamoebic infection. This article is protected by copyright. All rights reserved.
January 23, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
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