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https://www.readbyqxmd.com/read/28941318/voriconazole-in-lung-transplant-recipients-how-worried-should-we-be
#1
EDITORIAL
Hrishikesh S Kulkarni, Chad A Witt
Invasive aspergillosis (IA) is the most common invasive mold infection in solid organ transplant (SOT) recipients, occurring in 1-15% of recipients, with a 12-week mortality rate of 20-60%.(1) Lung transplant (LTx) recipients are at the highest risk for IA among all SOT recipients, ranging from ulcerative tracheobronchitis, anastomotic site involvement and airway wall necrosis, to pneumonia, mediastinitis, empyema and disseminated fungemia. Additionally, Aspergillus colonization is an independent risk factor for chronic lung allograft dysfunction...
September 23, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28904437/cryptococcal-infection-in-transplant-kidney-manifesting-as-chronic-allograft-dysfunction
#2
C Agrawal, V Sood, A Kumar, V Raghavan
Invasive fungal infections (IFIs) are a significant cause of morbidity in solid organ transplant (SOT) recipients. Common causes among them are Aspergillus, Candida, and Cryptococcus. Antifungal prophylaxis has led to decrease in overall incidence of IFI; however, there is very little decline in the incidence of Cryptococcal infections of SOT recipients because effective prophylaxis is not available against this infectious agent. Spectrum of manifestation of Cryptococcal infection varies in immunocompetent and immunocompromised host with subclinical and self-limiting with lungs being the primary site in immunocompetent and central nervous system as the most common site in an immunocompromised host...
September 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28859257/cytomegalovirus-infection-management-in-solid-organ-transplant-recipients-across-european-centers-in-the-time-of-molecular-diagnostics-an-esgich-survey
#3
David Navarro, Rafael San-Juan, Oriol Manuel, Estela Giménez, Mario Fernández-Ruiz, Hans H Hirsch, Paolo Antonio Grossi, José María Aguado
BACKGROUND: Scant information is available about how transplant centers are managing their use of quantitative molecular testing (QNAT) assays for active cytomegalovirus (CMV) infection monitoring in solid organ transplant (SOT) recipients. The current study was aimed at gathering information on current practices in the management of CMV infection across European centers in the era of molecular testing assays. METHODS: A questionnaire-based cross-sectional survey study was conducted by the European Study Group of Infections in Immunocompromised Hosts (ESGICH) of the Society of Clinical Microbiology and Infectious Diseases (ESCMID)...
August 31, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28858185/lumbar-spine-fusion-surgery-in-solid-organ-transplant-recipients-is-associated-with-increased-medical-complications-and-mortality
#4
Raj Amin, Varun Puvanesarajah, Rabia Qureshi, Amit Jain, Khaled Kebaish, Frank Shen, Hamid Hassanzadeh
STUDY DESIGN: Retrospective database review OBJECTIVE.: To characterize the outcomes of solid organ transplant (SOT) patients following 1 or 2 level lumbar fusion surgery. SUMMARY OF BACKGROUND DATA: Over the past decade advances in SOT patients have improved graft survival. As such, this patient population is increasingly eligible for elective surgery such as lumbar fusion procedures to improve mobility and quality of life. However, the outcomes of spine surgery in this population is not well defined...
August 29, 2017: Spine
https://www.readbyqxmd.com/read/28811074/management-of-multidrug-resistant-gram-negative-bacilli-infections-in-solid-organ-transplant-recipients-set-gesitra-seimc-reipi-recommendations
#5
REVIEW
J M Aguado, J T Silva, M Fernández-Ruiz, E Cordero, J Fortún, C Gudiol, L Martínez-Martínez, E Vidal, L Almenar, B Almirante, R Cantón, J Carratalá, J J Caston, E Cercenado, C Cervera, J M Cisneros, M G Crespo-Leiro, V Cuervas-Mons, J Elizalde-Fernández, M C Fariñas, J Gavaldà, M J Goyanes, B Gutiérrez-Gutiérrez, D Hernández, O Len, R López-Andujar, F López-Medrano, P Martín-Dávila, M Montejo, A Moreno, A Oliver, A Pascual, E Pérez-Nadales, A Román-Broto, R San-Juan, D Serón, A Solé-Jover, M Valerio, P Muñoz, J Torre-Cisneros
Solid organ transplant (SOT) recipients are especially at risk of developing infections by multidrug resistant (MDR) Gram-negative bacilli (GNB), as they are frequently exposed to antibiotics and the healthcare setting, and are regulary subject to invasive procedures. Nevertheless, no recommendations concerning prevention and treatment are available. A panel of experts revised the available evidence; this document summarizes their recommendations: (1) it is important to characterize the isolate's phenotypic and genotypic resistance profile; (2) overall, donor colonization should not constitute a contraindication to transplantation, although active infected kidney and lung grafts should be avoided; (3) recipient colonization is associated with an increased risk of infection, but is not a contraindication to transplantation; (4) different surgical prophylaxis regimens are not recommended for patients colonized with carbapenem-resistant GNB; (5) timely detection of carriers, contact isolation precautions, hand hygiene compliance and antibiotic control policies are important preventive measures; (6) there is not sufficient data to recommend intestinal decolonization; (7) colonized lung transplant recipients could benefit from prophylactic inhaled antibiotics, specially for Pseudomonas aeruginosa; (8) colonized SOT recipients should receive an empirical treatment which includes active antibiotics, and directed therapy should be adjusted according to susceptibility study results and the severity of the infection...
July 26, 2017: Transplantation Reviews
https://www.readbyqxmd.com/read/28805270/histoplasmosis-in-transplant-recipients
#6
REVIEW
Kiran Gajurel, Reshika Dhakal, Stan Deresinski
Histoplasma capsulatum is a dimorphic fungus that most often causes asymptomatic infection in the immunocompetent population. In immunocompromised patients, including solid organ transplant (SOT) and hematopoietic cell transplant (HCT) recipients, however, it is likely to cause severe life-threatening infection. Post-transplant histoplasmosis (PTH) in SOT is uncommon with an incidence of ≤ 1% and is even rarer in HCT patients. The majority of PTH in SOT is diagnosed in the first 2 years following transplantation...
August 14, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28751095/a-comprehensive-review-of-immunization-practices-in-solid-organ-transplant-and-hematopoietic-stem-cell-transplant-recipients
#7
REVIEW
Pearlie P Chong, Robin K Avery
BACKGROUND: Vaccine-preventable diseases, especially influenza, varicella, herpes zoster, and invasive pneumococcal infections, continue to lead to significant morbidity and mortality in solid organ transplant (SOT) and hematopoietic stem cell transplant (HSCT) recipients. METHODS: We highlight guideline recommendations for the use of key vaccines in SOT and HSCT recipients and to review the latest evidence and developments in the field. RESULTS: Physicians should vaccinate individuals with end-stage organ disease, as vaccine seroresponse rates are higher pretransplantation...
July 24, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28739424/respiratory-viruses-in-transplant-recipients-more-than-just-a-cold-clinical-syndromes-and-infection-prevention-principles
#8
REVIEW
Salma Abbas, Jillian E Raybould, Sangeeta Sastry, Oveimar de la Cruz
OBJECTIVES: The aim of this review is to provide updated information on the clinical spectrum, treatment options, and infection prevention strategies for respiratory viral infections (RVIs) in both solid organ (SOT) and hematopoietic stem cell transplant (HSCT) patients. METHODS: The MEDLINE and PubMed databases were searched for literature regarding the aforementioned aspects of RVIs, with focus on respiratory syncytial virus, adenovirus, influenza virus, parainfluenza virus, human metapneumovirus, and rhinovirus...
July 22, 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/28702199/prevalence-of-methicillin-resistance-and-macrolide-lincosamide-streptogramin-b-resistance-in-staphylococcus-haemolyticus-among-clinical-strains-at-a-tertiary-care-hospital-in-thailand
#9
S Teeraputon, P Santanirand, T Wongchai, W Songjang, N Lapsomthob, D Jaikrasun, S Toonkaew, P Tophon
Staphylococcus spp. is a major cause of nosocomial infection and sepsis. However, increasing drug resistance is becoming a challenge to microbiologists. The purpose of this study was to identify and determine antimicrobial resistance phenotypes and drug resistance genes of clinical coagulase-negative staphylococci (CoNS) isolates at Mae Sot Hospital in Tak province, Thailand. A total of 229 CoNS isolates were collected from clinical specimens during two periods in 2014 and in 2015. Staphylococcus haemolyticus was the most prevalent species (37...
September 2017: New Microbes and New Infections
https://www.readbyqxmd.com/read/28696077/legionnaires-disease-in-transplant-recipients-a-15-year-retrospective-study-in-a-tertiary-referral-center
#10
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/28650734/clostridium-difficile-associated-colitis-post-transplant-is-not-associated-with-elevation-of-tacrolimus-concentrations
#11
Hugo J R Bonatti, Karim W Sadik, Elizabeth D Krebs, Costi D Sifri, Timothy L Pruett, Robert G Sawyer
BACKGROUND: Diarrhea is a common condition after solid organ transplant (SOT); Clostridium difficile-associated colitis (CDAC) is one of the most common infections after SOT. We documented previously that some types of enteritis are associated with an elevation of tacrolimus (TAC) trough concentrations by interfering with the drug's complex metabolism. PATIENTS AND METHODS: Tacrolimus concentrations of 25 SOT recipients including 12 renal and 13 liver recipients before, during, and after CDAC were analyzed retrospectively...
August 2017: Surgical Infections
https://www.readbyqxmd.com/read/28647177/infectious-diseases-in-solid-organ-transplant-recipients-analysis-of-autopsied-cases-in-japan
#12
Yuhko Suzuki, Akira Kenjo, Tomiteru Togano, Natsuo Yamamoto, Hitoshi Ohto, Hikaru Kume
BACKGROUND: With the improvements in immunosuppressive agents and graft survival, infections such as mycoses have become major complications after solid organ transplantation (SOT). METHODS: Our group has continuously updated an epidemiological database of visceral mycoses (VM) among autopsy cases in Japan since 1989. Data on infectious agents and clinical information were complied using similar procedures. RESULTS: Among the all autopsied cases studied, 356 undergone SOT...
August 2017: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/28618165/herpes-simplex-virus-2-transmission-following-solid-organ-transplantation-donor-derived-infection-and-transplantation-from-prior-organ-recipients
#13
Nenad Macesic, Iain J Abbott, Matthew Kaye, Julian Druce, Allan R Glanville, Paul J Gow, Peter D Hughes, Tony M Korman, William R Mulley, Phillip J O'Connell, Helen Opdam, Miranda Paraskeva, Matthew C Pitman, Stella Setyapranata, William D Rawlinson, Paul D R Johnson
BACKGROUND: Owing to limited availability of donor organs, previous solid organ transplant (SOT) recipients are increasingly considered as potential organ donors. We report donor-derived transmission of herpes simplex virus type-2 (HSV-2) to two clusters of SOT recipients with transmission from the original donor and an HSV-2-infected recipient who subsequently became a donor. METHODS: We reviewed medical records of the donors and recipients in both clusters. Pre-transplant serology and virological features of HSV-2 were characterized...
June 15, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28614192/perioperative-antibiotic-prophylaxis-to-prevent-surgical-site-infections-in-solid-organ-transplantation
#14
Judith A Anesi, Emily A Blumberg, Lilian M Abbo
Antibiotic prophylaxis in the perioperative period is the standard of care for nearly all surgical procedures and routinely prescribed during solid organ transplantation (SOT). The primary goal of perioperative antibiotic prophylaxis is to minimize postoperative surgical site infections (SSIs). SSIs are a significant issue in SOT. Depending on the organ transplanted, SSIs occur in 3 to 53% of patients, with the highest rates observed in small bowel/multivisceral, liver, and pancreas transplant recipients. SOT recipients are also at increased risk of developing SSIs with antimicrobial-resistant organisms...
June 13, 2017: Transplantation
https://www.readbyqxmd.com/read/28599954/cmv-specific-t-cell-immunity-in-solid-organ-transplant-recipients-at-low-risk-of-cmv-infection-chronology-and-applicability-in-preemptive-therapy
#15
Juan Damián Mena-Romo, Pilar Pérez Romero, Cecilia Martín-Gandul, Miguel Ángel Gentil, Gonzalo Suárez-Artacho, Ernesto Lage, Magdalena Sánchez, Elisa Cordero
OBJECTIVES: To characterize whether the CMV-specific cellular immune response can be used as a predictor of the control of CMV infection and disease and determine thresholds in solid organ transplant (SOT) recipients seropositive for CMV (R+). METHODS: The CMV-specific T-cell response was characterized using intracellular cytokine staining and the evolution of clinical and virological parameters were recorded during the first year after transplantation. RESULTS: Besides having positive CMV serology, only 28...
June 13, 2017: Journal of Infection
https://www.readbyqxmd.com/read/28583524/epidemiology-and-outcome-of-ganciclovir-resistant-cytomegalovirus-infection-after-solid-organ-transplantation-a-single-transplant-center-experience-in-thailand
#16
J Bruminhent, P Rotjanapan, S P Watcharananan
BACKGROUND: Data on drug-resistant cytomegalovirus (CMV) infection in solid organ transplantation (SOT) are not often reported from resource-limited settings. We aimed to investigate the epidemiology and outcomes of this infection in SOT recipients at our institution. METHODS: This was a retrospective study conducted from January 2012 to May 2015. We included all SOT recipients who were suspected for drug-resistant CMV infection. Genotypic assay for UL97 gene mutation was analyzed by real-time polymerase chain reaction...
June 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28562417/strongyloides-stercoralis-in-solid-organ-transplantation-early-diagnosis-gets-the-worm
#17
Constance M Mobley, Atiya Dhala, Rafik Mark Ghobrial
PURPOSE OF REVIEW: Strongyloidiasis is a parasitic infection affecting millions of people worldwide. Complications of infection are strongly associated with alcoholism, immunosuppression, and organ transplantation. Delayed diagnosis results in hyperinfection syndrome and disseminated strongyloidiasis leading to mortality rates approaching 80%. Early detection, and prevention of infection and transmission are key to diminish this illness. RECENT FINDINGS: In this review, we cover the basic concepts in immunity, immunosuppression, and disorder necessary for understanding the infectious syndromes associated with Strongyloides stercoralis infection...
August 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28561517/malakoplakia-after-kidney-transplantation-case-report-and-literature-review
#18
John Fredy Nieto-Ríos, Isabel Ramírez, Mónica Zuluaga-Quintero, Lina María Serna-Higuita, Federico Gaviria-Gil, Alejandro Velez-Hoyos
Malakoplakia is a granulomatous disease associated with an infectious etiology, usually involving the urinary tract. It reveals itself as a recurrent urinary tract infection (r-UTI), and in some cases, it is associated with impairment of renal function. Immunosuppression is one of its main associated factors, and it has been increasingly described in patients with solid organ transplantation (SOT), mainly kidney transplantation. Macroscopically, it can form masses and sometimes it may be confused with neoplasia, which is why histological findings are fundamental for the diagnosis...
May 31, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28513974/fecal-microbiota-transplantation-outcomes-in-immunocompetent-and-immunocompromised-patients-a-single-center-experience
#19
Sally Alrabaa, Ripal Jariwala, Kristen Zeitler, Jose Montero
BACKGROUND: Clostridium difficile infection (CDI) is a major infectious disease focus for which fecal microbiota transplantation (FMT) has been used with success in various patient populations. METHODS: We conducted a retrospective study of FMT in immunocompetent and immunocompromised patients to review outcomes at our center, with a focus on identifying risk factors for FMT failure in solid organ transplant (SOT) patients. FMT was conducted using universal banked frozen stool via naso-duodenal tube in patients with recurrent CDI of 3 or more episodes per our institutional protocol...
August 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28511545/fosfomycin-tromethamine-for-the-treatment-of-cystitis-in-abdominal-solid-organ-transplant-recipients-with-renal-dysfunction
#20
Luiza Kerstenetzky, Margaret R Jorgenson, Jillian L Descourouez, Glen Leverson, Warren E Rose, Robert R Redfield, Jeannina A Smith
BACKGROUND: Urinary tract infection (UTI) after abdominal solid organ transplantation (SOT) is associated with significant morbidity and mortality. Fosfomycin tromethamine (FOS), a uroselective antibiotic, is FDA approved for uncomplicated UTIs in women and is used off-label for complicated UTIs and prostatitis in men. Literature supporting the use of FOS in the SOT population is limited, and efficacy is questioned in the setting of renal dysfunction. OBJECTIVE: To evaluate the success of FOS for the treatment of cystitis in SOT patients with renal dysfunction...
May 1, 2017: Annals of Pharmacotherapy
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