keyword
https://read.qxmd.com/read/38061404/analysis-of-healthcare-facility-onset-clostridioides-difficile-infection-cdi-in-a-hematopoietic-cell-transplant-hct-unit-a-call-for-diagnostic-stewardship-in-a-complex-patient-population
#21
JOURNAL ARTICLE
Michelle Swetky, Marie Wilson, Peggy Douglas, Amanda Milstein, Sandra Olson, Masumi Ueda Oshima, Frank Tverdek, Salma Walji, Catherine Liu, Steven A Pergam
Nearly half the patients identified as having healthcare facility-onset Clostridioides difficile infections (HO-CDI) on a hematopoietic cell transplant (HCT) unit had an alternative clinical explanation for diarrhea, including conditioning regimen toxicity or other medications. Our study supports that targeted diagnostic stewardship interventions should be explored and that additional risk-adjustments considered for facilities with oncology HCT (ONC-HCT) wards in the National Healthcare Safety Network (NHSN) LabID CDI standardized infection ratio (SIR) model...
December 5, 2023: American Journal of Infection Control
https://read.qxmd.com/read/38020750/new-approaches-to-manage-infections-in-transplant-recipients-report-from-the-2023-gti-infection-and-transplantation-group-annual-meeting
#22
JOURNAL ARTICLE
Alexandra Serris, Julien Coussement, Benoît Pilmis, Victoire De Lastours, Aurélien Dinh, François Parquin, Eric Epailly, Florence Ader, Olivier Lortholary, Emmanuel Morelon, Nassim Kamar, Edouard Forcade, David Lebeaux, Jérôme Dumortier, Filomena Conti, Agnes Lefort, Anne Scemla, Hannah Kaminski
No abstract text is available yet for this article.
2023: Transplant International
https://read.qxmd.com/read/37988587/post-exposure-prophylaxis-for-varicella-zoster-virus-exposure-in-high-risk-children
#23
JOURNAL ARTICLE
Emily Shteynberg, Shan Sun, Ravi Jhaveri, Sameer J Patel
BACKGROUND: Post-exposure prophylaxis with varicella immunoglobulin is recommended to minimize risk of varicella complications for high-risk children. However, providers frequently use alternatives like acyclovir or intravenous immunoglobulin. METHODS: A retrospective cohort study was conducted of post-exposure prophylaxis for varicella in children from January 2009 to December 2019. Data were provided by 47 children's hospitals who participate in the Pediatric Health Information Systems database...
November 21, 2023: Journal of the Pediatric Infectious Diseases Society
https://read.qxmd.com/read/37988269/approach-to-diagnostic-evaluation-and-prevention-of-invasive-fungal-disease-in-patients-prior-to-allogeneic-hematopoietic-stem-cell-transplant
#24
REVIEW
Jessica C O'Keeffe, Nikhil Singh, Monica A Slavin
In recent years, advancements in the treatment landscape for hematological malignancies, such as acute myeloid leukemia and acute lymphoblastic leukemia, have significantly improved disease prognosis and overall survival. However, the treatment landscape is changing and the emergence of targeted oral therapies and immune-based treatments has brought forth new challenges in evaluating and preventing invasive fungal diseases (IFDs). IFD disproportionately affects immunocompromised hosts, particularly those undergoing therapy for acute leukemia and allogeneic hematopoietic stem cell transplant...
November 2023: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://read.qxmd.com/read/37957773/vancomycin-resistant-enterococcus-risk-factors-for-hospital-colonization-in-hematological-patients-a-matched-case-control-study
#25
JOURNAL ARTICLE
Marianna Meschiari, Shaniko Kaleci, Martina Del Monte, Andrea Dessilani, Antonella Santoro, Francesco Scialpi, Erica Franceschini, Gabriella Orlando, Adriana Cervo, Morselli Monica, Fabio Forghieri, Claudia Venturelli, Enrico Ricchizzi, Johanna Chester, Mario Sarti, Giovanni Guaraldi, Mario Luppi, Cristina Mussini
BACKGROUND: Vancomycin-resistant enterococcus (VRE) was the fastest growing pathogen in Europe in 2022 (+ 21%) but its clinical relevance is still unclear. We aim to identify risk factors for acquired VRE rectal colonization in hematological patients and evaluate the clinical impact of VRE colonization on subsequent infection, and 30- and 90-day overall mortality rates, compared to a matched control group. METHODS: A retrospective, single center, case-control matched study (ratio 1:1) was conducted in a hematological department from January 2017 to December 2020...
November 13, 2023: Antimicrobial Resistance and Infection Control
https://read.qxmd.com/read/37947888/low-utilization-of-vancomycin-in-febrile-neutropenia-real-world-evidence-from-4-brazilian-centers
#26
JOURNAL ARTICLE
Jessica Fernandes Ramos, André Domingues Pereira, Maria Cristina Nunez Seiwald, Larissa Simão Gandolpho, Vinicius Campos Molla, Mariana Guaraná, Simone A Nouér, Marcio Nucci, Celso Arrais Rodrigues
PURPOSE: The prompt initiation of a betalactam antibiotic in febrile neutropenic patients is considered standard of care, while the empiric use of vancomycin is recommended by guidelines in specific situations, with a low level of evidence. The objective of this study was to assess the utilization of vancomycin in the management of febrile neutropenia within four Brazilian medical centers that implemented more stringent criteria for its administration. METHODS: A comprehensive retrospective analysis was performed encompassing all instances of febrile neutropenia observed during the period from 2013 to 2019...
November 10, 2023: Supportive Care in Cancer
https://read.qxmd.com/read/37930068/cmv-antiviral-stewardship-in-transplantation-the-next-frontier
#27
JOURNAL ARTICLE
Michelle K Yong
No abstract text is available yet for this article.
December 1, 2023: Current Opinion in Infectious Diseases
https://read.qxmd.com/read/37910586/how-i-approach-diarrhea-in-hematological-transplant-patients-a-practical-tool
#28
REVIEW
Natalia E Castillo Almeida, Catherine J Cichon, Carlos A Gomez
Diarrhea in hematopoietic stem-cell transplantation (HSCT) remains a multifactorial challenge that demands a nuanced diagnostic approach. The causes of infectious diarrhea in HSCT recipients are diverse and influenced by patient-specific risk factors, the post-transplant timeline, and local epidemiology. During the past decade, our understanding of diarrhea in HSCT has witnessed a transformative shift through the incorporation of gastrointestinal (GI) multiplex polymerase chain reaction (PCR) panels. However, the judicious application of these panels is imperative to avoid overtesting and prevent adverse outcomes...
November 1, 2023: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://read.qxmd.com/read/37897238/real-world-experience-with-cmv-insight-t-cell-immunity-testing-in-high-risk-kidney-and-pancreas-transplant-recipients
#29
JOURNAL ARTICLE
Jillian L Descourouez, Jeannina A Smith, Christopher M Saddler, Didier A Mandelbrot, Jon S Odorico, Margaret R Jorgenson
BACKGROUND: Cytomegalovirus (CMV)-specific cell-mediated immunity is important for control of CMV after transplant. Assays exist to measure this, but their place in therapy is unclear, particularly in CMV high-risk recipients, without pretransplant exposure. OBJECTIVE: The objective of this study was to evaluate predictive potential of a positive assay to determine freedom from DNAemia and describe subsequent 3-month CMV outcomes. METHODS: Adult CMV high-risk kidney and/or pancreas transplant recipients were included if a CMV inSIGHT T Cell Immunity Panel (TCIP, Eurofins Viracor) was ordered and resulted between 1 August, 2019 and 30 July, 2022...
October 28, 2023: Annals of Pharmacotherapy
https://read.qxmd.com/read/37815319/the-next-frontier-cytomegalovirus-antiviral-stewardship-programs-in-solid-organ-transplant
#30
REVIEW
Hanna L Kleiboeker, Christopher M Saddler, Margaret R Jorgenson
PURPOSE OF REVIEW: Cytomegalovirus (CMV) is a driver of negative patient and allograft outcomes after solid organ transplantation (SOT) and new tools are needed to circumvent these outcomes. We will review key elements of CMV antiviral stewardship in SOT, discuss the available evidence for CMV antiviral stewardship programs and feature areas for expansion in the current landscape of CMV management. RECENT FINDINGS: CMV remains a common complication after SOT. While consensus guidelines provide recommendations for the prevention and treatment of CMV, a one-size-fits-all approach is not necessarily appropriate for all unique patients and posttransplant courses, types of SOT recipients and transplant centers...
December 1, 2023: Current Opinion in Infectious Diseases
https://read.qxmd.com/read/37779493/the-influence-of-a-therapeutic-drug-monitoring-service-on-vancomycin-associated-nephrotoxicity
#31
JOURNAL ARTICLE
Jennifer J Yang, Jonathan Brett, Anna Sordo, Stephanie E Reuter, Sophie L Stocker, Richard O Day, Darren M Roberts, Jane E Carland
Vancomycin's widespread use as the mainstay antibiotic against methicillin-resistant Staphylococcus aureus infections is complicated by its narrow therapeutic index. Therapeutic drug monitoring (TDM) using area-under the concentration curve (AUC)-guided dosing is recommended to optimise therapy and prevent vancomycin-associated nephrotoxicity (VAN). In 2018, a consultative TDM Advisory Service (the Service) was piloted at an Australian hospital to enable AUC-guided vancomycin dosing. This study sought to compare the incidence of VAN pre- and post-Service implementation...
October 2, 2023: Journal of Clinical Pharmacology
https://read.qxmd.com/read/37746769/fluoroquinolone-prophylaxis-in-patients-with-neutropenia-at-high-risk-of-serious-infections-exploring-pros-and-cons
#32
REVIEW
Nikhil Singh, Karin Thursky, Gabriela Maron, Joshua Wolf
BACKGROUND: The use of fluoroquinolones to prevent infections in neutropenic patients with cancer or undergoing hematopoietic stem cell transplantation (HSCT) is a controversial issue, with international guidelines providing conflicting recommendations. Although potential benefits are clear, concerns revolve around efficacy, potential harms, and antimicrobial resistance (AMR) implications. DISCUSSION: Fluoroquinolone prophylaxis reduces neutropenic fever (NF) bloodstream infections and other serious bacterial infections, based on evidence from systematic reviews, randomized controlled trials, and observational studies in adults and children...
September 25, 2023: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://read.qxmd.com/read/37741735/antimicrobial-stewardship-in-immunocompromised-patients-current-state-and-future-opportunities
#33
REVIEW
Jonathan Hand, Hannah Imlay
Immunocompromised (IC) patients are high risk for complications due to a high rate of antibiotic exposure. Antimicrobial stewardship interventions targeted to IC patients can be challenging due to limited data in this population and a high risk of severe infection-related outcomes. Here, the authors review immunocompromised antimicrobial stewardship barriers, metrics, and opportunities for antimicrobial use and testing optimization. Last, the authors highlight future steps in the field.
December 2023: Infectious Disease Clinics of North America
https://read.qxmd.com/read/37739225/short-course-empiric-antibiotics-in-children-undergoing-allogeneic-hematopoietic-cell-transplant
#34
JOURNAL ARTICLE
Pratik A Patel, Mehgan F Teherani, Yijin Xiang, Valeria Bernardo, Shanmuganathan Chandrakasan, Kathryn P Goggin, Ann Haight, Edwin Horwitz, Wayne H Liang, Suhag H Parikh, Michelle L Schoettler, Kathleen Spencer, Elizabeth Stenger, Benjamin Watkins, Kirsten M Williams, Kathryn Leung, Preeti Jaggi, Muna Qayed
BACKGROUND: Fever is common in children undergoing hematopoietic cell transplant (HCT). Empiric antibiotics (EA) are initiated and often continued until neutrophil engraftment. Prolonged antibiotic exposure reduces microbiome diversity and causes overgrowth of pathogenic organisms, leading to complications such as infections from antibiotic-resistant organisms and Clostridium difficile colitis. Shorter courses of EA have been studied in adults undergoing HCT without significant safety concerns but data in children are lacking...
September 20, 2023: Transplantation and cellular therapy
https://read.qxmd.com/read/37647637/individualized-antibiotic-plans-as-a-quality-improvement-initiative-to-reduce-carbapenem-use-for-hematopoietic-cell-transplant-patients-at-a-freestanding-pediatric-hospital
#35
JOURNAL ARTICLE
Adam W Brothers, Daniel J Pak, Nicole M Poole, Matthew P Kronman, Brendan Bettinger, Jennifer J Wilkes, Paul A Carpenter, Janet A Englund, Scott J Weissman
BACKGROUND: Providers must balance effective empiric therapy against toxicity risks and collateral damage when selecting antibiotic therapy for patients receiving hematopoietic cell transplant (HCT). Antimicrobial stewardship (AMS) interventions during HCT are often challenging due to concern for undertreating potential infections. METHODS: In an effort to decrease unnecessary carbapenem exposure for patients undergoing HCT at our pediatric center, we implemented individualized antibiotic plans (IAPs) to provide recommendations for pre-engraftment neutropenia prophylaxis, empiric treatment of febrile neutropenia, and empiric treatment for hemodynamic instability...
August 30, 2023: Clinical Infectious Diseases
https://read.qxmd.com/read/37608632/systematic-fungal-biomarker-or-polymerase-chain-reaction-testing-in-lung-transplant-recipients-retrospective-analysis-to-optimize-their-use
#36
JOURNAL ARTICLE
Catherine-Audrey Boutin, Michael G Ison
BACKGROUND: Among lung transplant recipients, serial bronchoscopies are performed frequently. Often, serial galactomannan (GM), 1,3-β-d-glucan (BDG), and Pneumocystis jirovecii (PJ) testing is performed with these broncho-alveolar lavages (BALs) as standard of care with limited data to support their routine use. METHODS: After Institutional Review Board approval, we retrospectively collected all blood and BAL GM, BDG, and PJ test results from January 2015 to July 20, 2022...
October 2023: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://read.qxmd.com/read/37594214/rapid-antimicrobial-resistance-detection-methods-for-bloodstream-infection-in-solid-organ-transplantation-proposed-clinical-guidance-unmet-needs-and-future-directions
#37
REVIEW
Sarah E Turbett, David B Banach, Jennifer Dien Bard, Ronak G Gandhi, Alyssa R Letourneau, Marwan M Azar
Recent advances in antimicrobial resistance detection have spurred the development of multiple assays that can accurately detect the presence of bacterial resistance from positive blood cultures, resulting in faster institution of effective antimicrobial therapy. Despite these advances, there are limited data regarding the use of these assays in solid organ transplant (SOT) recipients and there is little guidance on how to select, implement, and interpret them in clinical practice. We describe a practical approach to the implementation and interpretation of these assays in SOT recipients using the best available data and expert opinion...
August 18, 2023: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://read.qxmd.com/read/37583091/carbapenem-resistance-in-enterobacterales-bloodstream-infections-among-children-with-cancer-or-post-haematopoietic-stem-cell-transplant-a-retrospective-cohort-study
#38
JOURNAL ARTICLE
Juan F López-Cubillos, Alejandro Díaz, Vicky C Cárdenas, German Camacho-Moreno, Erika Cantor, Eliana M Arcila, Isabel C Hurtado, Adriana M Correa, Tatiana M Tierradentro, Oscar Ramirez, Carlos A Portilla, Nelson Aponte-Barrios, Pio López, Daniela Torres, Mario Bustos-Paz, Ana M Bravo, Janeth J Escobar, Juan P Calle, Diana M Dávalos, Eduardo López-Medina
BACKGROUND: Risk factors for carbapenem resistance in Enterobacterales bloodstream infections among children with cancer or post-HSCT have not been thoroughly explored. METHODS: All children with cancer or post-HSCT who developed Enterobacterales bloodstream infections in two cancer referral centres in major Colombian cities between 2012 and 2021 were retrospectively examined. When the infection episode occurred, carbapenem resistance mechanisms were evaluated according to the available methods...
August 16, 2023: Journal of Antimicrobial Chemotherapy
https://read.qxmd.com/read/37577960/effects-of-antimicrobial-therapy-duration-and-class-on-risk-of-antimicrobial-resistant-gram-negative-bacillus-bloodstream-infection-in-patients-with-aml
#39
JOURNAL ARTICLE
Jonathan Huggins, Ian Barnett, Michael Z David
BACKGROUND: Antimicrobial-resistant Gram-negative bacilli (ARGNB) bloodstream infection (BSI) has been associated with prior antibiotic exposure among hematologic malignancy patients. The relationships between days of therapy (DOT), antimicrobial class, and ARGNB BSI risk are poorly understood. METHODS: This is a single-center, case-control study of acute myeloid leukemia (AML) patients including 115 cases with ARGNB BSI and 230 matched controls with non-ARGNB BSI between January 1, 2007 and December 31, 2018...
August 14, 2023: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://read.qxmd.com/read/37479034/a-joint-program-of-antimicrobial-stewardship-and-hospital-acquired-infection-control-to-reduce-healthcare-associated-infections-after-kidney-transplantation-the-hipomenes-study
#40
JOURNAL ARTICLE
José Tiago Silva, Juan Montoro, María Asunción Pérez-Jacoiste Asín, Mario Fernández-Ruiz, Natalia Polanco, Esther González, José Manuel Caro-Teller, Amado Andrés, José María Aguado, Francisco López-Medrano
Infection is a common complication in kidney transplant recipients (KTRs). The usefulness of antimicrobial stewardship programs (ASP) and hospital-acquired infection control (HAIC) initiatives in the general inpatient population is well established. We performed a quasi-experimental study to evaluate a joint ASP/HAIC initiative focused on KTRs. A dedicated ASP team optimized antimicrobial prescriptions in consecutive KTRs during the intervention period (June 2015-March 2016). A multifaceted, evidence-based HAIC program was concurrently implemented...
July 20, 2023: American Journal of Transplantation
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