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https://www.readbyqxmd.com/read/29780582/the-convergent-epidemiology-of-tuberculosis-and-human-cytomegalovirus-infection
#1
Frank Cobelens, Nico Nagelkerke, Helen Fletcher
Although several factors are known to increase the risk of tuberculosis, the occurrence of tuberculosis disease in an infected individual is difficult to predict. We hypothesize that active human cytomegalovirus infection due to recent infection, reinfection or reactivation plays an epidemiologically relevant role in the aetiology of tuberculosis by precipitating the progression from latent tuberculosis infection to disease. The most compelling support for this hypothesis comes from the striking similarity in age-sex distribution between the two infections, important because the age-sex pattern of tuberculosis disease progression has not been convincingly explained...
2018: F1000Research
https://www.readbyqxmd.com/read/29769027/immune-monitoring-after-pediatric-liver-transplantation-the-prospective-chilsfree-cohort-study
#2
Imeke Goldschmidt, André Karch, Rafael Mikolajczyk, Frauke Mutschler, Norman Junge, Eva Doreen Pfister, Tamara Möhring, Lorenzo d'Antiga, Patrick McKiernan, Deirdre Kelly, Dominique Debray, Valérie McLin, Joanna Pawlowska, Loreto Hierro, Kerstin Daemen, Jana Keil, Christine Falk, Ulrich Baumann
BACKGROUND: Although trough levels of immunosuppressive drugs are largely used to monitor immunosuppressive therapy after solid organ transplantation, there is still no established tool that allows for a validated assessment of functional degree of immunosuppression or the identification of clinically relevant over- or under-immunosuppression, depending on graft homeostasis. Reliable non-invasive markers to predict biopsy proven acute rejection (BPAR) do not exist. Literature data suggest that longitudinal measurements of immune markers might be predictive of BPAR, but data in children are scarce...
May 16, 2018: BMC Gastroenterology
https://www.readbyqxmd.com/read/29764228/anti-infective-chemoprophylaxis-after-solid-organ-transplantation
#3
Paul J Deziel, Raymund Razonable
Solid organ transplant recipients are at high risk of opportunistic infections due to bacterial, viral, fungal and parasitic pathogens. Anti-infective prophylaxis is a time-tested proven strategy for the prevention of these infections after solid organ transplantation. Areas covered: The current recommendations for the prevention of surgical site infections, herpes simplex, cytomegalovirus, invasive fungal infections, and selected parasitic diseases are highlighted. Recent peer-reviewed publications on the prevention of infection after solid organ transplantation were reviewed and their significance was discussed in the context of the current recommendations for preventing infectious complications...
May 15, 2018: Expert Review of Clinical Immunology
https://www.readbyqxmd.com/read/29754381/non-tuberculous-mycobacterial-infections-in-thoracic-transplant-candidates-and-recipients
#4
REVIEW
Mana Rao, Fernanda P Silveira
PURPOSE OF REVIEW: To review and discuss the epidemiology, risk factors, clinical presentation, diagnosis, and treatment of non-tuberculous mycobacteria (NTM) in thoracic transplantation. RECENT FINDINGS: Non-tuberculous mycobacteria are ubiquitous but are an uncommon cause of disease after solid organ transplantation. The incidence of infection is higher in thoracic transplant recipients than in abdominal transplant recipients, with most cases seen after lung transplantation...
May 12, 2018: Current Infectious Disease Reports
https://www.readbyqxmd.com/read/29746814/a-case-series-on-the-use-of-levonorgestrel-52mg-intrauterine-system-after-organ-transplant
#5
Cassia R T Juliato, Paulo Stahlscmidt, Arlete Fernandes, Ilza Monteiro, Luis Bahamondes
OBJECTIVE: To assess the clinical performance (pregnancy and occurrence of pelvic infection) of the levonorgestrel 52-mg intrauterine system (LNG IUS) in solid organ transplant recipients. STUDY DESIGN: We performed a retrospective chart review of all patients seen in the Family Planning Clinic at the University of Campinas Department of Obstetrics and Gynecology from 2007-2017 to identify women with solid organ transplantation using immunosuppression who received a LNG- IUS...
May 7, 2018: Contraception
https://www.readbyqxmd.com/read/29746470/new-insights-into-leishmaniasis-in-the-immunosuppressed
#6
REVIEW
Hannah Akuffo, Carlos Costa, Johan van Griensven, Sakib Burza, Javier Moreno, Mercè Herrero
Immunosuppression contributes significantly to the caseload of visceral leishmaniasis (VL). HIV coinfection, solid organ transplantation, malnutrition, and helminth infections are the most important immunosuppression-related factors. This review briefly describes the challenges of these associations. East Africa and the Indian subcontinent are the places where HIV imposes the highest burden in VL. In the highlands of Northern Ethiopia, migrant rural workers are at a greater risk of coinfection and malnutrition, while in India, HIV reduces the sustainability of a successful elimination programme...
May 2018: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/29745058/post-transplant-lymphoproliferative-disorder-in-pediatric-intestinal-transplant-recipients-a-literature-review
#7
REVIEW
Kaitlin Stanley, Erika Friehling, Sarangarajan Ranganathan, George Mazariegos, Linda M McAllister-Lucas, Rakesh Sindhi
Intestinal transplantation is a successful treatment for children with intestinal failure, but has many potential complications. PTLD, a clinically and histologically diverse malignancy, occurs frequently after intestinal transplantation and can be fatal. The management of this disease is particularly challenging. The rejection-prone intestinal allograft requires high levels of immunosuppression, a precondition for PTLD. While EBV infection clearly plays a role in disease pathogenesis, the relatively naïve immune system of children is another likely contributor...
May 10, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29743768/epidemiological-analysis-of-extended-spectrum-beta-lactamase-producing-bacterial-infections-in-adult-live-donor-liver-transplant-patients
#8
Ajeet Singh, Deepak Govil, Usha Krishan Baveja, Anand Gupta, Neha Tandon, Shrikanth Srinivasan, Sachin Gupta, Sweta J Patel, Sanjiv Saigal, Arvinder Singh Soin
Introduction: Bacterial infections are a leading cause of morbidity and mortality in patients receiving solid-organ transplants. Extended-spectrum beta-lactamases (ESBL) pathogens are the most important pathogenic bacteria infecting these patients. Aim: This study aims to evaluate for the incidence and characteristics of ESBL-positive organism, to look for the clinical outcomes in ESBL-positive infected cases, and to evaluate and draft the antibiotic policy in posttransplant patients during the first 28 days posttransplant...
April 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29741774/management-of-post-transplant-lymphoproliferative-disorders
#9
REVIEW
Christin B DeStefano, Sanjal H Desai, Aarthi G Shenoy, Joseph P Catlett
The post-transplant lymphoproliferative disorders (PTLDs) are a heterogeneous group of neoplasms that are one of the most serious complications of bone marrow and solid organ transplants. Because these disorders are rare, there are no randomized trials from which to derive optimal treatment. Management can be challenging and must balance the goal of PTLD eradication with the risks of graft rejection, graft-versus-host disease, further delays in immune reconstitution and life-threatening infections, among others...
May 9, 2018: British Journal of Haematology
https://www.readbyqxmd.com/read/29737887/current-approaches-to-visceral-leishmaniasis-treatment-in-solid-organ-transplant-recipients
#10
Wanessa Trindade Clemente, Paulo Henrique Orlandi Mourão, Jose María Aguado
The increasing number of transplants performed worldwide and the growing global mobility with migration and travel to and from developing countries and tropical areas are bringing new challenges for the management of transplant infectious diseases, previously less commonly seen, such as Leishmaniasis. However, in this scenario there is a lack of information and the current knowledge is based on a few studies. The selection of the most appropriate treatment depends on various factors, such as patient profile, Leishmania species, disease extent, drug availability, concomitant infections and previous treatments...
May 8, 2018: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/29718144/genomic-surveillance-reveals-diversity-of-multidrug-resistant-organism-colonization-and-infection-a-prospective-cohort-study-in-liver-transplant-recipients
#11
Nenad Macesic, Angela Gomez-Simmonds, Sean B Sullivan, Marla J Giddins, Samantha A Ferguson, Gautam Korakavi, David Leeds, Sarah Park, Kevin Shim, Madeleine G Sowash, Melanie Hofbauer, Ryan Finkel, Yue Hu, Jared West, Nora C Toussaint, William G Greendyke, Benjamin A Miko, Marcus R Pereira, Susan Whittier, Elizabeth C Verna, Anne-Catrin Uhlemann
Background: Multidrug-resistant organisms (MDROs) are an important cause of morbidity and mortality after solid organ transplantation. We aimed to characterize MDRO colonization dynamics and infection in liver transplant (LT) recipients through innovative use of active surveillance and whole-genome sequencing (WGS). Methods: We prospectively enrolled consecutive adult patients undergoing LT from March 2014 to March 2016. Fecal samples were collected at multiple timepoints from time of enrollment to 12 months posttransplant...
April 28, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29716597/hepatitis-e-virus-infection-in-turkey-a-systematic-review
#12
REVIEW
Hakan Leblebicioglu, Resat Ozaras
Hepatitis E virus (HEV), a non-enveloped single stranded RNA virus causes sporadic cases of hepatitis or outbreaks. The disease is generally self-limited although it may cause fulminant hepatitis in pregnant women, elderly, those with underlying chronic hepatitis, immunosuppressed, and transplant recipients. It is transmitted through fecal-oral route and zoonotic transmission. Hepatitis is a main health care problem in Turkey; HBV and HCV prevalences are 4 and 1% respectively. Hepatitis D represents another considerable hepatitis etiology with a prevalence of 5-27%...
May 2, 2018: Annals of Clinical Microbiology and Antimicrobials
https://www.readbyqxmd.com/read/29715551/severe-infections-in-critically-ill-solid-organ-transplant-patients
#13
REVIEW
Andre C Kalil, Uriel Sandkovsky, Diana F Florescu
BACKGROUND: Severe infections are among the most common causes of death in immunocompromised patients admitted to the intensive care unit. The epidemiology, diagnosis, and treatment of these infections has evolved in the last decade. AIMS: We aim to provide a comprehensive review of these severe infections in this population. SOURCES: Review of the literature pertaining to severe infections in critically ill solid organ transplant (SOT) patients...
April 28, 2018: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/29709266/saprochaete-capitata-geotrichum-capitatum-an-emerging-fungal-infection-in-kidney-transplant-recipients
#14
N Rizk, Z Hajar, W Medawar
We are reporting the case of an 82-year-old Yemeni patient, renal transplant recipient who was admitted to our institution and who subsequently developed disseminated infection with Saprochaete capitata. This pathogenic fungus is rarely reported in patients with solid organ trans-plants. Saprochaete capitata is an emerging fungal pathogen, ubiquitously spread in the environment. This is the second case to our knowledge of infection with Saprochaete capitata in a renal transplant patient. Our patient was treated for multiple nosocomial infections with prolonged antibiotic courses...
April 27, 2018: Journal de Mycologie Médicale
https://www.readbyqxmd.com/read/29686064/protection-from-cytomegalovirus-viremia-following-glycoprotein-b-vaccination-is-not-dependent-on-neutralizing-antibodies
#15
Ilona Baraniak, Barbara Kropff, Lyn Ambrose, Megan McIntosh, Gary R McLean, Sylvie Pichon, Claire Atkinson, Richard S B Milne, Michael Mach, Paul D Griffiths, Matthew B Reeves
Human cytomegalovirus (HCMV) is an important pathogen in transplant patients and in congenital infection. Previously, we demonstrated that vaccination with a recombinant viral glycoprotein B (gB)/MF59 adjuvant formulation before solid organ transplant reduced viral load parameters post transplant. Reduced posttransplant viremia was directly correlated with antibody titers against gB consistent with a humoral response against gB being important. Here we show that sera from the vaccinated seronegative patients displayed little evidence of a neutralizing antibody response against cell-free HCMV in vitro...
April 23, 2018: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/29681513/antimicrobial-consumption-and-resistance-in-adult-hospital-inpatients-in-53-countries-results-of-an-internet-based-global-point-prevalence-survey
#16
Ann Versporten, Peter Zarb, Isabelle Caniaux, Marie-Françoise Gros, Nico Drapier, Mark Miller, Vincent Jarlier, Dilip Nathwani, Herman Goossens
BACKGROUND: The Global Point Prevalence Survey (Global-PPS) established an international network of hospitals to measure antimicrobial prescribing and resistance worldwide. We aimed to assess antimicrobial prescribing and resistance in hospital inpatients. METHODS: We used a standardised surveillance method to collect detailed data about antimicrobial prescribing and resistance from hospitals worldwide, which were grouped by UN region. The internet-based survey included all inpatients (adults, children, and neonates) receiving an antimicrobial who were on the ward at 0800 h on one specific day between January and September, 2015...
April 19, 2018: Lancet Global Health
https://www.readbyqxmd.com/read/29669037/coccidioidomycosis-in-selected-immunosuppressed-hosts
#17
Janis E Blair, Neil M Ampel, Susan E Hoover
After contracting coccidioidomycosis, persons with impaired cellular immunity are more likely than healthy persons to have severe infection, disseminated infection, and higher mortality rates. In this brief review, we summarize the clinical manifestations, diagnosis, treatment, and prevention of coccidioidomycosis in persons infected with human immunodeficiency virus (HIV), recipients of solid organ or hematopoietic stem cell transplants, and recipients of biologic response modifiers. Among individuals infected with HIV, a diagnosis of acquired immunodeficiency syndrome (AIDS) and a CD4 T-lymphocyte count <250 cells/μl were associated with more severe coccidioidomycosis, whereas less severe disease occurred among those with undetectable HIV-RNA and higher CD4 T-lymphocyte counts, indicating that controlled HIV viremia and improved cellular immune status are important in limiting disease...
April 13, 2018: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
https://www.readbyqxmd.com/read/29668123/nocardia-infections-in-the-transplanted-host
#18
M Hemmersbach-Miller, J E Stout, M H Woodworth, G M Cox, J L Saullo
BACKGROUND: Nocardia are uncommon pathogens that disproportionately afflict the immunocompromised host. Epidemiology and outcome data of Nocardia infections in transplant recipients are limited. METHODS: We performed a retrospective chart review of all patients at Duke University Hospital with a history of solid organ transplant (SOT) or hematopoietic cell transplant (HCT) and at least one positive culture for Nocardia between 1996-2013. Our aim was to describe the epidemiology and outcomes of Nocardia infections in the transplanted host...
April 18, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29668122/aspergillus-infection-of-the-larynx-in-a-solid-organ-transplant-recipient
#19
Andrea Wisniowski-Yáñez, Jaqueline Ramírez-Anguiano, Rodrigo Rosado-Canto, Adolfo Valdivia-Cayoja, Teresa Pérez-Gutiérrez, Jennifer Cuellar-Rodriguez
Primary laryngeal aspergillosis is a rare condition. Only a few cases have been reported in the past years. Most of them have been reported in healthy patients or with a mild immunocompromised state. We report a case of primary laryngeal aspergillosis in a solid-organ transplant recipient (SOT), an infection not previously described in this population; we reviewed the published literature in all populations. This article is protected by copyright. All rights reserved.
April 18, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29668074/a-20-year-experience-with-nocardiosis-in-solid-organ-transplant-sot-recipients-in-the-southwestern-united-states-a-single-center-study
#20
Aneela Majeed, Norman Beatty, Ahmad Iftikhar, Adeela Mushtaq, Julia Fisher, Pryce Gaynor, Jeeyong C Kim, Jose Luis Marquez, Francisco E Mora, Anca Georgescu, Tirdad Zangeneh
BACKGROUND: Nocardiosis is a life-threatening opportunistic infection. Solid organ transplant (SOT) recipients are at higher risk (incidence 0.04% to 3.5%) of developing nocardiosis. Rate of nocardiosis in the Southwestern US may be high due to environmental factors. METHODS: We performed a retrospective review study on 54 SOT patients diagnosed with Nocardia between 1997 and 2016 at our center. To explore the association of various risk factors with both the development of disseminated disease and mortality, a series of Fisher's exact tests was used...
April 18, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
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