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https://www.readbyqxmd.com/read/28922286/nocardia-infections-in-solid-organ-and-hematopoietic-stem-cell-transplant-recipients
#1
Julien Coussement, David Lebeaux, Claire Rouzaud, Olivier Lortholary
PURPOSE OF REVIEW: Nocardia spp. is a gram-positive bacteria that may cause infections in humans. Nocardiosis has been described since the early years of transplantation. This review aims to provide an overview of present knowledge regarding posttransplant nocardiosis, with a focus on recent findings. RECENT FINDINGS: Nocardiosis is not rare among transplant recipients, especially after thoracic transplantation and/or in case of intense immunosuppressive regimen or use of tacrolimus...
September 15, 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28915342/transplantation-of-solid-organ-recipients-shedding-epstein-barr-virus-dna-pretransplant-a-prospective-study
#2
Priya S Verghese, David O Schmeling, Emma A Filtz, Jennifer M Grimm, Arthur J Matas, Henry H Balfour
Epstein-Barr virus (EBV) poses a significant threat to patient and graft survival posttransplant. We hypothesized that recipients who shed EBV at transplant had less immunologic control of the virus and hence were more likely to have active EBV infection and disease posttransplant. To test this hypothesis, we conducted a 5-year prospective study in primary solid organ transplant recipients. We measured EBV DNA in oral washes and blood samples by quantitative PCR before transplant and periodically thereafter for up to 4 years...
September 15, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28904437/cryptococcal-infection-in-transplant-kidney-manifesting-as-chronic-allograft-dysfunction
#3
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/28888133/rhesus-monkeys-for-a-nonhuman-primate-model-of-cytomegalovirus-infections
#4
REVIEW
Hannah L Itell, Amitinder Kaur, Jesse D Deere, Peter A Barry, Sallie R Permar
Human cytomegalovirus (HCMV) is the leading opportunistic viral infection in solid organ transplant patients and is the most common congenitally transmitted pathogen worldwide. Despite the significant burden of disease HCMV causes in immunosuppressed patients and infected newborns, there are no licensed preventative vaccines or effective immunotherapeutic treatments for HCMV, largely due to our incomplete understanding of the immune correlates of protection against HCMV infection and disease. Though CMV species-specificity imposes an additional challenge in defining a suitable animal model for HCMV, nonhuman primate (NHP) CMVs are the most genetically related to HCMV...
September 6, 2017: Current Opinion in Virology
https://www.readbyqxmd.com/read/28884635/psoriasis-in-solid-organ-transplant-patients-best-practice-recommendations-from-the-medical-board-of-the-national-psoriasis-foundation
#5
Ronald Prussick, Jashin J Wu, April W Armstrong, Michael P Siegel, Abby S Van Voorhees
BACKGROUND: Treatment of solid organ-transplant patients who have psoriasis can be a therapeutic challenge. Biologic and systemic drugs used to treat psoriasis can result in an increase in infections or malignancies. OBJECTIVE: We sought to develop a treatment algorithm for organ transplant recipients (OTR) diagnosed with psoriasis vulgaris. METHODS: A systematic literature search for psoriasis treatment in organ transplant patients was performed using MEDLINE and GOOGLE...
September 8, 2017: Journal of Dermatological Treatment
https://www.readbyqxmd.com/read/28882857/effect-of-sofosbuvir-based-hepatitis-c-virus-therapy-on-kidney-function-in-patients-with-ckd
#6
Meghan E Sise, Elke Backman, Guillermo A Ortiz, Gregory L Hundemer, Nneka N Ufere, Donald F Chute, Joseph Brancale, Dihua Xu, Jessica Wisocky, Ming V Lin, Arthur Y Kim, Ravi Thadhani, Raymond T Chung
BACKGROUND AND OBJECTIVES: Hepatitis C virus infection is common in patients with CKD and leads to accelerated progression to ESRD. Sofosbuvir is a potent direct-acting antiviral therapy against hepatitis C virus; however, there are concerns about its safety in patients with CKD. The objective of our study was to determine the safety and efficacy of sofosbuvir in patients with CKD. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We studied a retrospective observational cohort of patients with CKD defined by eGFR<60 ml/min per 1...
September 7, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28881059/pancreas-preserving-duodenectomy-after-living-donor-liver-transplantation-for-invasive-cytomegalovirus-disease
#7
Rodrigo Vincenzi, Eduardo A Fonseca, Paulo Chapchap, Marcel C C Machado, Karina M O Roda, Helry L Candido, Marcel R Benavides, Marco A D'Assuncao, Rogerio C Afonso, Plinio Turine, Fernando P Marson, João Seda Neto
CMV infection plays an important role in the postoperative course following solid organ transplantation. We present the case of an 11-year-old male patient who underwent LDLT due to severe hepatopulmonary syndrome and biliary cirrhosis. Four weeks after LDLT, he developed persistent GI bleeding and was subjected to repeated endoscopic treatment and radiological arterial embolization to stop the bleeding from duodenal ulcers. Diagnostic workup was negative for CMV disease. Because the bleeding persisted, surgical treatment was indicated, and a pancreas-preserving duodenectomy was performed...
September 7, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28874227/the-impact-of-virus-population-diversity-on-the-dynamics-of-cytomegalovirus-dnaemia-in-allogeneic-stem-cell-transplant-recipients
#8
Víctor Vinuesa, María Alma Bracho, Eliseo Albert, Carlos Solano, Manuela Torres-Puente, Estela Giménez, Fernando González-Candelas, David Navarro
Mixed cytomegalovirus (CMV) infections are associated with delayed viral clearance in solid organ transplant recipients. We investigated whether this could be extrapolated to allogeneic stem cell transplant (allo-SCT) recipients. A total of 48 plasma specimens, obtained during 29 episodes of active CMV infection in 25 non-consecutive allo-SCT patients, were analysed. Baseline blood specimens, drawn shortly prior to the inception of pre-emptive antiviral therapy (pre-treatment specimen; n=29), as well as follow-up samples obtained either after the initiation of antiviral therapy (post-treatment specimen; n=15) or during recurrent episodes (n=4) were analysed...
September 6, 2017: Journal of General Virology
https://www.readbyqxmd.com/read/28865149/bordetella-bronchiseptica-bloodstream-infection-in-a-renal-transplant-patient
#9
Harry R Powers, Kairav Shah
Bordetella bronchiseptica is a gram-negative coccobacillus that infects animals, but rarely affects humans. B. bronchiseptica has been reported to cause disease in immunocompromised hosts. We present a case of a 61-year-old man with a renal transplant who developed B. bronchiseptica bacteremia likely as a result of close contact between dogs and his skin cancer biopsy sites. The patient was successfully treated with 2 weeks of oral levofloxacin. This case alerts physicians to B. bronchiseptica as a cause of bacteremia in solid organ transplant patients with exposure to animals...
September 2, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
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
#10
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
#11
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/28852681/comparison-of-standardized-cytomegalovirus-cmv-viral-load-thresholds-in-whole-blood-and-plasma-of-solid-organ-and-hematopoietic-stem-cell-transplant-recipients-with-cmv-infection-and-disease
#12
M Veronica Dioverti, Brian D Lahr, Jeffrey J Germer, Joseph D Yao, Michelle L Gartner, Raymund R Razonable
BACKGROUND: Quantification of cytomegalovirus (CMV) deoxyribonucleic acid (DNA) has important diagnostic, prognostic, and therapeutic implications in the management of transplant recipients. We aimed to assess a viral load in plasma and whole blood that distinguishes CMV disease from asymptomatic infection in a cohort of solid organ and hematopoietic stem cell transplantation. METHODS: We prospectively measured and compared CMV viral load in paired plasma and whole blood samples collected from transplant recipients with CMV infection and disease...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/28852522/systematic-review-of-mixed-cryoglobulinemia-associated-with-hepatitis-e-virus-infection-association-or-causation
#13
REVIEW
Fateh Bazerbachi, Michael D Leise, Kymberly D Watt, M Hassan Murad, Larry J Prokop, Samir Haffar
Background and aim: Mixed cryoglobulinemia (MC) has been associated with several viral infections, and chronic hepatitis C is recognized as a major cause. MC associated with hepatitis E virus (HEV) has been described and little is known about this rare association. The aim of this study is to perform a systematic review of MC associated with HEV, and examine the presence of a causal relationship. Methods: An experienced librarian conducted a search of databases from each database's inception to 12 December 2016 based on a priori criteria...
August 2017: Gastroenterology Report
https://www.readbyqxmd.com/read/28844154/vancomycin-prophylaxis-for-prevention-of-clostridium-difficile-infection-recurrence-in-renal-transplant-patients
#14
Lindsey E Splinter, Luiza Kerstenetzky, Margaret R Jorgenson, Jillian L Descourouez, Glen E Leverson, Christopher M Saddler, Jeannina A Smith, Nasia Safdar, Robert R Redfield
BACKGROUND: Incidence of primary and recurrent Clostridium difficile infection (CDI) is higher in solid-organ transplant recipients than in the average hospitalized patient. Strategies for preventing recurrent CDI are limited. Prophylaxis with oral vancomycin (VPPx) for preventing recurrent CDI may be beneficial, but there is limited evidence supporting its use. OBJECTIVE: To examine the impact of VPPx (125 mg twice daily) for the prevention of recurrent CDI in renal transplant recipients (RTX) receiving high-risk broad spectrum antibiotics (BSAs)...
August 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28838461/fever-malaise-and-dyspnea-in-a-diabetic-heart-transplant-patient-a%C3%A2-case-report
#15
A Alperi, I Pascual, B D Molina, I Silva, R Lorca, D Hernández-Vaquero, P Avanzas, J L Lambert, C M de la Tassa
Patients with solid-organ transplants usually present at the emergency department with nonspecific symptoms. The physician should consider a great variety of syndromes and diseases, given the greater risk that solid-organ transplant patients carry because of immunosuppression and transplant-related conditions. Myocardial infarction caused by cardiac allograft vasculopathy must be always suspected and ruled out, even when initial symptoms do not orientate in that direction. We present a case that conjugates signs that can be present in different pathologies...
September 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28836710/airway-plaque-presenting-after-alteration-of-immunosuppression-in-a-pediatric-patient-remote-from-heart-transplantation
#16
Thomas D Ryan, Michael J Absalon, Alessandro de Alarcon, Anita Gupta, Anna L Peters, Angela Lorts, Lara A Danziger-Isakov, Clifford Chin
Success after solid organ transplantation is dependent on the proper balance of immunosuppression to prevent rejection of the allograft while limiting the risk of developing infections and malignancy. We present a 9-year-old girl, remote from transplant, who presented with airway plaque after a change in immunosuppression to include the mTOR inhibitor sirolimus. Differential diagnosis included direct medication side effect, infection, and neoplasia.
August 24, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28834861/opportunistic-pulmonary-infections-in-the-solid-organ-transplant-recipient-a-focus-on-drug-therapy
#17
Megan E Goetz, Rickey A Evans, TrisAnn Rendulic
Immunosuppression required to prevent allograft rejection in the solid organ transplant recipient increases vulnerability to infections. Given continuous environmental exposure, the lungs are increasingly susceptible to bacterial, viral, and fungal opportunistic infections. Drug therapy options for the treatment of opportunistic pulmonary infections are used infrequently. These medications are often classified as high risk with specific administration instructions, as well as a multitude of toxicities. Therefore, in this article, we will discuss select pulmonary opportunistic infections and their associated drug therapies...
October 2017: Critical Care Nursing Quarterly
https://www.readbyqxmd.com/read/28834860/review-of-infectious-disease-prophylaxis-in-solid-organ-transplantation
#18
Heather A Personett, Melissa R Laub
As immunosuppressive therapy has evolved over the years, rejection rates in solid organ transplant have declined, but infections remain a significant cause of morbidity and mortality in this population. Prophylaxis against bacterial, viral, and fungal infections is often used to prevent infection from common pathogens during high-risk periods. As an integral part of the multidisciplinary medical team, it is important that nurses caring for transplant recipients be familiar with methods to detect and prevent infectious diseases in this population...
October 2017: Critical Care Nursing Quarterly
https://www.readbyqxmd.com/read/28817445/the-safety-of-pembrolizumab-in-metastatic-melanoma-and-rheumatoid-arthritis
#19
Akshjot Puri, Jade Homsi
Immunotherapy has been in use for the treatment of melanoma since a very long time, but only recently have the cytotoxic T-lymphocyte antigen-4 (CTLA-4) antibody ipilimumab and programmed cell death-1 inhibitors such as nivolimumab and pembrolizumab been shown to induce marked improvements in survival in patients with metastatic melanoma. An important concern arises in terms of the safety of the use of these agents in patients with autoimmune diseases, solid organ transplant recipients on immunosuppression, patients with a history of previous hepatitis B or C, and patients with HIV infections as these patients were excluded from pivotal immunotherapy studies...
October 2017: Melanoma Research
https://www.readbyqxmd.com/read/28811074/management-of-multidrug-resistant-gram-negative-bacilli-infections-in-solid-organ-transplant-recipients-set-gesitra-seimc-reipi-recommendations
#20
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
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