{"title":"What Would You Choose? Oral CMV Prophylaxis in Maintenance Hemodialysis Patients After Solid Organ Transplantation.","authors":"Hidemasa Akazawa, Shinnosuke Fukushima, Hideharu Hagiya","doi":"10.1111/tid.70123","DOIUrl":"https://doi.org/10.1111/tid.70123","url":null,"abstract":"","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70123"},"PeriodicalIF":2.6,"publicationDate":"2025-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145368640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Paige T Stratton, Mary Grace Fitzmaurice, Rachel M Kenney, Domingo J Franco Palacios, George J Alangaden, Michael P Veve
{"title":"Implementation of a Protocol With a Shortened Vancomycin Prophylaxis Duration is Associated With Reduced Acute Kidney Injury in Lung Transplant Recipients: A Quasi-Experimental Study.","authors":"Paige T Stratton, Mary Grace Fitzmaurice, Rachel M Kenney, Domingo J Franco Palacios, George J Alangaden, Michael P Veve","doi":"10.1111/tid.70118","DOIUrl":"https://doi.org/10.1111/tid.70118","url":null,"abstract":"<p><strong>Background: </strong>Vancomycin plus an antipseudomonal β-lactam are common antibiotics used for lung transplant surgical prophylaxis, but the optimal post-operative duration is unknown. The study objective was to assess the impact of a shortened antibacterial surgical prophylaxis duration on post-operative acute kidney injury (AKI) in lung transplant recipients.</p><p><strong>Methods: </strong>This was an IRB approved, single pre-/post-test quasi-experiment of lung transplant recipients who received post-operative antibiotic prophylaxis from January 1, 2016-September 30, 2020 (pre-group) to October 1, 2020-March 31, 2025 (post-group). The intervention included modifying vancomycin (and cefepime) post-operative prophylaxis durations to 72 h; the previous prophylaxis standard included continuing vancomycin until chest tube removal. The primary endpoint was incidence of AKI, defined by the KDIGO criteria, while receiving post-operative vancomycin up to 14 days. Thirty-day secondary outcomes included surgical site infection (SSI), treatment of lower respiratory-tract infection, and isolation of multi-drug-resistant organisms (MDRO).</p><p><strong>Results: </strong>Ninety patients were included-45 pre- and 45 post-intervention. Most patients were men (64.4%) and had a median (IQR) age of 63 (58-68) years. The most common indication for transplant was pulmonary fibrosis (37.8%). The incidence of 14-day AKI was reduced when comparing pre- and post-intervention groups (48.9% vs. 28.9%, p = 0.052), with no differences in SSI (2.2% vs. 2.2%, p = 1.0), treatment of lower respiratory tract infection (57.8% vs. 73.3%, p = 0.120), and isolation of MDRO (15.6% vs. 13.3%, p = 0.764). When accounting for baseline renal function, patients in the post-intervention group had a significantly decreased odds of AKI (adjOR, 0.385; 95%CI, 0.154-0.959).</p><p><strong>Conclusion: </strong>Implementation of a shortened post-operative vancomycin prophylaxis duration protocol was associated with reduced odds of AKI in lung transplant recipients, with similar post-operative infectious complications.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70118"},"PeriodicalIF":2.6,"publicationDate":"2025-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145368583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Camilla Genovese, Martina Offer, Marta Colaneri, Francesca Dore, Giorgia Montrucchio, Giovanni Scaglione, Gianpaola Monti, Alessandra Bandera, Bruno Viaggi, Andrea Gori, Emanuele Palomba, Andrea Lombardi, Stefano Finazzi
{"title":"Hospital Acquired Infections Among Solid Organ Transplant Recipients Hospitalized in Intensive Care Unit (2018-2024): A Study of the GiViTI Group.","authors":"Camilla Genovese, Martina Offer, Marta Colaneri, Francesca Dore, Giorgia Montrucchio, Giovanni Scaglione, Gianpaola Monti, Alessandra Bandera, Bruno Viaggi, Andrea Gori, Emanuele Palomba, Andrea Lombardi, Stefano Finazzi","doi":"10.1111/tid.70120","DOIUrl":"https://doi.org/10.1111/tid.70120","url":null,"abstract":"<p><strong>Introduction: </strong>Limited data exist regarding the burden of intensive care unit (ICU)-acquired infections in the early post-solid organ transplant (SOT) period, particularly in multidrug resistant organisms-endemic settings. This study aims at describing the epidemiology, clinical characteristics, and outcomes of patients who developed an ICU-acquired infection following a SOT procedure in Italy from 2018 to 2024.</p><p><strong>Methods: </strong>A multicenter, retrospective study was conducted within the Italian PROSAFE project across 31 ICUs from 2018 to 2024. All adult patients admitted to ICU during the same hospitalization as their organ transplant procedure were included. Bloodstream infections, ventilator associated pneumonia, intra-abdominal infections, and urinary tract infections occurring more than 48 h after ICU admission were retrieved.</p><p><strong>Results: </strong>Among 2210 SOT recipients, 154 (6.9%) developed 193 ICU-acquired infections. Ventilator associated pneumonia was the most frequent (74, 38.3%), followed by bloodstream infections (56, 29%). Multidrug resistant organisms were identified in 34/87 (39%) isolates with available antibiogram. ICU-acquired infections were associated with significantly higher intra-ICU mortality (35/154, 22.4% vs. 49/2056, 2.4%; p < 0.001) and longer ICU stays (24 vs. 4 days; p < 0.001). Patients with infections due to multidrug resistant organisms showed higher mortality and length of stay.</p><p><strong>Conclusions: </strong>ICU-acquired infections occurred in nearly 7% of SOT recipients admitted to ICU following a SOT procedure, with a significant contribute of multidrug resistant organisms. These infections were associated with striking differences in mortality and length of stay. Finally, this study suggested that patients with MDRO infections showed trends toward higher mortality and length of stay.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70120"},"PeriodicalIF":2.6,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145347512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ryosuke Yamamuro, Alba Romero, Ahsha Khandelwal-Young, Atul Humar, Deepali Kumar
{"title":"Disseminated Varicella-Zoster Virus Infection in Organ Transplant Recipients: A 10-year Retrospective Study.","authors":"Ryosuke Yamamuro, Alba Romero, Ahsha Khandelwal-Young, Atul Humar, Deepali Kumar","doi":"10.1111/tid.70117","DOIUrl":"https://doi.org/10.1111/tid.70117","url":null,"abstract":"<p><strong>Background: </strong>Data on disseminated herpes zoster (HZ) infections in solid organ transplant (SOT) recipients are limited. We aimed to investigate the clinical characteristics and outcomes of HZ infection in SOT patients presenting with microbiologically confirmed disease.</p><p><strong>Methods: </strong>All SOT recipients who tested positive for varicella-zoster virus (VZV) from any sample type between January 2013 and December 2022 were included. Disseminated HZ was defined as skin lesions involving > 2 contiguous dermatomes or evidence of end organ disease. An analysis of risk factors associated with disseminated infection was performed.</p><p><strong>Results: </strong>A total of 146 adult SOT patients with confirmed VZV infections were included in the study. Of these, 4 were primary varicella and 142 were HZ. Median time to HZ presentation was 1.8 years (range 0.02-27). Disseminated HZ was diagnosed in 55/142(38.7%). Post-herpetic neuralgia (PHN) occurred in 33(22.6%) patients and vaccine breakthrough in 5(3.5%). Hospitalization was in 101(71.6%) patients, and 5(3.5%) died within 30 days, none attributable to HZ. VZV DNAemia was detected in 12/13 (92.3%) patients with disseminated disease versus 11/29 (37.9%) with localized disease (p = 0.002). Recurrent HZ rate was 10/142 (7.0%) over a median follow-up of 4.1 years with 90% of recurrences occurring in thoracic transplant. On multivariable logistic regression, no clinical factors were associated with disseminated disease.</p><p><strong>Conclusions: </strong>In a large cohort of SOT patients with VZV, disseminated disease and PHN were frequent. VZV DNAemia was noted in both disseminated and localized infections suggesting that subclinical detection of virus in blood is frequent. The implications of this require further study.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70117"},"PeriodicalIF":2.6,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145337735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Realworld Efficacy of Extending Duration of Letermovir Prophylaxis for Allogeneic Stem Cell Recipients.","authors":"Yasutaka Masuda, Takashi Toya, Riki Yamakawa, Kairi Kojo, Kana Kato, Yasutaka Sadaga, Kaori Kondo, Chika Kato, Hiroki Hatsusawa, Fumihiko Ouchi, Yukie Terasaki, Masashi Shimabukuro, Atsushi Jinguji, Hiroaki Shimizu, Yuho Najima, Noriko Doki","doi":"10.1111/tid.70116","DOIUrl":"https://doi.org/10.1111/tid.70116","url":null,"abstract":"<p><strong>Background: </strong>Cytomegalovirus (CMV) reactivation following allogeneic hematopoietic stem cell transplantation (HSCT) leads to significant morbidity and mortality. Recently, a pivotal trial demonstrated extended duration of letermovir until post-HSCT Day 200 reduced clinically significant CMV infection (csCMVi). Here we evaluated the real-world efficacy of extended letermovir.</p><p><strong>Methods: </strong>We retrospectively reviewed consecutive patients who underwent HSCT and received letermovir prophylaxis for CMV seropositivity of the donor and/or the recipient at a transplant center between July 2018 and March 2024.</p><p><strong>Results: </strong>A total of 236 HSCTs with letermovir prophylaxis were performed. Letermovir was administered until Days 75-125 in 189 cases, and until Day 150- in 37 cases, who were assigned as short and extended letermovir group, respectively. The cumulative incidence of csCMVi at Day 200 was significantly lower in cases with extended letermovir, with no patient developed csCMVi in this group compared to 26.8% in short prophylaxis group (p < 0.001). However, the incidence was comparable at Day 400, with 19.7% in extended and 28.4% in short prophylaxis group (p = 0.14). Multivariable analysis for csCMVi showed age ≥ 50 years at HSCT (hazard ratio [HR], 3.24; p < 0.001) and steroid administration at letermovir discontinuation (HR, 2.25; p = 0.003) were identified as significant risk factors, and patients with both factors were associated with higher incidence of csCMVi regardless of letermovir duration. Immunoglobulin G, but not lymphocyte count, was persistently lower in these high-risk patients until Day 400.</p><p><strong>Conclusion: </strong>Despite the efficacy of letermovir in preventing csCMVi during immunosuppression, the occurrence of csCMVi following letermovir cessation was still a clinical concern.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70116"},"PeriodicalIF":2.6,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145286925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tali Shafat, Amy Spallone, Fareed Khawaja, Ying Jiang, Jennifer Jackson, Lior Nesher, Roy F Chemaly
{"title":"Respiratory Syncytial Virus Exceeded SARS-CoV-2 and Influenza in Lower Respiratory Infection and Mortality Rates Among Patients With Hematologic Malignancies During the 2023-2024 Respiratory Virus Season.","authors":"Tali Shafat, Amy Spallone, Fareed Khawaja, Ying Jiang, Jennifer Jackson, Lior Nesher, Roy F Chemaly","doi":"10.1111/tid.70113","DOIUrl":"https://doi.org/10.1111/tid.70113","url":null,"abstract":"<p><strong>Background: </strong>Respiratory viral infections (RVIs) significantly impact patients with hematologic malignancies (HMs). During the 2023-2024 respiratory viral (RV) season, we observed a decline in SARS-CoV-2-related hospitalizations in our center compared to the two previous seasons. Given the changing epidemiology of RVIs in the post-pandemic era, the low acceptance of SARS-CoV-2 and influenza vaccination, and the availability of new respiratory syncytial virus (RSV) vaccines in 2023, we aimed to compare outcomes of RSV, influenza, and SARS-CoV-2 infections in patients with HMs during the 2023-2024 RV season.</p><p><strong>Methods: </strong>We retrospectively analyzed adults with HMs diagnosed with RSV, influenza, or SARS-CoV-2 between October 2023 and April 2024. The primary outcomes were lower respiratory tract infection (LRI), hospitalization, and 30-day all-cause mortality.</p><p><strong>Results: </strong>We identified 503 patients with 536 consecutive RVIs: 50.0% with SARS-CoV-2, 26.1% with RSV, and 22.2% with influenza (1.7% co-infections). Among RSV-infected patients, 50.7% developed LRI, compared to 41.2% with influenza and 39.2% with SARS-CoV-2 (p = 0.076). The 30-day all-cause mortality was 9.3% for RSV, 7.6% for influenza, and 3.4% for SARS-CoV-2 (p = 0.037). In the multivariable analysis, RSV was associated with higher LRI rate compared to SARS-CoV-2, along with older age, refractory/relapsed cancer, nosocomial infections, and lymphopenia. Older age, allogeneic hematopoietic cell transplantation, nosocomial infections, and LRIs were associated with increased mortality.</p><p><strong>Conclusions: </strong>During the 2023-2024 RV season, the clinical impact of these viruses on patients with HMs remains significant, with higher morbidity and mortality from RSV, highlighting the persistent unmet need for better management strategies for RVIs in the post-pandemic era.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70113"},"PeriodicalIF":2.6,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Karim A Elyamany, Ravi V Durvasula, Sammer M Elwasila, Matthew M Crowe, Daniel E Wessell, Jennifer G Katsolis
{"title":" Myonecrosis: A Rare Presentation of Cytomegalovirus Disease.","authors":"Karim A Elyamany, Ravi V Durvasula, Sammer M Elwasila, Matthew M Crowe, Daniel E Wessell, Jennifer G Katsolis","doi":"10.1111/tid.70109","DOIUrl":"https://doi.org/10.1111/tid.70109","url":null,"abstract":"","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70109"},"PeriodicalIF":2.6,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}