Transplant Infectious Disease最新文献

{"title":"Antibiotic Exposure and Risk of Allograft Rejection and Survival After Liver Transplant: An Observational Cohort Study From a Tertiary Referral Centre.","authors":"Olivia C Smibert, Sara Vogrin, Marie Sinclair, Avik Majumdar, Mohamed Nasra, Dinesh Pandey, Hossein Jahanabadi, Jason A Trubiano, Kate A Markey, Monica A Slavin, Adam Testro, Jason C Kwong","doi":"10.1111/tid.70026","DOIUrl":"https://doi.org/10.1111/tid.70026","url":null,"abstract":"<p><strong>Introduction: </strong>Our goal is to understand whether there is an association between Abx exposure-and the inferred downstream damage to the intestinal microbiome-and the key patient outcomes of overall survival and rejection following liver transplant.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of 462 liver transplant recipients treated at a multistate liver transplant (LTx) service during a 7-year period. The association between antibiotic exposure and outcome was tested across models that addressed antibiotic spectrum, duration, and timing relative to transplant. Cox proportional hazard regression was used to evaluate the relationship between antibiotics with survival and rejection.</p><p><strong>Results: </strong>The observed 1-year survival in this cohort was 95% (95% CI: 93%, 97%), and 20.8% of patients (96/462) experienced rejection at 1 year. In multivariable analyses, exposure to anaerobe-targeting antibiotics for longer than 14 days pretransplant (p = 0.055) or posttransplant (p = 0.040) was significantly associated with reduced 1-year survival. In multivariable analyses, exposure to any anaerobe-targeting Abx posttransplant was significantly associated with an increased risk of rejection (p = 0.001).</p><p><strong>Conclusions: </strong>Exposure to anaerobic spectrum antibiotics either before or after LTx was associated with poor outcomes during the first year posttransplant and provides an impetus to further characterize the relationship between antibiotic use, microbiota disruption, and cellular immunity in liver transplantation.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70026"},"PeriodicalIF":2.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735699","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":"Re: Universal Multiplex Panel Testing of Donor Lungs as a Strategy to Optimize Antibiotic Prophylaxis against Multidrug-Resistant Bacteria.","authors":"Andrea Lombardi, Davide Mangioni, Giulia Renisi, Arianna Liparoti, Alessandra Bandera","doi":"10.1111/tid.70029","DOIUrl":"https://doi.org/10.1111/tid.70029","url":null,"abstract":"","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70029"},"PeriodicalIF":2.6,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731623","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":"Don't Wait for the Storm-Fix the Roof While the Sun Shines! Lessons for Ensuring Safe Transplantation in Patients at Risk for Chagas Disease.","authors":"Laura Barcán, Marcelo Radisic","doi":"10.1111/tid.70028","DOIUrl":"https://doi.org/10.1111/tid.70028","url":null,"abstract":"","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70028"},"PeriodicalIF":2.6,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701665","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":"The Swiss Transplant Cohort Study: Implications for Transplant Infectious Diseases Research.","authors":"Christian van Delden, Oriol Manuel, Cédric Hirzel, Laura N Walti, Nina Khanna, Hans H Hirsch, Neofytos Dionyios, Philipp Kohler, Irene A Abela, Nicolas J Mueller","doi":"10.1111/tid.70023","DOIUrl":"https://doi.org/10.1111/tid.70023","url":null,"abstract":"<p><p>The longitudinal, nationwide Swiss Transplant Cohort Study (STCS) follows > 92% of all transplant recipients with comprehensive data collection tailored to overall and organ-specific transplant outcomes. Transplant infectious disease events are assembled under the auspices of transplant ID specialists using common definitions. With over 6000 active patients and a median follow-up exceeding 6 years, the cohort offers a unique platform for understanding real-world epidemiology in transplanted patients. Beyond observational analysis, the STCS supports randomized controlled trials to address specific research questions. This overview highlights the achievements of the STCS and explores its future directions.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70023"},"PeriodicalIF":2.6,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701668","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":"Cytomegalovirus-Induced Arterial Intimal Fibrosis in the Kidney Transplant.","authors":"Anukul Ghimire, Simon R Walker, Fareed Kamar","doi":"10.1111/tid.70027","DOIUrl":"https://doi.org/10.1111/tid.70027","url":null,"abstract":"","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70027"},"PeriodicalIF":2.6,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701655","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":"Direct-Acting Antiviral Treatment Failure and Retreatment Strategies Following Hepatitis C-Positive Solid Organ Transplantation in Hepatitis C-Negative Recipients: A Multicenter Case Series.","authors":"Alicia B Carver, Claire Özoral, Morgan Lange, Alysa Mattise, Kristen Whelchel, Roman Perri","doi":"10.1111/tid.70024","DOIUrl":"https://doi.org/10.1111/tid.70024","url":null,"abstract":"<p><strong>Background: </strong>Transplanting solid organs from hepatitis C virus (HCV) nucleic acid testing (NAT+) donors (D+) into HCV-negative recipients (R-) has become more common with the development of curative direct-acting antiviral (DAA) treatment. Limited information exists to guide retreatment strategies for patients not achieving sustained virologic response (SVR) with DAAs. This multisite case series examines retreatment strategies and subsequent SVR rates in HCV-negative solid-organ transplant (SOT) recipients who did not achieve SVR following reactive initial DAA therapy following NAT+ SOT.</p><p><strong>Methods: </strong>A retrospective multisite case series was conducted on patients not achieving SVR with initial DAA treatment post-NAT+ HCV SOT between September 2016 and September 2022 across four tertiary medical centers in the United States.</p><p><strong>Results: </strong>Thirteen patients were identified, predominantly receiving HCV NAT+ kidneys (77%) and SOF/VEL for 12 weeks as initial DAA therapy (43%). Baseline resistance testing was not performed. Median time to treatment initiation post-SOT was 35 [IQR 22-41] days, and to retreatment postpositive viral load was 35 days [IQR 17-76]. Most patients (62%) were retreated with sofosbuvir/velpatasvir/voxilaprevir (SOF/VEL/VOX) for 12 weeks. Two patients required retreatment extension with SOF/VEL/VOX and SOF/VEL/VOX + ribavirin (RBV) from 12 to 24 weeks due to persistent viremia. Only one patient did not achieve SVR following retreatment with SOF/VEL/VOX for 12 weeks but did achieve SVR after a third course of treatment with SOF + GLE/PIB + RBV for 24 weeks.</p><p><strong>Conclusion: </strong>Despite initial DAA failures, all HCV-negative SOT recipients achieved SVR following one or more courses of retreatment with DAAs.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70024"},"PeriodicalIF":2.6,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701662","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":"Impact of Severe Persistent BK Polyomavirus on Graft Function and Quality of Life Outcomes in Kidney Transplant Recipients.","authors":"Emily M Eichenberger, Wairimu Magua, Geeta Karadkhele, Grace Zhou, Payaswini Vasanth, Christian Larsen","doi":"10.1111/tid.70010","DOIUrl":"https://doi.org/10.1111/tid.70010","url":null,"abstract":"<p><strong>Background: </strong>The risk factors and outcomes associated with severe persistent BK polyomavirus (BKPyV) in kidney transplant recipients (KTR) are unknown.</p><p><strong>Methods: </strong>This is a single-center retrospective study of KTR with severe persistent BKPyV compared to (1) KTR with low/no BKPyV-DNAemia and (2) KTR with high BKPyV-DNAemia. Severe persistent BKPyV was defined as BKPyV load reaching > 6 log₁₀ (1 000 000 copies/mL) for ≥ 90 days. Low/no BKPyV was defined as BKPyV load remaining < 3 log₁₀ (1000 copies/mL), and high BKPyV was defined as BKPyV load ≥ 3 log₁₀ without meeting criteria for severe persistent BKPyV.</p><p><strong>Results: </strong>Out of 2586 KTR, 22 had severe persistent BKPyV and were compared to 1843 KTR with low/no BKPyV and 721 KTR with high BKPyV. A low absolute lymphocyte count during the first month posttransplant was associated with an increased risk of severe persistent BKPyV relative to those with low/no BKPyV and high BKPyV (OR 0.91, 95%CI 0.84, 0.99). KTR with severe persistent BKPyV had significantly lower eGFR at 2 years posttransplant relative to low/no and high BKPyV groups eGFR (36 vs. 61 and 59 mL/min; p < 0.001 for both). Additionally, KTR with severe persistent BKPyV required more lab draws and incurred significantly higher total lab-associated costs relative to KTR with low/no BKPyV and high BKPyV ($7516 vs. $4631, p < 0.001; $7516 vs. $5811, p < 0.001, respectively).</p><p><strong>Conclusions: </strong>Severe persistent BKPyV is uncommon but associated with poor outcomes including impaired renal function, a higher burden of labs, and lab-associated costs. Future studies are needed to determine underlying factors that predict severe persistent BKPyV.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70010"},"PeriodicalIF":2.6,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658619","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":"De Novo Lymphocytic Choriomeningitis Virus in a Heart-Kidney Transplant Recipient.","authors":"Kevin D He, Hawra Al Lawati, Audrey Li","doi":"10.1111/tid.70017","DOIUrl":"https://doi.org/10.1111/tid.70017","url":null,"abstract":"","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70017"},"PeriodicalIF":2.6,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658424","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":"Critique on \"Infection-Associated Immune Reconstitution Inflammatory Syndrome in Hematopoietic Cell Transplantation\".","authors":"Javed Iqbal, Muna A Al-Maslamani","doi":"10.1111/tid.70022","DOIUrl":"https://doi.org/10.1111/tid.70022","url":null,"abstract":"","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70022"},"PeriodicalIF":2.6,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658241","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":"Prophylactic Vancomycin in the Primary Prevention of Clostridium difficile in Allogeneic Stem Cell Transplant.","authors":"Brendon Fusco, Jasmine Tomita-Barber, Natale Mazzaferro, Anne Tyno, Nicole McEntee, Patricia Greenberg, Roger Strair, Dale Schaar, Dennis Cooper","doi":"10.1111/tid.70025","DOIUrl":"https://doi.org/10.1111/tid.70025","url":null,"abstract":"<p><strong>Background: </strong>Clostridium difficile (C. difficile) infection is a frequent complication following hematopoietic stem cell transplant, contributing to increased morbidity in this population. Despite current infection prevention strategies, rates among posttransplant patients at some centers remain high. Oral vancomycin is a safe and well-tolerated antibiotic that may be a potential adjunct to prevent C. difficile.</p><p><strong>Objectives: </strong>To evaluate the effectiveness of oral vancomycin in preventing C. difficile among allogeneic stem cell transplant patients and assess other posttransplant outcomes.</p><p><strong>Study design: </strong>A retrospective cohort study was conducted comparing the rate of C. difficile following allogeneic transplant in patients who received oral vancomycin versus no prophylaxis during hospitalization. The primary outcome was the development of C. difficile infection within the first 100 days following transplant, defined as a positive stool toxin assay or PCR. Secondary outcomes included hospital length of stay, hospital-acquired infections, overall mortality, graft-versus-host disease (GVHD), and rehospitalization.</p><p><strong>Results: </strong>Among the 202 patients, one case of C. difficile occurred in the prophylaxis group (1/71, 1.4%) compared to 31 cases in the unexposed group (31/131, 23.6%). Patients who received prophylaxis were significantly less likely to develop C. difficile infection during the study period (OR 0.046, p = 0.003). No differences were observed between groups in hospital-acquired infections, mortality, incidence of acute GVHD, and rehospitalization.</p><p><strong>Conclusion: </strong>Prophylactic vancomycin was associated with a marked reduction in C. difficile infection in allogeneic transplant patients. Despite no significant impact on other clinical outcomes, there was a significant reduction in symptomatic C. difficile infection. Further prospective studies are warranted.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70025"},"PeriodicalIF":2.6,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658766","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}