Transplant Infectious Disease最新文献

{"title":"Yersinia enterocolitica Pneumonia in a Heart Transplant Recipient.","authors":"Carlos Alejandro Portales Castillo, Adam G Stewart, Camille N Kotton","doi":"10.1111/tid.14422","DOIUrl":"10.1111/tid.14422","url":null,"abstract":"","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e14422"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847791","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 Bebtelovimab Treatment Timing on COVID-19 Outcomes in Ambulatory Solid Organ Transplant Recipients.","authors":"Sonsoles Salto-Alejandre, Willa Cochran, Zishan Siddiqui, Julie Langlee, Lauren Boyer, Kristin Freed, Sophia Purekal, Ishaan Gupta, Mary Grace Bowring, Daniel C Brennan, William Werbel, Robin K Avery","doi":"10.1111/tid.14405","DOIUrl":"10.1111/tid.14405","url":null,"abstract":"<p><strong>Background: </strong>Outcomes after bebtelovimab treatment for COVID-19 were favorable for most but not all solid organ transplant recipients (SOTRs) during the era of Omicron BA.2 to BA.5, but effects of timing of bebtelovimab administration on these outcomes are unknown. We sought to compare outcomes of SOTR who received early bebtelovimab (\"EBT\", given ≤ 2 days from diagnosis) versus late bebtelovimab (\"LBT\", given between Days 3 and 7), versus no bebtelovimab (NBT).</p><p><strong>Methods: </strong>This was a retrospective cohort study of SOTRs with mild-to-moderate COVID-19, with endpoint of 30-day COVID-19-related hospitalization. Multivariable logistic regression was performed to determine variables associated with receiving EBT, and to assess impact of EBT on hospitalization. A propensity score (PS) was calculated for EBT versus NBT.</p><p><strong>Results: </strong>Of 297 SOTRs, 162 (58.1%) received EBT, 46 (16.5%) LBT, and 71 (25.4%) NBT. Early bebtelovimab treatment was associated with a lower risk of 30-day COVID-19-related hospitalization compared to NBT (OR, 0.112 [95% CI, 0.018-0.686]; p = 0.018). There was no significant difference in hospitalization risk between LBT and NBT, suggesting that delayed administration may not confer additional benefits over no treatment.</p><p><strong>Conclusions: </strong>Early bebtelovimab treatment in outpatient SOTRs was associated with a lower risk of hospitalization compared to no treatment, while late administration did not show a significant advantage over no treatment. Although bebtelovimab is no longer authorized, these findings suggest that the timing of COVID therapies for SOTRs may be important to optimize outcomes.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e14405"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cellular Immunity Against BK Polyomavirus in Kidney Transplant Recipients: A Comprehensive Review.","authors":"Mohammed Al-Talib, Anna Skaria, Siân Griffin","doi":"10.1111/tid.14401","DOIUrl":"10.1111/tid.14401","url":null,"abstract":"<p><p>BK polyomavirus (BKPyV) is an important opportunistic viral infection that complicates kidney transplantation. Uncontrolled viral replication may result in BKPyV-associated nephropathy (BKPyVAN), a major cause of premature allograft damage and failure. In the continued absence of proven treatments, management relies on the empirical reduction of immunosuppression to facilitate an effective host immune response to clear the virus. This may be complicated by the risk of allograft rejection. There is compelling evidence that cellular immune responses are key to establishing control after viral reactivation. Measurable peripheral BKPyV-specific T cell responses temporally correlate with declining viral loads and subsequent clearance. Conversely, these responses are delayed or absent in BKPyVAN. How these peripheral findings correspond to the intragraft response, and whether BKPyV-specific T cells contribute to the immunopathology of BKPyVAN, remains poorly understood. Molecular techniques have provided some insights; however, these have been unable to fully discriminate BKPyVAN from cellular rejection to date. Furthermore, the contributions of components of innate cellular immunity, such as natural killer cells, are not known. Herein, we review the role of cellular immunity in BKPyV infection in kidney transplant recipients. We discuss advances in the understanding of how the development, phenotype, and functionality of these responses may determine the balance between viral control and immunopathology, and how this knowledge is being translated into tools to prognosticate and guide individualized immunosuppression reduction. Lastly, we consider how further elucidation of these responses may inform the design of therapies that would revolutionize how BKPyV is managed after transplantation.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e14401"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effectiveness and Safety of the Short-Course Therapy in Liver Transplant Recipients With Uncomplicated Gram-Negative Bacteremia: A Retrospective Study.","authors":"Toshiki Miwa, Koh Okamoto, Shotaro Ishikawa, Kazuhiko Ikeuchi, Shinya Yamamoto, Mahoko Ikeda, Shu Okugawa, Akihiko Ichida, Nobuhisa Akamatsu, Kiyoshi Hasegawa, Takeya Tsutsumi","doi":"10.1111/tid.14434","DOIUrl":"10.1111/tid.14434","url":null,"abstract":"<p><strong>Introduction: </strong>The appropriate duration of therapy for uncomplicated gram-negative bloodstream infection (GN-BSI) in liver transplant (LTx) recipients remains unknown. This study aims to explore the effectiveness of a short-course antimicrobial therapy.</p><p><strong>Methods: </strong>This retrospective study was performed in a single LTx center in Japan. All LTx recipients with GN-BSI receiving 6-16 days of therapy with adequate source control between 2010 and 2022 were included. We collected data on demographics, underlying medical conditions, clinical manifestations, laboratory and microbiology data, ID consultation, oral switch therapy, and subsequent clinical course through chart review. We compared the 30-day composite outcome comprising mortality and recurrence of BSI or local infection between patients receiving a short-course (6-10 days) therapy and those receiving a long-course (11-16 days) therapy.</p><p><strong>Results: </strong>Of 91 study participants, 27 (29.7%) and 64 (70.3%) received short-course and long-course antimicrobial therapy, respectively. Cholangitis was the most common source of BSI (57/91 [62.6%]). Overall, the primary composite outcome occurred in 18 patients (19.8%), most of which was the recurrence of local infection (n = 14). The primary composite outcome was numerically compatible between these groups (5/27 [18.5%] vs. 13/64 [20.3%]; p = 0.84).</p><p><strong>Conclusions: </strong>A short-course therapy may be an effective option in selected LTx recipients with uncomplicated GN-BSI. Whether a short-course oral switch therapy is a viable option or not warrants further research.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e14434"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142898232","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":"Evaluation of Crushed Posaconazole Delayed Release Tablets in Lung Transplant Recipients.","authors":"Rachael Gordon, Bo Yen, Katherine Dewey, Ripal Jariwala, Jasleen Kukreja, Steven Hays, Jonathan P Singer, Rebecca Florez","doi":"10.1111/tid.14402","DOIUrl":"10.1111/tid.14402","url":null,"abstract":"<p><strong>Background: </strong>Invasive fungal infections can cause serious complications after lung transplant; therefore, prophylaxis with posaconazole is common. The posaconazole delayed-release (DR) tablet is preferred. Although the package insert states DR tablets cannot be crushed, recent data suggest it is reasonable. We hypothesized that crushed posaconazole DR tablets could reach therapeutic levels in lung transplant recipients.</p><p><strong>Methods: </strong>A retrospective study of lung transplant recipients between January 2018 and July 2023, who received crushed posaconazole DR for at least 5 days was completed. Posaconazole troughs were evaluated, and differences were compared between subjects who were therapeutic to those who were subtherapeutic. A cost analysis was also performed.</p><p><strong>Results: </strong>Thirty subjects received crushed posaconazole DR and 50% were therapeutic. The median trough was 1 mg/L for those who were therapeutic and 0.4 mg/L for those who were not (p < 0.001). The median cumulative dose was 2000 mg, and there were no significant differences in the incidence of diarrhea or tube feeds. More subjects in the therapeutic group were loaded (33% vs. 13%), although this was not statistically significant (p = 0.39). No subjects had breakthrough aspergillus one month after starting crushed therapy.</p><p><strong>Conclusion: </strong>Crushed posaconazole DR tablets are a viable and cost savings option, but loading doses and higher maintenance doses may be required to reach therapeutic levels. Those who received loading doses (intravenously or crushed) followed by a daily crushed dose of 400 mg were more likely to be therapeutic. Limitations of our study include that it is single-center, small in sample size, and retrospective.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e14402"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimated Median Waiting Time for Organ Procurement and Transplantation Network Human Immunodeficiency Virus Organ Policy Equity Act Variance Kidney Candidates: A Propensity Score Matched Analysis.","authors":"Amber R Fritz, Jesse Howell, Cameron R Wolfe, Samantha M Noreen, David K Klassen","doi":"10.1111/tid.14411","DOIUrl":"10.1111/tid.14411","url":null,"abstract":"<p><strong>Background: </strong>Prior to the 2013 HIV Organ Policy Equity (HOPE) Act, which enabled research on the transplantation of solid organs from donors with human immunodeficiency virus (HIV) to candidates living with HIV, it was prohibited for HIV+ individuals to donate organs in the United States. In 2015, alongside the release of HOPE Act research criteria, the Organ Procurement and Transplantation Network (OPTN) made organ allocation policy and system changes to allow HIV+ to HIV+ transplantation.</p><p><strong>Methods: </strong>The OPTN database was queried for all adult kidney registrations ever waiting from November 23, 2015, to December 31, 2022; the cohort was split into a HOPE cohort (ever willing to accept an HIV+ kidney) and a non-HOPE cohort (all remaining). Estimated median waiting times (eMWTs) were calculated using a period prevalent Kaplan-Meier approach; HOPE registrations were matched 1:5 without replacement to non-HOPE registrations using a logistic regression propensity score.</p><p><strong>Results: </strong>Using all waiting time, the eMWT for the HOPE cohort was significantly lower than the matched non-HOPE cohort (3.04 years [95% confidence interval {CI}: 2.70, 3.41] versus 5.88 years [95% CI: 5.65, 6.18]). This trend persisted when estimating MWT using other active time and geographical definitions (ignoring geography and donor service area).</p><p><strong>Conclusion: </strong>These results suggest that transplantation through the OPTN HOPE variance yields decreases eMWT, perhaps reducing the medium and longer-term impacts of living with HIV.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e14411"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740557","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":"Hypercalcemia associated with Pneumocystis jirovecii pneumonia in lung transplant recipients: Two case reports.","authors":"Shadi Saberianfar, Tristan Dégot, Benjamin Renaud-Picard","doi":"10.1111/tid.14391","DOIUrl":"10.1111/tid.14391","url":null,"abstract":"","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e14391"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378252","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":"Scedosporium endophthalmitis in a patient with second allogeneic stem cell transplantation for acute myeloid leukemia.","authors":"Kentaro Narita, Daisuke Ikeda, Kosei Matsue","doi":"10.1111/tid.14397","DOIUrl":"10.1111/tid.14397","url":null,"abstract":"","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e14397"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629023","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":"Letter to the Editor: Severe Outcomes of Pneumocystis Pneumonia: A 10-year Retrospective Cohort Study.","authors":"Alina Zaman Khan, Saad Khan, Safa Nasir, Zermeen Naveed, Hira Hameed","doi":"10.1111/tid.14442","DOIUrl":"10.1111/tid.14442","url":null,"abstract":"","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e14442"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011306","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":"Recurrent Outbreak of Carbapenem-Resistant IMP-1-Producing Pseudomonas aeruginosa in Kidney Transplant Recipients: The Impact of Prolonged Patient Colonization.","authors":"Maristela P Freire, Carlos Henrique Camargo, Laina Bubach, Amanda Yaeko Yamada, Fernanda Spadão, Carolina Andrade Lopes, Claudio Tavares Sacchi, Karoline Rodrigues Campos, Marlon Benedito Nascimento Santos, Jose Otto Reusing Junior, Ana Paula Cury, Flavia Rossi, Evangelina da Motta P A de Araujo, Anna Sara Levin, William Carlos Nahas, Elias David-Neto, Ligia C Pierrotti","doi":"10.1111/tid.14414","DOIUrl":"10.1111/tid.14414","url":null,"abstract":"<p><strong>Background: </strong>Infections by carbapenem-resistant Pseudomonas aeruginosa (CRPA) have been associated with high morbidity and mortality among solid organ recipients.</p><p><strong>Objectives: </strong>To delineate the epidemiological and molecular characteristics of a recurrent outbreak of imipenem (IMP)-producing P. aeruginosa (CRPA) among kidney transplant (KT) recipient METHODS: We described a recurring CRPA outbreak in a KT ward, divided into two periods: before unit closure (Feb 2019-2020) and after reopening (Aug 2020-Dec 2023). Routine surveillance cultures (SCs) were performed using axillary-perineum-rectal swabs with immunochromatographic tests. A case-control study identified risk factors for CRPA acquisition. Pulsed-field gel electrophoresis and whole genome sequencing characterized the strains.</p><p><strong>Results: </strong>After reopening, new cases arose from patients previously colonized, peaking 18 months later. A total of 67 KT recipients with CRPA-IMP-producing strains were identified. All except one sequenced strain belonged to the ST446 clone, differing by a maximum of 110 single nucleotide polymorphisms. Forty-five (67.2%) cases were identified through SC, with 45.7% showing intermittent SC positivity. Patients remained colonized for up to 623 days. Twenty-four (35.8%) patients had infections, with the most common site being the urinary tract. Identified risk factors included older age, deceased donor, re-transplantation, reoperation, carbapenem or quinolone use, lymphopenia, hospital stay >10 days, and the first 60 days post-KT.</p><p><strong>Conclusion: </strong>KT recipients can harbor CRPA for extended periods, and detecting CRPA-colonized patients is challenging. These characteristics highlight the patient as the major source and a critical point in outbreak control.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e14414"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781153","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}