Transplant Infectious Disease最新文献

{"title":"Personalized CZA-ATM dosing against an XDR E. coli in liver transplant patients; the application of the in vitro hollow fiber system.","authors":"Zahra Sadouki, Emmanuel Q Wey, Satheesh Iype, David Nasralla, Jonathan Potts, Mike Spiro, Alan Williams, Timothy D McHugh, Frank Kloprogge","doi":"10.1111/tid.14396","DOIUrl":"10.1111/tid.14396","url":null,"abstract":"<p><strong>Background: </strong>A patient with an extensively drug-resistant (XDR) New Delhi metallo-β-lactamase (NDM) and oxacillinase (OXA-48) producing Escherichia coli (E. coli) infection was awaiting orthotopic liver transplant. There is no standardized antibiotic prophylaxis regimen; however, in line with the Infectious Diseases Society of America guidance, an antibiotic prophylactic regimen of ceftazidime-avibactam 2.5 g TDS with aztreonam 2 g three times a day (TDS) IV was proposed.</p><p><strong>Methods: </strong>The hollow fiber system (HFS) was applied to inform the individualized pharmacodynamic outcome likelihood prior to prophylaxis.</p><p><strong>Results: </strong>A 4-log reduction in CFU/mL in the first 10 h of the regimen exposure was observed; however, the killing dynamics were slow and six 8-hourly infusions were required to reduce bacterial cells to below the limit of quantification. Thus, the HFS supported the use of the regimen for infection clearance; however, it highlighted the need for several infusions. Standard local practice is to administer prophylaxis antibiotics at induction of orthotopic liver transplantation (OLT); however, the HFS provided data to rationalize earlier dosing. Therefore, the patient was dosed at 24 h prior to their OLT induction and subsequently discharged 8 days after surgery.</p><p><strong>Conclusion: </strong>The HFS provides a dynamic culture solution for informing individualized medicine by testing antibiotic combinations and exposures against the bacterial isolates cultured from the patient's infection. .</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e14396"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569516","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":"Effect of COVID-19 on Pulmonary Function in Allogeneic Hematopoietic Stem Cell Transplantation Recipients.","authors":"Yoshimi Nabe, Daichi Sadato, Takashi Toya","doi":"10.1111/tid.14415","DOIUrl":"10.1111/tid.14415","url":null,"abstract":"","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e14415"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781151","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":"Deceased Donor Infectious Diseases Testing and Antimicrobial Use: Surveys of Organ Procurement Organizations and Transplant Professionals.","authors":"Stephanie M Pouch, Judith A Anesi, Timothy Pruett, Michael Harmon, Sara O Dionne, Richard Hasz, Ricardo M La Hoz, Cameron Wolfe, Michael G Ison","doi":"10.1111/tid.14407","DOIUrl":"10.1111/tid.14407","url":null,"abstract":"<p><strong>Background: </strong>Donor screening and antimicrobial management processes are inconsistent across organ procurement organizations (OPOs) and transplant centers. As part of a Controversies Conference addressing the evaluation and management of infectious diseases (ID) in deceased donors sponsored by the American Society of Transplantation (AST), two online pre-meeting surveys were developed to inform conference proceedings and assess current practices and opinions on donor screening and antimicrobial management.</p><p><strong>Methods: </strong>Survey 1 addressed the current state of deceased donor ID testing, culture data communication, antimicrobial utilization, and involvement of transplant ID during donor management and was distributed to all 56 United States OPOs. Survey 2 evaluated transplant professionals' opinions regarding donor antimicrobial use and was sent to the AST Infectious Disease, Kidney Pancreas, Liver and Intestinal, and Thoracic and Critical Care Community of Practice listservs. Descriptive statistics were performed.</p><p><strong>Results: </strong>Thirty-five (63%) unique responses were received from OPOs for Survey 1. Findings included variability in the timing of donor culture collection, frequent sampling of indwelling catheters, wide variation in the location of culture processing, and availability of additional susceptibility testing. Eighty-eight unique responses were received from approximately 1552 (6%) transplant providers for Survey 2. Of the respondents, 37% would not recommend standard antibiotics prior to organ recovery in the absence of suspected or confirmed infection.</p><p><strong>Conclusions: </strong>These surveys demonstrate variability in donor testing, donor antimicrobial utilization, and transplant provider opinions regarding the need for and selection of antimicrobial agents. Findings highlight opportunities for standardized approaches to donor testing and management.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e14407"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740543","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":"Social Media Savvy, It's More Than Just the #Hashtags: How the Use of Social Media in Transplant Infectious Diseases Can Impact the Field and Patients.","authors":"Courtney E Harris, Simran Gupta, Paul E Sax, Gabriel Vilchez, Ilan S Schwartz, Deeksha Jandhyala, Pratik A Patel, Rebecca N Kumar, Chelsea A Gorsline","doi":"10.1111/tid.14420","DOIUrl":"10.1111/tid.14420","url":null,"abstract":"<p><p>Social media provides platforms for transplant infectious diseases (TIDs) clinicians to network, exchange ideas, and educate each other and the broader public. A #TxIDChat on the social media platform X was conducted on the perceptions of social media in TID by the account @TxID_Fellows. This article examines the current usage of social media by TID clinicians, and its role in education, patient outreach, and networking. Guidance is also provided for trainees to help navigate a public space at the intersection of professional and social platforms.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e14420"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847789","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":"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":"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":"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":"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}