Transplant Infectious Disease最新文献

{"title":"The Challenge of Bacterial Infections During Intensive Care Unit Stay After Heart Transplantation.","authors":"Rita Minucci, Annalisa De Silvestri, Patrizia Cambieri, Marta Corbella, Carlo Pellegrini, Silvia Roda, Chiara Dezza, Stefano Pelenghi, Raffaele Bruno, Mirko Belliato, Elena Seminari","doi":"10.1111/tid.70031","DOIUrl":"10.1111/tid.70031","url":null,"abstract":"<p><strong>Background: </strong>Infections occurring in the early post-heart transplant (HT) period heavily contribute to morbidity and mortality. Our goal is to evaluate the incidence of hospital-acquired pneumonia/ventilator-associated pneumonia (HAP/VAPs) and/or bloodstream infections (BSIs) after HT during the intensive care unit (ICU) stay and identify their associated risk factors in our tertiary hospital.</p><p><strong>Methods: </strong>Observational prospective study including all adult patients who consecutively underwent HT from January 1, 2015 to August 31, 2023 at Fondazione IRCCS Policlinico San Matteo, Pavia, Italy. HAP/VAPs and BSIs diagnosed during ICU were included in the analysis.</p><p><strong>Results: </strong>A total of 106 patients were included, 38 of whom had at least one infectious episode (35.8%), for a total of 57 independent episodes and their incidence was 2.2 per 100 days (95% CI 1.7-2.8). Length of ICU stay was 8 days (IQR: 6-11) for patients without infectious events and 27 days (IQR 14-52) for those with infectious events (p < 0.001). Gram-negative bacteria were associated with 62.8% of BSIs (mainly Enterobacterales) and with 77.9% of HAP/VAP, in this setting Pseudomonas aeruginosa accounted for 17.6% of infections while Klebsiella spp. accounted for 22.1% of infections. Colonization with resistant bacteria (HR 2.21, 95% CI 1.12-4.35) was associated with increased risk of infections while perioperative antimicrobial prophylaxis (PAP) covering Gram-negative bacteria at transplant (HR 0.45, 95% CI 0.23-0.90, p = 0.023) was a protective factor.</p><p><strong>Conclusion: </strong>This study shows that Gram-negative infections represent the major challenge for HT patients during ICU stay and shows some evidence in support of the PAP covering Gram-negative infections at transplant.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70031"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12205279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038640","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":"Collateral Damage: Unpacking Antibiotic Risks in Liver Transplantation.","authors":"Hannah Imlay, Erica J Stohs","doi":"10.1111/tid.70044","DOIUrl":"10.1111/tid.70044","url":null,"abstract":"","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70044"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144011830","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":"Research Advice for Early Career Transplant Infectious Disease Clinicians.","authors":"Rebecca N Kumar, Michael J Scolarici, Chelsea Gorsline, Lara Danziger-Isakov, John Baddley, Courtney E Harris","doi":"10.1111/tid.70041","DOIUrl":"10.1111/tid.70041","url":null,"abstract":"<p><p>As part of an ongoing series of social media discussions, the Transplant Infectious Diseases Early Career Network hosted an open forum for the transplant infectious disease community to discuss the development of research careers for junior faculty. Topics discussed included opportunities for research, identifying potential research questions, institutional support, grant funding, common barriers to research, and trainee involvement. The forum highlighted symbiotic relationships between junior faculty and trainees. The insights from the forum provide a valuable resource for early-career transplant infectious diseases (TID) researchers.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70041"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12205271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143982588","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":"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":"10.1111/tid.70017","url":null,"abstract":"","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70017"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","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":"10.1111/tid.70022","url":null,"abstract":"","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70022"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","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":"Mycobacterium abscessus Complex Infections Among Lung Transplant Recipients: A Multicenter Retrospective Cohort Study in Canada.","authors":"Roni Bitterman, Hafid Soualhine, Pierre-Marie Akochy, Charles Poirier, Pasquale Ferraro, Dima Kabbani, Alim Hirji, Gregory Tyrrell, Celine Bergeron, Robert D Levy, Alissa Wright, Victor Leung, Lianne G Singer, Cecilia Chaparro, Shaf Keshavjee, Melissa Richard-Greenblatt, Shahid Husain, Me-Linh Luong","doi":"10.1111/tid.70003","DOIUrl":"10.1111/tid.70003","url":null,"abstract":"<p><strong>Background: </strong>Mycobacterium abscessus complex is known to cause life-threatening disease in lung transplantation (LT) recipients (LTRs). Therefore, many centers consider the presence of M. abscessus as a relative contraindication to LT.</p><p><strong>Methods: </strong>We conducted a multicenter retrospective cohort study including all 4 LT centers in Canada. All LTRs transplanted in 2006-2016 with at least one respiratory sample positive for M. abscessus prior or posttransplantation were included. Pulmonary disease was defined using the American Thoracic Society criteria. Minimal follow-up duration was 5 years after transplantation.</p><p><strong>Results: </strong>Among 2181 LTRs across Canada, 14 had M. abscessus disease after LT (incidence rate 1.1/1000 transplant-years) and 6 had pulmonary colonization (incidence rate 0.5/1000 transplant-years). Fifteen patients had M. abscessus cultured before LT. Among those with pretransplant M. abscessus, 53% (8/15) developed M. abscessus infection posttransplant (6 disease, 2 colonization). Posttransplant disease was less frequent among those with microbiologic eradication before transplant (0% vs. 85.7%, p = 0.001). LTRs with pretransplant M. abscessus had comparable survival to those without M. abscessus (log rank p = 0.37). Among patients with pretransplant infection, mortality was higher in those who did not achieve microbiological eradication before transplantation (57.1% vs. 0%, p = 0.03) and those who developed disease after transplantation (66.7% vs. 0%, p = 0.01).</p><p><strong>Conclusions: </strong>M. abscessus is an uncommon cause of infection among LTRs. Survival among those with pretransplant M. abscessus infection was similar to that observed in noninfected LTRs. However, lack of eradication before transplantation was associated with higher posttransplant disease and mortality.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70003"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12205293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441401","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":"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":"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":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12205301/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Universal Multiplex Panel Testing of Donor Lungs as a Strategy to Optimize Antibiotic Prophylaxis Against Multidrug-Resistant Bacteria.","authors":"Rayid Abdulqawi, Rana A Saleh, Reem M Alameer, Roaa Alabiri, Ruba Alabiri, Khaled Alkattan, Reem S Almaghrabi, Zainab Al Duhailib, Sahar Althawadi, Najib M Rahman, Waleed Saleh, Amani H Yamani, Eid A Al-Mutairy","doi":"10.1111/tid.14446","DOIUrl":"10.1111/tid.14446","url":null,"abstract":"<p><strong>Background: </strong>Twenty percent of lung donors in our transplant program carry respiratory carbapenem-resistant (CR) gram-negative bacteria (GNB), most commonly CR Acinetobacter baumannii. Universal multiplex panel testing of lung transplant donors was introduced in June 2022 as a strategy to expedite CR-GNB detection and optimize perioperative antibiotic prophylaxis. We herein describe our experiences with this approach.</p><p><strong>Methods: </strong>Retrospective single-center cohort study including 53 adult patients who underwent lung-only transplantation between June 2022 and December 2023.</p><p><strong>Results: </strong>The most common bacteria identified by the multiplex panel were Staphylococcus aureus (n = 20), A. baumannii (n = 13), Klebsiella pneumoniae (n = 13), and Pseudomonas aeruginosa (n = 10). The panel detected 6/9 A. baumannii, 2/2 CR K. pneumoniae, 1/1 CR P. aeruginosa, and 7/8 methicillin-resistant S. aureus that were grown on conventional cultures, corresponding to negative predictive values of 94%, 100%, 100%, and 98%. Based on panel or culture results, IV tigecycline was administered as prophylaxis in 19% of patients, colistin in 17%, and novel beta-lactams in 15%.</p><p><strong>Conclusion: </strong>The multiplex panel rapidly detected donor CR-GNB with a high negative predictive value and resulted in clinical effects of reducing broad-spectrum antibiotic prescriptions and maintaining adequate posttransplant outcomes. Prospective studies with predefined outcomes are needed to compare panel-directed therapy against current standards of care.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e14446"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441411","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":"Seizures and Lung Lesions in a Solid Organ Transplant Recipient: Bringing Things Together.","authors":"Matthew B Roberts, Julien Coussement, David Lebeaux, P Toby Coates, Wanessa Trindade Clemente","doi":"10.1111/tid.14449","DOIUrl":"10.1111/tid.14449","url":null,"abstract":"<p><p>A 28-year-old male presented to an Australian hospital with sudden-onset headache and seizure following a kidney transplant for end-stage renal disease due to IgA nephropathy. Clinical approach to the cases and management of the diagnosed disease are discussed.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e14449"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450479","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":"Drug-Induced Hypersensitivity Syndrome/Drug Reaction With Eosinophilia and Systemic Symptoms With Reactivation of Human Herpesvirus-6 in a Liver Transplant Recipient.","authors":"Rebecca Unterborn, Kaitlin Blotske, Maheen Z Abidi","doi":"10.1111/tid.14447","DOIUrl":"10.1111/tid.14447","url":null,"abstract":"","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e14447"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12254022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066670","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}