Therapeutic Advances in Infectious Disease最新文献

{"title":"Prescribing equity: physicians as advocates for access to essential medicines. A call to action from medical graduates.","authors":"Emmanuel Adams-Gelinas, Amanda Bianco, Virginie Boisvert-Plante, Santina Conte, Inès Dupuis, Anda Gaita, Lina Hadidi, Yutong Huang, Meryem Jabrane, Kimiya Kaffash, Loubna Lamrani, Marine Leblanc, Sara Marier, Alexander Moise, Chloe Pereira-Kelton, Amélie Rochon, Shanti Rumjahn-Gryte, Veronika Svistkova, Marie-Catherine Viau, Kiana Yau","doi":"10.1177/20499361241281136","DOIUrl":"10.1177/20499361241281136","url":null,"abstract":"","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"11 ","pages":"20499361241281136"},"PeriodicalIF":3.8,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11489904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time to incident hypertension and independent predictors among people living with HIV in Nigeria.","authors":"Oluseye Ayodele Ajayi, Prosper Okonkwo, Temitope Olumuyiwa Ojo, Oluwaseun Kikelomo Ajayi, Olabanjo Ogunsola, Emmanuel Osayi, Ifeyinwa Onwuatuelo, Jay Osi Samuels","doi":"10.1177/20499361241289800","DOIUrl":"10.1177/20499361241289800","url":null,"abstract":"<p><strong>Background: </strong>Understanding the time to hypertension occurrence after antiretroviral treatment (ART) initiation in people living with HIV (PLHIV) and its determinants is important for designing interventions for control.</p><p><strong>Objective: </strong>This study sought to estimate the median time of ART use to hypertension onset and its predictors in Nigerian PLHIV.</p><p><strong>Design: </strong>A retrospective longitudinal study.</p><p><strong>Methods: </strong>This retrospective review of 2503 normotensive adult PLHIV (⩾18 years) from 2004 to 2020 in two HIV clinics in Nigeria. Incident hypertension was based on clinical diagnosis or two consecutive blood pressure readings ⩾140/90 mmHg, taken during the 8 months of data collection. Survival event was defined as incident hypertension during follow-up or interview day for observed patients unless they were right censored. The Kaplan-Meier survival curve was used to estimate the survival probabilities of hypertension. The Cox proportional hazard model was fitted to identify predictors of hypertension at <i>p</i> < 0.05.</p><p><strong>Results: </strong>A total of 2503 PLHIV was followed up. The majority were females (74.6%) and on Dolutegravir-based therapy (93.0%). About 22 (0.9%) were diabetic. Median age at ART initiation was 35 (interquartile range: 29-41) years. The median period of follow-up was 12.0 ± 3.9 years. The cumulative incidence of hypertension was 32.5% (381/2540), with an incidence rate of 40.1/1000 person-years. The median time to incident hypertension was 17.0 years (95% CI: 12.5-21.5 years). Shorter hypertension-free survival times were seen in males, those aged 60+, with diabetes, unsuppressed viral load, history of tuberculosis, other opportunistic infections, or co-trimoxazole use. Significant risk factors included male sex (adjusted odds ratio (AOR) = 1.3, 95% CI = 1.1-1.6), middle age (AOR = 2.3, 95% CI = 1.7-3.2), old age (AOR = 5.6, 95% CI = 3.9-8.4), and unsuppressed viral load (AOR = 1.9, 95% CI = 1.3-2.7).</p><p><strong>Conclusion: </strong>Hypertension is commoner among PLHIV with unsuppressed viral load, males, and persons older than 40 years. Effective ART with viral suppression remains essential. Incorporating regular hypertension screening and treatment into HIV care is necessary for optimum health outcomes.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"11 ","pages":"20499361241289800"},"PeriodicalIF":3.8,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11489917/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cutaneous manifestations of deep mycoses in Nigeria: a systematic review.","authors":"Thelma E Bassey, Ikechukwu Okekemba, Walter O Egbara, Promise Owai, Love E Okafor, David E Elem, Geraldine L Edim, Asukwo Onukak, Bassey E Ekeng","doi":"10.1177/20499361241286973","DOIUrl":"https://doi.org/10.1177/20499361241286973","url":null,"abstract":"<p><strong>Background: </strong>Deep mycoses are serious fungal diseases commonly associated with the immunocompromised but can also present in the immunocompetent following severe exposure to fungal pathogens. Included in this group are subcutaneous and systemic fungal infections.</p><p><strong>Objectives: </strong>Reviews highlighting skin involvement in patients with deep mycosis in the Nigerian setting are sparse in the literature. This systematic review summarized the clinical presentation, risk factors, and diagnosis of deep mycosis presenting with cutaneous manifestations in Nigerians.</p><p><strong>Design: </strong>This was a systematic review conducted following the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines.</p><p><strong>Data sources and methods: </strong>PubMed, Google Scholar, and the African Journal Online database were searched from inception to February 2024 to identify published articles from Nigeria on deep mycoses with cutaneous manifestations. We included single case reports and case series on cutaneous involvement in deep fungal infections in Nigeria. Review articles, guidelines, meta-analyses, animal studies, and fungal studies not relating to the Nigerian setting were excluded.</p><p><strong>Results: </strong>We identified 16 well-documented articles on deep cutaneous mycoses published in Nigeria over the past six decades which amounted to 137 cases; 102 (74.5%) cases were reported before the year 2000, while the remainder were published within the past two decades. The 137 cases were majorly histoplasmosis (<i>n</i> = 87, 63.5%) and eumycetoma (<i>n</i> = 19, 13.9%) and predominant risk factors, farming (<i>n</i> = 13, 9.5%) and diabetes mellitus (<i>n</i> = 3, 2.2%), The diagnosis of cases was predominantly via histopathology (<i>n</i> =131, 95.6%) with a few cases diagnosed by fungal culture (<i>n</i> = 15, 10.9%), and antigen assay (<i>n</i> = 1, 0.7%) respectively. Twenty-one (15.3%) were clinically diagnosed as cancers including a case of carcinoma of the skin, and one each (0.7%) as skin tuberculosis or neurofibromatosis but all histologically confirmed as deep cutaneous mycoses.</p><p><strong>Conclusion: </strong>The decline of reports on deep cutaneous mycoses in recent times suggests neglect or a low index of suspicion from attending clinicians. This is further buttressed in the misdiagnosis of cases as other clinical entities. Ensuring a histological diagnosis of skin lesions, especially in at-risk patients will mitigate these gaps.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"11 ","pages":"20499361241286973"},"PeriodicalIF":3.8,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11483805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and factors associated with surgical site infections among mothers after cesarean section at Mbarara Regional Referral Hospital, Uganda: an observational retrospective study.","authors":"Daniel Chans Mwandah, Tadele Mekuriya Yadesa, Ivan Ibanda, Aboda Alex Komakech, Deo Kyambadde, Joseph Ngonzi","doi":"10.1177/20499361241286838","DOIUrl":"https://doi.org/10.1177/20499361241286838","url":null,"abstract":"<p><strong>Background: </strong>The risk of infection following cesarean delivery is 5-20 times higher than that following normal delivery, contributing to 10% of pregnancy-related mortality. In 2019, Mbarara Regional Referral Hospital (MRRH) performed cesarean section for 40% of deliveries, surpassing the WHO's recommended 15%-20%. The availability and provision of effective prophylactic antibiotics are crucial in preventing surgical site infections (SSIs).</p><p><strong>Objectives: </strong>To determine the prevalence and predictors of SSIs among mothers after cesarean section, length of hospital stay, and antibiotic use at MRRH.</p><p><strong>Design: </strong>This was an observational retrospective study conducted in the maternity ward of the MRRH.</p><p><strong>Methods: </strong>Data on the diagnosis of SSI, length of hospital stay, and antibiotic use were extracted and entered into EpiData software version 3.1 and analyzed using STATA version 15. We conducted logistic regression analysis to identify factors independently associated with SSIs. We also compared the length of hospital stay.</p><p><strong>Results: </strong>The prevalence of post-cesarean SSIs was 7.9% (95% CI: 6.3%-9.9%). Mothers aged 25 years and younger were less likely to develop SSIs (adjusted odds ratio (aOR): 0.53, 95% CI: 0.30-0.93; <i>p</i> = 0.027). Those with more than six pregnancies were more likely to develop SSIs (aOR: 3.4; 95% CI: 1.35-8.58; <i>p</i> = 0.009). The median length of stay was 8 days for mothers who developed an SSI (interquartile range (IQR): 5, 16) and 3 (IQR: 3, 4) days for those who did not (<i>p</i> < 0.001). Prophylactic antibiotics were prescribed to 83.4% of the women (95% CI: 80.7-85.8). Ampicillin (88.2%) was the most prescribed prophylactic antibiotic, and metronidazole was the most prescribed postoperatively (97.8%) and at discharge (77.6%).</p><p><strong>Conclusion: </strong>The current prevalence of post-cesarean SSIs is higher in Uganda than in developed countries. Older age and having had more than six pregnancies are independent predictors of SSIs, and post-cesarean SSI significantly prolonged hospital stay.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"11 ","pages":"20499361241286838"},"PeriodicalIF":3.8,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11468585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge, attitudes, and practices toward preventing and controlling hepatitis B virus infection among pregnant women attending antenatal care at a University Hospital in Central Ethiopia: a cross-sectional study.","authors":"Yilma Markos Larebo, Abebe Alemu Anshebo, Sujit Kumar Behera, Natarajan Gopalan","doi":"10.1177/20499361241285342","DOIUrl":"10.1177/20499361241285342","url":null,"abstract":"<p><strong>Background: </strong>Ethiopia is a country with a high endemicity of the hepatitis B virus, and the primary mode of transmission for this virus is mother-to-child transmission. However, the country lacks a comprehensive plan for viral hepatitis surveillance, prevention, and control.</p><p><strong>Objectives: </strong>To assess the knowledge, attitudes, and practices toward preventing and controlling hepatitis B virus infection among pregnant women attending antenatal care at a University Hospital in Central Ethiopia.</p><p><strong>Design: </strong>A hospital-based cross-sectional study was conducted among pregnant women from October to November 2023 at a University Hospital in Central Ethiopia.</p><p><strong>Methods: </strong>A total of 412 pregnant women were selected and included in the study using a systematic random sampling technique. An interviewer-administered questionnaire was used to collect the data. The collected data were imported into Epi-data version 3.1 and then exported to the Statistical Package for Social Sciences version 25 for analysis. In the bivariate analysis, variables with a <i>p</i>-value less than 0.25 were included in the multivariate analysis. A logistic regression model was used. A <i>p</i>-value <0.05 indicated statistical significance.</p><p><strong>Results: </strong>The overall response rate was 94.1%. Of the total 412 respondents, 37.6% exhibited good practices. Notably, pregnant women within the age categories of 29-39 years (adjusted odds ratio (AOR): 0.31; 95% confidence interval (CI): 0.15, 0.64) and ⩾40 years (AOR: 0.17; 95% CI: 0.06, 0.50), residing in rural areas (AOR: 0.35; 95% CI: 0.17, 0.70), with smaller family sizes (AOR: 0.13; 95% CI: 0.07, 0.25), lacking information about hepatitis B virus infection (AOR: 5.15; 95% CI: 2.91, 9.13), having a positive attitude (AOR: 0.03; 95% CI: 0.02, 0.06), and possessing good knowledge (AOR: 0.38; 95% CI: 0.20, 0.71) were significantly associated with poor practice.</p><p><strong>Conclusion: </strong>This study revealed that pregnant women had a low level of knowledge, attitudes, and practices related to hepatitis B virus infection prevention and control. A greater understanding is necessary to effectively prevent and control the spread of infection through prioritized health education programs targeting pregnant women. These programs must focus on raising awareness through campaigns that promote knowledge and immunization for their children.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"11 ","pages":"20499361241285342"},"PeriodicalIF":3.8,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11526330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Catheter-associated urinary tract infections in critically Ill patients with COVID-19: a retrospective cohort study.","authors":"Paulina Dąbrowska, Mateusz Bartoszewicz, Klaudia Bartoszewicz, Juliusz Kosel, Samuel Stróż, Jerzy Robert Ładny, Sławomir Lech Czaban","doi":"10.1177/20499361241278218","DOIUrl":"10.1177/20499361241278218","url":null,"abstract":"<p><strong>Background: </strong>Catheter-associated urinary tract infections (CA-UTIs) pose a significant challenge in intensive care unit (ICU) patients with COVID-19.</p><p><strong>Objective: </strong>The study aims to assess the prevalence of CA-UTIs, identify the causative pathogens and their resistance profiles, and determine the risk factors and outcomes associated with CA-UTIs in ICU patients with COVID-19.</p><p><strong>Design: </strong>Single-center, retrospective cohort study.</p><p><strong>Methods: </strong>The study included 201 adult ICU patients diagnosed with COVID-19 between March 2020 and July 2021. Patients were categorized into CA-UTI (<i>n</i> = 56) and non-CA-UTI (<i>n</i> = 145) groups. Data on demographic characteristics, clinical course, treatment, and outcomes were collected. Logistic regression analysis was used to identify risk factors for CA-UTI.</p><p><strong>Results: </strong>CA-UTIs developed in 28% of patients (<i>n</i> = 56). Incidence density of 15.8 episodes per 1000 catheter days. The average onset occurrence is 7.2 days after ICU admission. Patients with CA-UTI had longer ICU stays (18.8 days vs 10.5 days, <i>p</i> < 0.001) and more elevated mortality rates (75.0% vs 54.5%, <i>p</i> = 0.010), higher mechanical ventilation (MV) usage (98.2% vs 88.3%, <i>p</i> = 0.027), a longer average duration of MV (16.6 days vs 9.1 days, <i>p</i> < 0.001). Longer ICU and hospital stays were significant risk factors for CA-UTI. Other factors, such as the use of corticosteroids, chronic organ insufficiency or immunocompromized status, female sex, age, diabetes mellitus, and the duration of urinary catheterization, did not show significant associations with CA-UTI risk in this cohort. Gram-negative bacteria, particularly <i>Klebsiella pneumoniae</i> (28 cases), was the most common pathogen, with a high prevalence of multidrug resistance (38.8%) with type ESBL, MBL, NDM, and OXA-48. The occurrence of multidrug resistant (MDR) organisms was 68.8%.</p><p><strong>Conclusion: </strong>The findings of this study underscore the prevalence of CA-UTIs in ICU patients with COVID-19, significantly impacting patient outcomes. Effective infection control and targeted antimicrobial therapy are crucial to managing these infections.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"11 ","pages":"20499361241278218"},"PeriodicalIF":3.8,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11452867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142381970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uptake of cervical cancer screening among sex workers living with HIV in Nairobi, Kenya: a cross-sectional study.","authors":"Maureen Akolo, Lawrence Gelmon, Horatius Musembi, Benard Mutwiri, Isabel Kambo, Joshua Kimani, Christopher Akolo","doi":"10.1177/20499361241284238","DOIUrl":"https://doi.org/10.1177/20499361241284238","url":null,"abstract":"<p><strong>Background: </strong>Hospitals within Nairobi County, Kenya, offer cervical cancer screening services. However, most female sex workers do not seek this service.</p><p><strong>Objective: </strong>To determine uptake of cervical cancer screening among female sex workers living with HIV in Nairobi, Kenya.</p><p><strong>Design: </strong>A descriptive cross-sectional study.</p><p><strong>Methods: </strong>Computerized simple random sampling was used to select 75 study participants who met the inclusion criteria; data were collected using a structured questionnaire. The study was carried out among female sex workers living with HIV in Nairobi, Kenya, attending the Sex Workers Outreach Program.</p><p><strong>Results: </strong>40% (<i>n</i> = 30) of respondents were aged 18-25 years. Only 45.3% (34) had been screened for cervical cancer within the last 1 year. 65.3% (<i>n</i> = 49) of respondents knew that cervical cancer affects the cervix but were not aware of what caused the disease. 77.6% (<i>n</i> = 58) found the 8 am-5 pm health facility opening hours a hinderance to seeking services and 66.7% (<i>n</i> = 50) found the screening method uncomfortable. Cultural practices and beliefs fostered stigma in 39.2% (<i>n</i> = 29) of the sex workers; hence, they did not seek out services.</p><p><strong>Conclusion: </strong>Lack of information, cultural barriers, and facility operating hours prevent female sex workers living with HIV from getting tested for cervical cancer. These barriers once addressed could improve cervical cancer screening uptake among this high-risk population.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"11 ","pages":"20499361241284238"},"PeriodicalIF":3.8,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11483850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Update on invasive fungal infections: emerging trends in the incidence of fungal infections in immunosuppressed patients and associated conditions.","authors":"Jon Salmanton-García","doi":"10.1177/20499361241282835","DOIUrl":"https://doi.org/10.1177/20499361241282835","url":null,"abstract":"","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"11 ","pages":"20499361241282835"},"PeriodicalIF":3.8,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11457195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of isolated native tricuspid valve infective endocarditis by a multidisciplinary program: a single-center retrospective cohort study.","authors":"Bennett Collis, Talal Alnabelsi, Evan Hall, Chloe Cao, Meredith Johnson, John Gurley, Luke Strnad, Hassan Reda, Tessa London, Erinn Ogburn, Michael Sekela, Bobbi Jo Stoner, Sami El-Dalati","doi":"10.1177/20499361241280690","DOIUrl":"10.1177/20499361241280690","url":null,"abstract":"<p><strong>Background: </strong>Isolated native tricuspid valve infective endocarditis remains a challenging disease to treat given the large number of patients with substance use disorder. There is limited data on the optimal treatment strategy and the impact of a multidisciplinary endocarditis program on outcomes for this population.</p><p><strong>Objectives: </strong>To assess the clinical outcomes associated with management of native tricuspid valve infective endocarditis by a multidisciplinary team.</p><p><strong>Design: </strong>Single-center, retrospective cohort study.</p><p><strong>Methods: </strong>Patient cases were identified from the registry of the institutional multidisciplinary endocarditis team. Patients with left-sided endocarditis, multivalvular endocarditis, prosthetic tricuspid valves and cardiac implantable electronic devices were excluded.</p><p><strong>Results: </strong>Between September 7th, 2021 and February 1st, 2024 72 consecutive patients with isolated native tricuspid valve infective endocarditis were identified. Sixty-six (91.7%) patients were managed medically. Five patients underwent percutaneous mechanical aspiration of tricuspid valve vegetations and one patient underwent tricuspid valve replacement during the index hospitalization. In-hospital mortality was 1.4% and 90-day mortality was 2.8%. Nineteen (26.4%) patients discharged before medically advised and 25% were re-admitted within 30 days. Ten (13.9%) patients underwent elective tricuspid valve replacements after outpatient follow-up.</p><p><strong>Conclusion: </strong>Among 72 patients with isolated native tricuspid valve infective endocarditis managed by a multidisciplinary endocarditis program over a 2.5-year period, in-hospital, 90-day mortality and 1-year mortality were very low despite low rates of percutaneous mechanical aspiration and tricuspid valve surgery. Multidisciplinary follow-up can lead to elective tricuspid valve surgery in a delayed fashion.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"11 ","pages":"20499361241280690"},"PeriodicalIF":3.8,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11452872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142381971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coadministration of isavuconazole and sirolimus in allogeneic hematopoietic stem cell transplant recipients.","authors":"Francesca Farina, Andrea Acerbis, Chiara Oltolini, Matteo Chiurlo, Elisabetta Xue, Daniela Clerici, Sarah Marktel, Sara Mastaglio, Alessandro Bruno, Simona Piemontese, Elisa Diral, Giorgio Orofino, Edoardo Campodonico, Consuelo Corti, Maria Teresa Lupo Stanghellini, Paolo Scarpellini, Raffaele Dell'Acqua, Antonella Castagna, Iacopo Peccatori, Fabio Ciceri, Raffaella Greco","doi":"10.1177/20499361241252539","DOIUrl":"10.1177/20499361241252539","url":null,"abstract":"<p><strong>Background: </strong>Invasive fungal infections (IFIs) represent a major cause of morbidity among allogeneic hematopoietic stem cell transplantation (allo-HSCT). Isavuconazole (ISA) is a broad-spectrum triazole with favorable safety profile.</p><p><strong>Objectives and design: </strong>Herein, we evaluate the real life coadministration of ISA and sirolimus in allo-HSCT recipients in a single-center retrospective analysis, describing clinical efficacy, safety, and therapeutic drug monitoring (TDM) of both drugs.</p><p><strong>Methods: </strong>All consecutive allo-HSCT recipients who received the coadministration of ISA and sirolimus for at least 2 weeks between July 2017 and December 2022 were included in this retrospective analysis. TDM was longitudinally performed during treatment. IFIs were classified according to the revised European Organization for Research and Treatment of Cancer/Mycoses Study Group consensus criteria.</p><p><strong>Results: </strong>A total of 51 recipients were included in the analysis. A total of 17 patients received ISA as continuous antifungal treatment for IFI diagnosed before transplant: one patient experienced a probable invasive pulmonary aspergillosis, and one patient switched from ISA to liposomal amphotericin B for a possible IFI. A total of 34 patients started ISA as antifungal therapy for IFI diagnosed after transplant. Sixteen of 34 were treated for a proven/probable breakthrough IFI during mold-active prophylaxis: 6/16 patients died for IFI after a median of 51 days of ISA. Eighteen of 34 started ISA as empirical therapy for a possible IFI: 15/18 patients were alive with resolution of infection after 6 weeks, 1 died for disease progression, and 2 had empirically changed antifungal therapy due to pneumonia progression. Clinical and radiological response rate was 68% after 90 days from IFI diagnosis. No toxicities related to drug-drug interaction have been registered in patients reaching concomitant therapeutic levels of ISA and sirolimus.</p><p><strong>Conclusion: </strong>The coadministration of ISA and sirolimus was safe and feasible in this cohort, confirming favorable clinical efficacy in patients with multiple-drug coadministration.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"11 ","pages":"20499361241252539"},"PeriodicalIF":3.8,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11440545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142356109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}