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  • 1
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    Online Resource
    A comprehensive review of Strongyloides stercoralis infection after solid organ and hematopoietic stem cell transplantation
    Wiley ; 2022
    In:  Clinical Transplantation Vol. 36, No. 11 ( 2022-11)
    Details
    In: Clinical Transplantation, Wiley, Vol. 36, No. 11 ( 2022-11)
    Abstract: We reviewed the scientific literature to gain insight on the epidemiology and outcome of Strongyloides stercoralis infections after transplantation. Methods CINAHL, PUBMED, and OVID/MEDLINE were reviewed from inception through March 31, 2022 using key words Strongyloides and transplantation. Results Our review identified 108 episodes of Strongyloides infection among 91 solid organ transplant (SOT) and 15 hematopoietic cell transplant (HCT) recipients. Median time to infection was 10.8 (range, .14–417) and 8.8 (range, 0–208) weeks after SOT and HCT, respectively. Gastrointestinal symptoms were frequent (86/108 [79.6%]), while skin rash (22/108 [20.3%] ) and fever (31/103 [30%]) were less common. Peripheral eosinophilia was observed in half of patients (41/77 [53.2%] ). Bacteremia (31/59 [52.5%]) was frequently due to Gram‐negative organisms (24/31 [77.4%] ). Abnormal chest radiologic findings were reported in half (56/108 [51.9%]). The majority had hyperinfection syndrome (97/108 [89.8%] ) while disseminated strongyloidiasis was less common (11/108 [10.2%]). Thirty‐two cases were categorized as donor‐derived infection (DDI), with donors (23/24 [95.8%] ) who had traveled to or lived in endemic areas. Median time to DDI was 8 weeks (range .5–34.3 weeks) after transplantation. Treatment consisted of ivermectin ( n  = 26), a benzimidazole ( n  = 27), or both drugs ( n  = 28). There was high all‐cause mortality (48/107, 44.9%) and a high Strongyloides ‐attributable mortality (32/49, 65.3%). Conclusions Strongyloidiasis should be strongly considered among recipients with epidemiologic risk factors for infection, even in the absence of eosinophilia or rash. A policy that provides guidance on pro‐active screening is needed, to ensure preventive measures are provided to recipients at increased risk.
    Type of Medium: Online Resource
    ISSN: 0902-0063 , 1399-0012
    URL: Issue
    URL: Article
    DOI: 10.1111/ctr.v36.11
    DOI: 10.1111/ctr.14795
    Language: English
    Publisher: Wiley
    Publication Date: 2022
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  • 2
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    Donor‐derived endemic mycoses after solid organ transplantation: A review of reported cases
    Wiley ; 2024
    In:  Clinical Transplantation Vol. 38, No. 1 ( 2024-01)
    Details
    In: Clinical Transplantation, Wiley, Vol. 38, No. 1 ( 2024-01)
    Abstract: Donor‐derived endemic mycoses are infrequently reported. We summarized the clinical characteristics and outcomes of these infections to provide guidance to transplant clinicians. Methods Multiple databases were reviewed from inception through May 31, 2023 using endemic fungi as key words (e.g., Coccidioides, histoplasma, blastomyces, talaromyces, paracoccidioides). Only donor‐derived infections (DDI) were included. Results Twenty‐four cases of DDI were identified from 18 published reports; these included 16 coccidioidomycosis, seven histoplasmosis, and one talaromycosis. No cases of blastomycosis and paracoccidiodomycosis were published. The majority were male (17/24,70.8%). Half of the cases were probable (12/24, 50%), seven were possible (29.2%), and only five were proven DDI (20.8%). Donor‐derived coccidioidomycosis were observed in kidney ( n  = 11), lung ( n  = 6), liver ( n  = 3), heart ( n  = 2) and combined SOT recipients (1 KP, 1 KL) at a median time of .9 (range .2–35) months after transplantation. For histoplasmosis, the majority were kidney recipients (6 of 7 cases) at a median onset of 8 (range .4–48) months after transplantation. The single reported possible donor‐derived talaromycosis occurred in a man whose organ donor had at‐risk travel to Southeast Asia. Collectively, the majority of donors had high‐risk exposure to Coccidioides (9/11) or Histoplasma sp. (6/6). Most donor‐derived endemic mycoses were disseminated (18/24, 75%), and mortality was reported in almost half of recipients (11/24, 45.8%). Conclusion Donor‐derived endemic mycoses are often disseminated and are associated with high mortality. A detailed evaluation of donors for the potential of an undiagnosed fungal infection prior to organ donation is essential to mitigate the risk of these devastating infections.
    Type of Medium: Online Resource
    ISSN: 0902-0063 , 1399-0012
    URL: Issue
    URL: Article
    DOI: 10.1111/ctr.v38.1
    DOI: 10.1111/ctr.15199
    Language: English
    Publisher: Wiley
    Publication Date: 2024
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  • 3
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    Online Resource
    Treatment of latent TB Infection and the risk of tuberculosis after solid organ transplantation: Comprehensive review
    Wiley ; 2019
    In:  Transplant Infectious Disease Vol. 21, No. 6 ( 2019-12)
    Details
    In: Transplant Infectious Disease, Wiley, Vol. 21, No. 6 ( 2019-12)
    Abstract: Mycobacterium tuberculosis disease may occur after treatment of latent TB infection (LTBI). Prompted by a case of reactivation TB disease in a solid organ transplant (SOT) recipient who received LTBI treatment, we reviewed the literature to examine outcomes, adverse effects, resistance, and treatment choices of tuberculosis after LTBI therapy. Methods MEDLINE and Web of Science from inception to 5/2019 were reviewed using key words “latent tuberculosis infection” and “SOT” or “transplantation.” The search yielded nine cases, 41 cohort studies and six randomized controlled trials (RCT). Results Cohort and RCT demonstrated significant reduction in TB disease among transplanted patients who received LTBI therapy; only 56/2651 (2.1%) SOT patients developed TB after LTBI therapy. Adverse drug reactions occurred in 149/1148 (12.9%) and 73/641 (11.4%) of cohort and RCT patients, respectively. Among liver recipients, 56/266 (21%) developed side effects, of which half (29/56, 51.8%) was INH‐related. There was no reported INH resistance. Conclusions Latent TB infection treatment is efficacious in SOT recipients at risk of TB disease. However, tuberculosis may still occur despite LTBI treatment. Hepatotoxicity associated with LTBI therapy is infrequent, although more commonly observed among liver recipients.
    Type of Medium: Online Resource
    ISSN: 1398-2273 , 1399-3062
    URL: Issue
    URL: Article
    DOI: 10.1111/tid.v21.6
    DOI: 10.1111/tid.13178
    Language: English
    Publisher: Wiley
    Publication Date: 2019
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  • 4
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    Online Resource
    Multi‐drug resistant and rifampin‐resistant tuberculosis in transplant recipients
    Wiley ; 2023
    In:  Transplant Infectious Disease Vol. 25, No. 4 ( 2023-08)
    Details
    In: Transplant Infectious Disease, Wiley, Vol. 25, No. 4 ( 2023-08)
    Abstract: Management of multidrug‐resistant (MDR) and rifampin‐resistant (RR) tuberculosis is challenging. Data on transplant recipients is limited. We reviewed published literature to examine treatment choices, outcomes, and adverse effects from MDR‐TB/RR‐TB treatment in transplant recipients. Methods Multiple databases from inception to 12/2022 were reviewed using the keywords “drug‐resistant TB” or “drug‐resistant tuberculosis” or “multidrug‐resistant TB” or “multidrug‐resistant tuberculosis”. MDR‐TB was defined as resistance to isoniazid (H) and rifampin (R), and RR if resistant to rifampin alone. Cases without patient‐level data and reports which did not describe treatment and/or outcomes for MDR‐TB were excluded. Results A total of 12 patients (10 solid organ transplants and two hematopoietic cell transplants) were included. Of these, 11 were MDR‐TB and one was RR‐TB. Seven recipients were male. The median age was 41.5 (range 16–60) years. Pre‐transplant evaluation for the majority (8/12, 66.7%) did not reveal a prior history of TB or TB treatment, but 9/12 were from TB intermediate or high‐burden countries. Seven patients were initially treated with the quadruple first‐line anti‐TB regimen. Those who had early RR confirmation (5/12) via Xpert MTB/RIF assay were initiated on alternative therapies. Final regimens were individualized based on susceptibility profiles and tolerability. Adverse events were reported in seven recipients, including acute kidney injury ( n = 3), cytopenias ( n = 3), and jaundice ( n = 2). Four recipients died, with two deaths attributable to TB. The remaining eight patients who survived had functioning allografts at the last follow‐up. Conclusions MDR‐TB treatment in transplant recipients is associated with many complications. Xpert MTB/RIF detected RR early and guided early empiric therapy. image
    Type of Medium: Online Resource
    ISSN: 1398-2273 , 1399-3062
    URL: Issue
    URL: Article
    DOI: 10.1111/tid.v25.4
    DOI: 10.1111/tid.14088
    Language: English
    Publisher: Wiley
    Publication Date: 2023
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  • 5
    Online Resource
    Online Resource
    A review of endemic mycoses after hematopoietic stem cell transplantation
    Wiley ; 2023
    In:  Transplant Infectious Disease
    Details
    In: Transplant Infectious Disease, Wiley
    Abstract: Endemic mycoses after hematopoietic stem cell transplantation (HSCT) are rarely reported. We aimed to comprehensively review the clinical presentation and outcomes of endemic mycoses in this immunocompromised population. Methods Multiple databases were reviewed from inception through May 31, 2023 using endemic fungi as keywords (e.g., coccidioides, histoplasma, blastomyces, talaromyces, and paracoccidioides). Only hematopoietic transplants were included. Results There were 16 publications on endemic mycoses after HSCT that reported nine unique cases of histoplasmosis, seven coccidioidomycosis, and two talaromycosis. No cases of paracoccidioides and blastomycoses were identified. Fifteen cases were allogeneic hematopoietic transplant recipients and three were autologous. Many were male (14/18, 77.8%) and overall median age was 50 (range 21–75) years. Among the 16 patients with coccidiodomycosis or histoplasmosis, fever, cytopenias and disseminated disease were the most common clinical presentations, with median onset of 8 or 12 months after HSCT, respectively. Likewise, the two HSCT patients with talaromycosis presented with disseminated disease at 12 and 48 months after transplantation. The vast majority were not on effective azole prophylaxis at the time of presentation, and many had recent intensification of immunosuppression. Nine of 18 patients died (50%), and all deaths occurred among patients with disseminated endemic mycoses. Conclusion Endemic mycoses among HSCT are uncommon. Onset was late, after discontinuation of azole prophylaxis, or was associated with intensification of immunosuppression. Disseminated disease was a common presentation, manifested by fever and cytopenias. Attributable mortality was high, and emphasizes the need for a high index of clinical suspicion so that prompt diagnosis and treatment is provided. image
    Type of Medium: Online Resource
    ISSN: 1398-2273 , 1399-3062
    URL: Article
    DOI: 10.1111/tid.14155
    Language: English
    Publisher: Wiley
    Publication Date: 2023
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  • 6
    Online Resource
    Online Resource
    Mycobacterium tuberculosis after solid organ transplantation: A review of more than 2000 cases
    Wiley ; 2018
    In:  Clinical Transplantation Vol. 32, No. 6 ( 2018-06)
    Details
    In: Clinical Transplantation, Wiley, Vol. 32, No. 6 ( 2018-06)
    Abstract: Mycobacterium tuberculosis ( TB ) is a common pathogen worldwide, and it may cause significant infection after solid organ transplantation ( SOT ). We reviewed all reported TB cases to provide an update on its epidemiology, clinical presentation, management, and outcome after SOT . Methods MEDLINE , EMBASE , and OVID were reviewed from January 1, 1998, to December 31, 2016, using keywords tuberculosis and solid organ transplant or transplantation. Results There were 187 publications reporting 2082 cases of TB among kidney (n = 1719), liver (n = 253), heart (n = 77), lung (n = 25), and kidney‐pancreas (n = 8) recipients. Among cohort studies, the median incidence was 2.37% (range, 0.05%‐13.27%) overall. Most TB disease was considered reactivation of latent infection, occurring beyond the first year after SOT . Early‐onset cases were seen among donor‐derived TB cases. Fever was the most common symptom. Radiologic findings were highly variable. Extrapulmonary and disseminated TB occurred 29.84% and 15.96%, respectively. Multidrug‐resistant TB was rare. Treatment using 4 or 5 drugs was commonly associated with hepatotoxicity and graft dysfunction. All‐cause mortality was 18.84%. Conclusions This large review highlights the complexity of TB after SOT . Reactivation TB , donor‐transmitted infection, extrapulmonary involvement, and disseminated disease are common occurrences. Treatment of TB is commonly associated with hepatotoxicity and graft dysfunction.
    Type of Medium: Online Resource
    ISSN: 0902-0063 , 1399-0012
    URL: Issue
    URL: Article
    DOI: 10.1111/ctr.2018.32.issue-6
    DOI: 10.1111/ctr.13259
    Language: English
    Publisher: Wiley
    Publication Date: 2018
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  • 7
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    An update on Mycobacterium tuberculosis infection after hematopoietic stem cell transplantation in adults
    Wiley ; 2018
    In:  Clinical Transplantation Vol. 32, No. 12 ( 2018-12)
    Details
    In: Clinical Transplantation, Wiley, Vol. 32, No. 12 ( 2018-12)
    Abstract: Mycobacterium tuberculosis (TB) is common worldwide, but is rarely reported after hematopoietic transplantation (HSCT). We reviewed all TB cases among HSCT since 2010 to provide an update on its epidemiology, clinical presentation, management and outcome. Methods Several databases were reviewed from January 1, 2010 to June 30, 2018 using key words tuberculosis and hematopoietic transplantation. Results The 47 cases of TB were reported during the study period. The highest TB frequency was reported from India (2.9%), with a median frequency of 2% (range, 0.18%‐2.9%). The majority were recipients of allogeneic transplants (45/47, 95.7%). Pulmonary TB was the most common clinical presentation (20/47, 42.6%). The median time to clinical presentation was 4.6 (range, 3‐12.9) and 2.4 (range, 0.6‐5) months, based on cohort data and case reports, respectively. Fever was reported in 87.5% (14/16) of patients. First‐line quadruple drug therapy was frequently used (29/35, 82.9%), with a median length of 12 and 9 months for cohorts and case reports, respectively. All‐cause and attributable mortality was 27.6% (13/47), and 8.5% (4/47), respectively. Conclusions Mycobacterium tuberculosis presents early after HSCT, most commonly as fever. A high index of suspicion is needed for early diagnosis and treatment, to prevent TB‐attributable mortality.
    Type of Medium: Online Resource
    ISSN: 0902-0063 , 1399-0012
    URL: Issue
    URL: Article
    DOI: 10.1111/ctr.2018.32.issue-12
    DOI: 10.1111/ctr.13430
    Language: English
    Publisher: Wiley
    Publication Date: 2018
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  • 8
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    Epidemiology and risk factors for infection after living donor liver transplantation
    Ovid Technologies (Wolters Kluwer Health) ; 2017
    In:  Liver Transplantation Vol. 23, No. 4 ( 2017-04), p. 465-477
    Details
    In: Liver Transplantation, Ovid Technologies (Wolters Kluwer Health), Vol. 23, No. 4 ( 2017-04), p. 465-477
    Abstract: The epidemiology of infections after living donor liver transplantation (LDLT) is limited. We aimed to study the epidemiology and risk factors of infections after LDLT. The medical records of 223 adult patients who underwent LDLT from January 1, 2000 to August 31, 2015 were reviewed for all infections occurring up to 1 year. We estimated the cumulative incidence of infection using the Kaplan‐Meier product limit method. Risk factors were analyzed with time‐dependent Cox regression modeling. The majority of patients were Caucasian (94.6%) and male (64.6%), and the median age at transplantation was 55 years. The most common indication for transplantation was primary sclerosing cholangitis (37.7%). A total of 122 patients developed an infection during the follow‐up period (1‐year cumulative event rate of 56%), with the majority (66%) of these occurring within 30 days after transplantation. Enterococcus sp . was the most frequent pathogen identified. Multivariate analysis showed that increased Model for End‐Stage Liver Disease (MELD) score (per 10‐point change: hazard ratio [HR], 1.59), history of recurrent infections prior to transplant (HR, 2.01), Roux‐en‐Y anastomosis (HR, 2.37), increased log‐number of packed red blood cell transfusions (HR, 1.39), and biliary complications (HR, 4.26) were independently associated with a higher risk of infection. Infections occur commonly after LDLT, with most infections occurring early and being related to the hepatobiliary system. Higher MELD scores, the type of biliary anastomosis, presence of biliary complications, and prior pretransplant infections are independently associated with a higher risk for infections. Liver Transplantation 23 465–477 2017 AASLD.
    Type of Medium: Online Resource
    ISSN: 1527-6465 , 1527-6473
    URL: Article
    DOI: 10.1002/lt.24739
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2017
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  • 9
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    Global Online Interest in HIV/AIDS care Services in the time of COVID-19: A Google Trends Analysis
    Springer Science and Business Media LLC ; 2023
    In:  AIDS and Behavior Vol. 27, No. 6 ( 2023-06), p. 1998-2004
    Details
    In: AIDS and Behavior, Springer Science and Business Media LLC, Vol. 27, No. 6 ( 2023-06), p. 1998-2004
    Type of Medium: Online Resource
    ISSN: 1090-7165 , 1573-3254
    URL: Article
    DOI: 10.1007/s10461-022-03933-w
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2014832-X
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  • 10
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    The clinical profile and outcomes of adult patients given intravenous colistin for multidrug-resistant gram negative infections in a Philippine tertiary hospital
    Elsevier BV ; 2020
    In:  International Journal of Infectious Diseases Vol. 93 ( 2020-04), p. 9-14
    Details
    In: International Journal of Infectious Diseases, Elsevier BV, Vol. 93 ( 2020-04), p. 9-14
    Type of Medium: Online Resource
    ISSN: 1201-9712
    URL: Article
    DOI: 10.1016/j.ijid.2020.01.022
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2020
    detail.hit.zdb_id: 2070533-5
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