The American Society of Transplantation Online Transplant Infectious Diseases Library

Endemic fungi are thermally dimorphic and occur naturally in specific geographic areas. Histoplasmosis, coccidioidomycosis, and blastomycosis are the three major disease entities encountered in North America. Even in endemic areas, disease incidence is low among transplant recipients. Infection is typically acquired via inhalation of molds from the environment. Disseminated infection is more likely to occur in immunocompromised individuals. Definitive diagnosis is established by growing the...

Scope: Presenting symptoms, distributions and patterns of diseases and vulnerability to invasive aspergillosis (IA) are similar between children and adults. However, differences exist in the epidemiology and underlying conditions, the usefulness of newer diagnostic tools, the pharmacology of antifungal agents and in the evidence from interventional phase 3 clinical trials. Therefore, the European Society for Clinical Microbiology and Infectious Diseases (ESCMID) and the European...

Historically, potential lung donors who have detectable antibodies to hepatitis C virus have been declined by most centers due to concern for possible disease transmission. We sought to evaluate hepatitis C viral transmission rates from donors who were known to be HCV Ab positive but HCV NAT negative. We performed a single-center retrospective review of a prospectively collected database for lung transplant recipients at our center including HCV Ab+NAT- donors (approved January 2017). Donor...

Enterobacteriaceae comprise important pathogens for recipients of solid organ and hematopoietic stem cell transplants. Especially common in the early posttransplant period when transplant recipients are still hospitalized, they can occur at any time following the procedure. Increasing frequency of colonization and invasive disease due to antimicrobial-resistant pathogens has been described in recipients of solid organ and hematopoietic stem cell transplants. In solid organ transplant...

These updated guidelines from the Infectious Diseases Community of Practice of the American Society of Transplantation will review the current state of the art of donor-derived infections. Specifically, the guideline will summarize standardized definitions and approaches to defining imputability, updated data on the epidemiology of donor-derived infections, and approaches to risk mitigation against transmission of infections. This update will additionally provide guidance on the use of HIV+...

Hematopoietic stem cell transplantation (HSCT) has the potential to provide long-term survival and potential cure in patients with hematological malignancies and nonmalignant hematologic and autoimmune disorders. Conditioning regimens are designed to make room for the stem cell allograft by ablation of hosts’ immune system with the objective of sustained foreign immune cell engraftment. However, a number of short-term and long-term complications are associated with regimens used for...

Acute bloodstream infection (BSI) is one of the most severe forms of infection. BSI may be primary or secondary and community-acquired or healthcare-associated. BSI is frequently observed among immunocompromised and critically ill patients, but is rarely asymptomatic and may be associated with multiple organ failure (Pittet et al. JAMA. 1994;271(20):1598–601; Edmond et al. Clin Infect Dis. 1999;29(2):239–44; Marshall et al. Crit Care Med. 2003;31(5):1560–7). Infective endocarditis (IE) is...

Increasing bacterial resistance and poor patient adherence rates limit the effectiveness of conventional antibiotic therapies for urinary tract infection (UTI). The objective of this study was to investigate whether a single aminoglycoside dose adequately treated UTI., Increasing bacterial resistance and poor patient adherence rates limit the effectiveness of conventional antibiotic therapies for urinary tract infection (UTI). The objective of this study was to investigate whether a single...

AbstractBackground. 1,3-beta-D Glucan (BDG) assay has good accuracy for distinguishing patients with invasive fungal infections from patients without. Some pro

Brucellosis, a disease endemic in many countries including Turkey, is a systemic infectious disease. Brucellosis is rare in renal transplant recipients. Only 4 cases have been reported in the literature. In this report, we describe the clinical manifestations and laboratory findings of a brucellosis case with pulmonary involvement in a renal transplant recipient. A 20-year-old man who had a living-donor kidney transplant 4 months earlier presented to our transplant clinic with fever, cough,...

Favipiravir for Chronic Norovirus Infection Norovirus may cause chronic diarrhea, especially in immunosuppressed patients. There is no established treatment. In this case report, favipiravir is shown to have some evidence of activity and to induce some selective pressure on the virus.

<h2>ABSTRACT</h2><p>Disruption of the intestinal microbiome early after allogeneic hematopoietic cell transplantation (allo-HCT) has been linked to adverse outcomes in transplant recipients. To date, whether microbiome-directed interventions will be able to impact important clinical endpoints remains unknown. Fecal microbiota transplantation (FMT) is a compelling intervention to restore healthy diversity to the intestinal microenvironment after allo-HCT, but currently has no established role...

<h3>Background</h3><p>We sought to better understand the patient population who receive a temporary total artificial heart (TAH) as bridge to transplant or as bridge to decision by evaluating data from the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) database.</p><h3>Methods</h3><p>We examined data related to survival, adverse events, and competing outcomes from patients who received TAHs between June 2006 and April 2017 and used hazard function analysis to...

Increased hydration is often recommended as a preventive measure for women with recurrent cystitis, but supportive data are sparse.To assess the efficacy of increased daily water intake on the frequency of recurrent cystitis in premenopausal women.Randomized, open-label, controlled, 12-month trial at a clinical research center (years 2013-2016). Among 163 healthy women with recurrent cystitis (≥3 episodes in past year) drinking less than 1.5 L of fluid daily assessed for eligibility, 23 were...

Although the widespread use of mold-active agents (especially the new generation of triazoles) has resulted in reductions of documented invasive mold infections (IMIs) in patients with hematological malignancies and allogeneic hematopoietic stem cell transplantation (HSCT), a subset of such patients still develop breakthrough IMIs (bIMIs). There are no data from prospective randomized clinical trials to guide therapeutic decisions in the different scenarios of bIMIs. In this viewpoint, we...

We report the case of a 65-year-old patient with pseudolymphoma who developed acute toxoplasmosis following 6 cycles of rituximab and bendamustine therapy. Acute toxoplasmosis in the setting of biological response modifiers, rather than reactivation, is a unique unreported infection. The patient developed severe disease with multi-organ involvement, including retinitis, myocarditis, and myositis. We discuss the clinical findings, epidemiology, and laboratory diagnosis.

<h3>BACKGROUND</h3><p>Hepatitis C (HCV) donors are rarely used for cardiac transplantation due to historically poor outcomes. In 2015, nucleic acid testing (NAT) for viral load was added to the routine work-up of organ donors, allowing for the distinction between subjects who remain viremic (HCV Ab⁺/NAT⁺) and those who have cleared HCV and are no longer viremic (HCV Ab⁺/NAT^–). The American Society of Transplantation recently recommended that HCV...

Background: Clostridiumdifficile infection (CDI) is a leading cause of infectious complications in allogeneic hematopoietic cell transplant recipients (alloHCT). We sought to evaluate whether prophylactic oral vancomycin reduces the incidence of CDI in alloHCT recipients. Methods: We conducted a retrospective cohort study to examine the effectiveness of CDI prophylaxis with oral vancomycin compared to no prophylaxis in 145 consecutive adult alloHCT recipients at the University of...

Original Article from The New England Journal of Medicine — Baloxavir Marboxil for Uncomplicated Influenza in Adults and Adolescents

PurposeTo provide an updated joint ASCO/Infectious Diseases Society of America (IDSA) guideline on antimicrobial prophylaxis for adult patients with immunosuppression associated with cancer and its treatment.MethodsASCO and IDSA convened an update Expert Panel and conducted a systematic review of relevant studies from May 2011 to November 2016. The guideline recommendations were based on the review of evidence by the Expert Panel.ResultsSix new or updated meta-analyses and six new primary...