Onco-Transplant Infectious Diseases Fellowship Position
We report a case of 12-year-old female with primary hyperoxaluria with regular haemodialysis for the end-stage renal disease. She underwent a combined liver and renal transplantation which got infected by aspergillosis. In this case study, it is speculated that the most likely source of Aspergillus was contaminated preservative solution (perfusate), resulting in infection within the donor kidney and subsequent systemic infection in the recipient. This case study calls for critical analysis and needs for the routine culture of the preservative solution before transplantation, to detect any fungal contamination and manage it prophylactically.
Publication date: Available online 25 October 2018Source: Medical Mycology Case ReportsAuthor(s): Timothy J. Hatlen, Scott G. Filler, Arnold Bayer, Sonia Shah, Shivani Shodhan, Tam T. VanAbstractFungal endocarditis remains an uncommon clinical diagnosis, though is likely to become more frequent due to the global increase in transplantations and cardiac valvular surgery. A case of prosthetic valve endocarditis due to Aspergillus fumigatus is described that was diagnosed with serologic fungal markers and confirmed with positive blood cultures, an uncommon finding.
CONCLUSIONS: This case highlights the importance of early and accurate identification, debridement, and systemic antifungals to prevent widespread infection. With changes in antifungal care over recent years, engaging infectious disease physicians during treatment is recommended. PMID: 30312971 [PubMed - in process]
ConclusionsWe identified four risk factors-unrelated donor transplantation, smoking, EBMT risk score> 2 and moderate to severe cGVHD to predict IMIs among acute leukemia patients undergoing allo-HSCT. This cohort study suggests early identification of high-risk patients and to provide better prevention strategies would reduce the incidence and severity of IMIs in these patients.
In conclusion, moderate inter-patient variability in isavuconazole exposure, identification of factors associated with lower exposure, recognition that Ctrough is a surrogate marker for AUC and availability of a simple analytical method, suggest that therapeutic drug monitoring (TDM) may be useful for guiding treatment in at least some SOT recipients. Future studies are needed to correlate isavuconazole exposure with patients' clinical outcomes, and to determine the clinical role of TDM. PMID: 30275091 [PubMed - as supplied by publisher]
Abstract The environmental mold Aspergillus fumigatus is the primary cause of invasive aspergillosis. In patients with high-risk conditions, including stem cell and organ transplant recipients, mortality exceeds 50%. Triazole antifungals have greatly improved survival (1); however, triazole-resistant A. fumigatus infections are increasingly reported worldwide and are associated with increased treatment failure and mortality (2). Of particular concern are resistant A. fumigatus isolates carrying either TR34/L98H or TR46/Y121F/T289A genetic resistance markers, which have been associated with environmental triazole f...
Invasive aspergillosis (IA) is the most common airborne fungal infection mainly affecting individuals with a suppressed immune system including those with prolonged neutropenia, and hematopoietic stem cell transplantation (1). IA is caused by infection with different Aspergillus species, with A. fumigatus accounting for ∼90% of all cases (1). IA has become one of the leading causes of death in immunocompromised patients, with 6-week mortality rates of around 30% (2).
In this study, we analyzed the cytotoxicity, immunosuppressive activity, and antifungal activity of four FK506 analogs, 31-O-demethyl-FK506, 9-deoxo-FK506, 9-deoxo-31-O-demethyl-FK506, and 9-deoxo-prolyl-FK506, in comparison with FK506. The four FK506 analogs generally possess lower cytotoxicity and immunosuppressive activity than FK506. The FK506 analogs, except for 9-deoxo-prolyl FK506, have strong antifungal activity against Cryptococcus neoformans and Candida albicans, which are two major invasive pathogenic yeasts, due to the inhibition of the calcineurin pathway. Furthermore, the FK506 analogs, except for 9-deoxo-pro...
This article reviews the epidemiology, risk factors, microbiology, diagnostic, and treatment approach to mold infections in SOT recipients.
Publication date: Available online 29 July 2018Source: Biological ControlAuthor(s): L.M. Manici, F. Caputo, A. Rossi, A.R. Topp, M. Zago, M. KeldererAbstractA study aiming at investigating biological control agents for protecting strawberry during the post-transplant period was performed. For this purpose, a series of fertile soils, rich in organic matter, which had been subjected to intensive strawberry cultivation, were selected. Soil samples taken from those soils were subjected to thermal treatment (up to 80 °C) for a short time to induce microbial changes aiming at improving soil suppressiveness. A greenhouse grow...