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1. Efficacy of beta-lactam/beta-lactamase inhibitors to treat extended-spectrum beta-lactamase-producing Enterobacterales bacteremia secondary to urinary tract infection in kidney transplant recipients (INCREMENT-SOT Project)

Author

Pierrotti, Ligia C., Perez-Nadales, Elena, Fernandez-Ruiz, Mario, Gutierrez-Gutierrez, Belen, Hock Tan, Ban, Carratala, Jordi, Oriol, Isabel, Paul, Mical, Cohen-Sinai, Noa, Lopez-Medrano, Francisco, San-Juan, Rafael, Montejo, Miguel, Freire, Maristela P., Cordero, Elisa, David, Miruna D., Merino, Esperanza, Mehta Steinke, Seema, Grossi, Paolo A., Cano, Angela, Seminari, Elena M., Valerio, Maricela, Gunseren, Filiz, Rana, Meenakshi, Mularoni, Alessandra, Martin-Davila, Pilar, van Delden, Christian, Hamiyet Demirkaya, Melike, Kocak Tufan, Zeliha, Loeches, Belen, Iyer, Ranganathan N., Soldani, Fabio, Eriksson, Britt-Marie, Pilmis, Benoit, Rizzi, Marco, Coussement, Julien, Clemente, Wanessa T., Roilides, Emmanuel, Pascual, Alvaro, Martinez-Martinez, Luis, Rodriguez-Bano, Jesus, Torre-Cisneros, Julian, Maria Aguado, Jose, Pierrotti, Ligia C., Perez-Nadales, Elena, Fernandez-Ruiz, Mario, Gutierrez-Gutierrez, Belen, Hock Tan, Ban, Carratala, Jordi, Oriol, Isabel, Paul, Mical, Cohen-Sinai, Noa, Lopez-Medrano, Francisco, San-Juan, Rafael, Montejo, Miguel, Freire, Maristela P., Cordero, Elisa, David, Miruna D., Merino, Esperanza, Mehta Steinke, Seema, Grossi, Paolo A., Cano, Angela, Seminari, Elena M., Valerio, Maricela, Gunseren, Filiz, Rana, Meenakshi, Mularoni, Alessandra, Martin-Davila, Pilar, van Delden, Christian, Hamiyet Demirkaya, Melike, Kocak Tufan, Zeliha, Loeches, Belen, Iyer, Ranganathan N., Soldani, Fabio, Eriksson, Britt-Marie, Pilmis, Benoit, Rizzi, Marco, Coussement, Julien, Clemente, Wanessa T., Roilides, Emmanuel, Pascual, Alvaro, Martinez-Martinez, Luis, Rodriguez-Bano, Jesus, Torre-Cisneros, Julian, and Maria Aguado, Jose

Abstract

Background Whether active therapy with beta-lactam/beta-lactamase inhibitors (BLBLI) is as affective as carbapenems for extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-E) bloodstream infection (BSI) secondary to urinary tract infection (UTI) in kidney transplant recipients (KTRs) remains unclear. Methods We retrospectively evaluated 306 KTR admitted to 30 centers from January 2014 to October 2016. Therapeutic failure (lack of cure or clinical improvement and/or death from any cause) at days 7 and 30 from ESBL-E BSI onset was the primary and secondary study outcomes, respectively. Results Therapeutic failure at days 7 and 30 occurred in 8.2% (25/306) and 13.4% (41/306) of patients. Hospital-acquired BSI (adjusted OR [aOR]: 4.10; 95% confidence interval [CI]: 1.50-11.20) and Pitt score (aOR: 1.47; 95% CI: 1.21-1.77) were independently associated with therapeutic failure at day 7. Age-adjusted Charlson Index (aOR: 1.25; 95% CI: 1.05-1.48), Pitt score (aOR: 1.72; 95% CI: 1.35-2.17), and lymphocyte count <= 500 cells/mu L at presentation (aOR: 3.16; 95% CI: 1.42-7.06) predicted therapeutic failure at day 30. Carbapenem monotherapy (68.6%, primarily meropenem) was the most frequent active therapy, followed by BLBLI monotherapy (10.8%, mostly piperacillin-tazobactam). Propensity score (PS)-adjusted models revealed no significant impact of the choice of active therapy (carbapenem-containing vs any other regimen, BLBLI- vs carbapenem-based monotherapy) within the first 72 hours on any of the study outcomes. Conclusions Our data suggest that active therapy based on BLBLI may be as effective as carbapenem-containing regimens for ESBL-E BSI secondary to UTI in the specific population of KTR. Potential residual confounding and unpowered sample size cannot be excluded (ClinicalTrials.gov identifier: NCT02852902).

Published
2021
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2. Perspectives on Scedosporium species and Lomentospora prolificans in lung transplantation: Results of an international practice survey from ESCMID fungal infection study group and study group for infections in compromised hosts, and European Confederation of Medical Mycology

Author

Rammaert, Blandine, Puyade, Mathieu, Cornely, Oliver A., Seidel, Danila, Grossi, Paolo, Husain, Shahid, Picard, Clement, Lass-Floerl, Cornelia, Manuel, Oriol, Le Pavec, Jerome, Lortholary, Olivier, Nagel, Claudia, Westall, Glen, Morrissey, Orla, Chambers, Daniel, Eschertzhuber, Stephan, Coussement, Julien, Vos, Robin, Dupont, Lieven, Dumonceaux, Michel, Campos, Silvia Vidal, Kabbani, Dima, Cervera, Carlos, Blanchard, Elodie, Senechal, Agathe, Brugiere, Olivier, Boussaud, Veronique, Guillemain, Romain, Bervar, Jean-Francois, Claustre, Johanna, Haloun, Alain, Hirschi, Sandrine, Reynaud, Martine, Kneidinger, Nikolaus, Gottlieb, Jens, Roilides, Emmanuel, Zarrinfar, Hossein, Rosso, Lorenzo, Morlacchi, Letizia Corinna, Dell'Amore, Andrea, Loy, Monica, dos Santos, Claudy Oliveira, Monforte, Victor, Teresa Martin-Gomez, Maria, Lopez Medrano, Francisco, Fernandez-Ruiz, Mario, Sole, Amparo, Cifrian, Jose M., Neofytos, Dionysios, Mueller, Nicolas, Benden, Christian, Brill, Anne Kathrin, Kiyan, Esen, Gould, Kate, Gkrania-Klotsas, Effrossyni, David, Miruna, Weigt, Sam, Kwak, Eun Jeong, Silveira, Femanda, Hadjiliadis, Denis, Baddley, John, Danziger-Isakov, Lara, Bhorade, Sangeeta, Ison, Michael, Wolfe, Cameron, Aslam, Saima, Budem, Marie, Musetti, Ana, Rammaert, Blandine, Puyade, Mathieu, Cornely, Oliver A., Seidel, Danila, Grossi, Paolo, Husain, Shahid, Picard, Clement, Lass-Floerl, Cornelia, Manuel, Oriol, Le Pavec, Jerome, Lortholary, Olivier, Nagel, Claudia, Westall, Glen, Morrissey, Orla, Chambers, Daniel, Eschertzhuber, Stephan, Coussement, Julien, Vos, Robin, Dupont, Lieven, Dumonceaux, Michel, Campos, Silvia Vidal, Kabbani, Dima, Cervera, Carlos, Blanchard, Elodie, Senechal, Agathe, Brugiere, Olivier, Boussaud, Veronique, Guillemain, Romain, Bervar, Jean-Francois, Claustre, Johanna, Haloun, Alain, Hirschi, Sandrine, Reynaud, Martine, Kneidinger, Nikolaus, Gottlieb, Jens, Roilides, Emmanuel, Zarrinfar, Hossein, Rosso, Lorenzo, Morlacchi, Letizia Corinna, Dell'Amore, Andrea, Loy, Monica, dos Santos, Claudy Oliveira, Monforte, Victor, Teresa Martin-Gomez, Maria, Lopez Medrano, Francisco, Fernandez-Ruiz, Mario, Sole, Amparo, Cifrian, Jose M., Neofytos, Dionysios, Mueller, Nicolas, Benden, Christian, Brill, Anne Kathrin, Kiyan, Esen, Gould, Kate, Gkrania-Klotsas, Effrossyni, David, Miruna, Weigt, Sam, Kwak, Eun Jeong, Silveira, Femanda, Hadjiliadis, Denis, Baddley, John, Danziger-Isakov, Lara, Bhorade, Sangeeta, Ison, Michael, Wolfe, Cameron, Aslam, Saima, Budem, Marie, and Musetti, Ana

Abstract

Background Scedosporium species and Lomentospora prolificans (S/L) are the second most common causes of invasive mold infections following Aspergillus in lung transplant recipients. Methods We assessed the current practices on management of S/L colonization/infection of the lower respiratory tract before and after lung transplantation in a large number of lung transplant centers through an international practice survey from October 2016 to March 2017. Results A total of 51 respondents from 45 lung transplant centers (17 countries, 4 continents) answered the survey (response rate 58%). S/L colonization was estimated to be detected in candidates by 48% of centers. Only 18% of the centers used a specific medium to detect S/L colonization. Scedosporium spp. colonization was a contraindication to transplantation in 10% of centers whereas L prolificans was a contraindication in 31%; 22% of centers declared having had 1-5 recipients infected with S/L in the past 5 years. Conclusions This survey gives an overview of the current practices regarding S/L colonization and infection in lung transplant centers worldwide and underscores the need of S/L culture procedure standardization before implementing prospective studies.

Published
2019

3. Perspectives on Scedosporium species and Lomentospora prolificans in lung transplantation: Results of an international practice survey from ESCMID fungal infection study group and study group for infections in compromised hosts, and European Confederation of Medical Mycology

Author

Rammaert, Blandine, Puyade, Mathieu, Cornely, Oliver A., Seidel, Danila, Grossi, Paolo, Husain, Shahid, Picard, Clement, Lass-Floerl, Cornelia, Manuel, Oriol, Le Pavec, Jerome, Lortholary, Olivier, Nagel, Claudia, Westall, Glen, Morrissey, Orla, Chambers, Daniel, Eschertzhuber, Stephan, Coussement, Julien, Vos, Robin, Dupont, Lieven, Dumonceaux, Michel, Campos, Silvia Vidal, Kabbani, Dima, Cervera, Carlos, Blanchard, Elodie, Senechal, Agathe, Brugiere, Olivier, Boussaud, Veronique, Guillemain, Romain, Bervar, Jean-Francois, Claustre, Johanna, Haloun, Alain, Hirschi, Sandrine, Reynaud, Martine, Kneidinger, Nikolaus, Gottlieb, Jens, Roilides, Emmanuel, Zarrinfar, Hossein, Rosso, Lorenzo, Morlacchi, Letizia Corinna, Dell'Amore, Andrea, Loy, Monica, dos Santos, Claudy Oliveira, Monforte, Victor, Teresa Martin-Gomez, Maria, Lopez Medrano, Francisco, Fernandez-Ruiz, Mario, Sole, Amparo, Cifrian, Jose M., Neofytos, Dionysios, Mueller, Nicolas, Benden, Christian, Brill, Anne Kathrin, Kiyan, Esen, Gould, Kate, Gkrania-Klotsas, Effrossyni, David, Miruna, Weigt, Sam, Kwak, Eun Jeong, Silveira, Femanda, Hadjiliadis, Denis, Baddley, John, Danziger-Isakov, Lara, Bhorade, Sangeeta, Ison, Michael, Wolfe, Cameron, Aslam, Saima, Budem, Marie, Musetti, Ana, Rammaert, Blandine, Puyade, Mathieu, Cornely, Oliver A., Seidel, Danila, Grossi, Paolo, Husain, Shahid, Picard, Clement, Lass-Floerl, Cornelia, Manuel, Oriol, Le Pavec, Jerome, Lortholary, Olivier, Nagel, Claudia, Westall, Glen, Morrissey, Orla, Chambers, Daniel, Eschertzhuber, Stephan, Coussement, Julien, Vos, Robin, Dupont, Lieven, Dumonceaux, Michel, Campos, Silvia Vidal, Kabbani, Dima, Cervera, Carlos, Blanchard, Elodie, Senechal, Agathe, Brugiere, Olivier, Boussaud, Veronique, Guillemain, Romain, Bervar, Jean-Francois, Claustre, Johanna, Haloun, Alain, Hirschi, Sandrine, Reynaud, Martine, Kneidinger, Nikolaus, Gottlieb, Jens, Roilides, Emmanuel, Zarrinfar, Hossein, Rosso, Lorenzo, Morlacchi, Letizia Corinna, Dell'Amore, Andrea, Loy, Monica, dos Santos, Claudy Oliveira, Monforte, Victor, Teresa Martin-Gomez, Maria, Lopez Medrano, Francisco, Fernandez-Ruiz, Mario, Sole, Amparo, Cifrian, Jose M., Neofytos, Dionysios, Mueller, Nicolas, Benden, Christian, Brill, Anne Kathrin, Kiyan, Esen, Gould, Kate, Gkrania-Klotsas, Effrossyni, David, Miruna, Weigt, Sam, Kwak, Eun Jeong, Silveira, Femanda, Hadjiliadis, Denis, Baddley, John, Danziger-Isakov, Lara, Bhorade, Sangeeta, Ison, Michael, Wolfe, Cameron, Aslam, Saima, Budem, Marie, and Musetti, Ana

Abstract

Background Scedosporium species and Lomentospora prolificans (S/L) are the second most common causes of invasive mold infections following Aspergillus in lung transplant recipients. Methods We assessed the current practices on management of S/L colonization/infection of the lower respiratory tract before and after lung transplantation in a large number of lung transplant centers through an international practice survey from October 2016 to March 2017. Results A total of 51 respondents from 45 lung transplant centers (17 countries, 4 continents) answered the survey (response rate 58%). S/L colonization was estimated to be detected in candidates by 48% of centers. Only 18% of the centers used a specific medium to detect S/L colonization. Scedosporium spp. colonization was a contraindication to transplantation in 10% of centers whereas L prolificans was a contraindication in 31%; 22% of centers declared having had 1-5 recipients infected with S/L in the past 5 years. Conclusions This survey gives an overview of the current practices regarding S/L colonization and infection in lung transplant centers worldwide and underscores the need of S/L culture procedure standardization before implementing prospective studies.

Published
2019

4. Diagnosis and management of asymptomatic bacteriuria in kidney transplant recipients: a survey of current practice in Europe

Author

Coussement, Julien, Maggiore, Umberto, Manuel, Oriol, Scemla, Anne, Lopez-Medrano, Francisco, Nagler, Evi, V, Hamersvelt, H.W. van, Maria Aguado, Jose, Abramowicz, Daniel, Coussement, Julien, Maggiore, Umberto, Manuel, Oriol, Scemla, Anne, Lopez-Medrano, Francisco, Nagler, Evi, V, Hamersvelt, H.W. van, Maria Aguado, Jose, and Abramowicz, Daniel

Abstract

Item does not contain fulltext

Published
2018

5. Diagnosis and management of asymptomatic bacteriuria in kidney transplant recipients: a survey of current practice in Europe

Author

Coussement, Julien, Maggiore, Umberto, Manuel, Oriol, Scemla, Anne, Lopez-Medrano, Francisco, Nagler, Evi, V, Hamersvelt, H.W. van, Maria Aguado, Jose, Abramowicz, Daniel, Coussement, Julien, Maggiore, Umberto, Manuel, Oriol, Scemla, Anne, Lopez-Medrano, Francisco, Nagler, Evi, V, Hamersvelt, H.W. van, Maria Aguado, Jose, and Abramowicz, Daniel

Abstract

Item does not contain fulltext

Published
2018

6. Diagnosis and management of asymptomatic bacteriuria in kidney transplant recipients: a survey of current practice in Europe

Author

Coussement, Julien, Maggiore, Umberto, Manuel, Oriol, Scemla, Anne, Lopez-Medrano, Francisco, Nagler, Evi, V, Hamersvelt, H.W. van, Maria Aguado, Jose, Abramowicz, Daniel, Coussement, Julien, Maggiore, Umberto, Manuel, Oriol, Scemla, Anne, Lopez-Medrano, Francisco, Nagler, Evi, V, Hamersvelt, H.W. van, Maria Aguado, Jose, and Abramowicz, Daniel

Abstract

Item does not contain fulltext

Published
2018

7. Risk Factors for Nontuberculous Mycobacteria Infections in Solid Organ Transplant Recipients: A Multinational Case-Control Study

Author

Mejia-Chew, Carlos, Carver, Peggy L., Rutjanawech, Sasinuch, Aranha Camargo, Luis F., Fernandes, Ruan, Belga, Sara, Daniels, Shay Anne, Mueller, Nicolas J., Burkhard, Sara, Theodoropoulos, Nicole M., Postma, Douwe F., van Duijn, Pleun J., Carmen Farinas, Maria, Gonzalez-Rico, Claudia, Hand, Jonathan, Lowe, Adam, Bodro, Marta, Vanino, Elisa, Cruz, Ana Fernandez, Ramos, Antonio, Makek, Mateja Jankovic, Mjahed, Ribal Bou, Manuel, Oriol, Kamar, Nassim, Calvo-Cano, Antonia, Rueda Carrasco, Laura, Munoz, Patricia, Rodriguez, Sara, Perez-Recio, Sandra, Sabe, Nuria, Rodriguez Alvarez, Regino, Tiago Silva, Jose, Mularoni, Alessandra, Vidal, Elisa, Alonso-Titos, Juana, del Rosal, Teresa, Classen, Annika Y., Goss, Charles W., Agarwal, Mansi, Lopez-Medrano, Francisco, Mejia-Chew, Carlos, Carver, Peggy L., Rutjanawech, Sasinuch, Aranha Camargo, Luis F., Fernandes, Ruan, Belga, Sara, Daniels, Shay Anne, Mueller, Nicolas J., Burkhard, Sara, Theodoropoulos, Nicole M., Postma, Douwe F., van Duijn, Pleun J., Carmen Farinas, Maria, Gonzalez-Rico, Claudia, Hand, Jonathan, Lowe, Adam, Bodro, Marta, Vanino, Elisa, Cruz, Ana Fernandez, Ramos, Antonio, Makek, Mateja Jankovic, Mjahed, Ribal Bou, Manuel, Oriol, Kamar, Nassim, Calvo-Cano, Antonia, Rueda Carrasco, Laura, Munoz, Patricia, Rodriguez, Sara, Perez-Recio, Sandra, Sabe, Nuria, Rodriguez Alvarez, Regino, Tiago Silva, Jose, Mularoni, Alessandra, Vidal, Elisa, Alonso-Titos, Juana, del Rosal, Teresa, Classen, Annika Y., Goss, Charles W., Agarwal, Mansi, and Lopez-Medrano, Francisco

Abstract

Background Risk factors for nontuberculous mycobacteria (NTM) infections after solid organ transplant (SOT) are not well characterized. Here we aimed to describe these factors. Methods Retrospective, multinational, 1:2 matched case-control study that included SOT recipients >= 12 years old diagnosed with NTM infection from 1 January 2008 to 31 December 2018. Controls were matched on transplanted organ, NTM treatment center, and post-transplant survival greater than or equal to the time to NTM diagnosis. Logistic regression on matched pairs was used to assess associations between risk factors and NTM infections. Results Analyses included 85 cases and 169 controls (59% male, 88% White, median age at time of SOT of 54 years [interquartile range {IQR} 40-62]). NTM infection occurred in kidney (42%), lung (35%), heart and liver (11% each), and pancreas transplant recipients (1%). Median time from transplant to infection was 21.6 months (IQR 5.3-55.2). Most underlying comorbidities were evenly distributed between groups; however, cases were older at the time of NTM diagnosis, more frequently on systemic corticosteroids and had a lower lymphocyte count (all P < .05). In the multivariable model, older age at transplant (adjusted odds ratio [aOR] 1.04; 95 confidence interval [CI], 1.01-1.07), hospital admission within 90 days (aOR, 3.14; 95% CI, 1.41-6.98), receipt of antifungals (aOR, 5.35; 95% CI, 1.7-16.91), and lymphocyte-specific antibodies (aOR, 7.73; 95% CI, 1.07-56.14), were associated with NTM infection. Conclusions Risk of NTM infection in SOT recipients was associated with older age at SOT, prior hospital admission, receipt of antifungals or lymphocyte-specific antibodies. NTM infection should be considered in SOT patients with these risk factors. In this multinational, 1:2 matched case-control study of solid organ transplant (SOT) recipients, older age at transplantation; and hospital admission, receipt of antifungals or lymphocyte-specific antibodies within 90 d

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