Search

Your search keyword '"Thursky, Karin A."' showing total 467 results
Start Over Author "Thursky, Karin A." Publication Type Academic Journals
467 results on '"Thursky, Karin A."'

6. WHO global research priorities for antimicrobial resistance in human health

Author

Aanensen, David, Alanio, Alexandre, Alastruey-Izquierdo, Ana, Alemayehu, Tinsae, Al-Hasan, Majdi, Allegaert, Karel, Al-Maani, Amal Saif, Al-Salman, Jameela, Alshukairi, Abeer Nizar, Amir, Afreenish, Applegate, Tanya, Araj, George F, Villalobos, Marlen Arce, Årdal, Christine, Ashiru-Oredope, Diane, Ashley, Elizabeth A, Babin, François-Xavier, Bachmann, Laura H, Bachmann, Till, Baker, Kate Susan, Balasegaram, Manica, Bamford, Colleen, Baquero, Fernando, Barcelona, Laura Isabel, Bassat, Quique, Bassetti, Matteo, Basu, Sulagna, Beardsley, Justin, Vásquez, Grey Benoit, Berkley, James A, Bhatnagar, Anuj K, Bielicki, Julia, Bines, Julie, Bongomin, Felix, Bonomo, Robert A, Bradley, John S, Bradshaw, Catriona, Brett, Ana, Brink, Adrian, Brown, Colin, Brown, Jeremy, Buising, Kirsty, Carson, Carolee, Carvalho, Anna Cristina, Castagnola, Elio, Cavaleri, Marco, Cecchini, Michele, Chabala, Chishala, Chaisson, Richard E, Chakrabarti, Arunaloke, Chandler, Clare, Chandy, Sujith John, Charani, Esmita, Chen, Lisa, Chiara, Francesca, Chowdhary, Anuradha, Chua, Arlene, Chuki, Pem, Chun, Doo Ryeon, Churchyard, Gavin, Cirillo, Daniela, Clack, Lauren, Coffin, Susan E, Cohn, Jennifer, Cole, Michelle, Conly, John, Cooper, Ben, Corso, Alejandra, Cosgrove, Sara E, Cox, Helen, Daley, Charles L, Darboe, Saffiatou, Darton, Tom, Davies, Gerry, de Egea, Viviana, Dedeić-Ljubović, Amela, Deeves, Miranda, Denkinger, Claudia, Dillon, Jo-Anne R, Dramowski, Angela, Eley, Brian, Roberta Esposito, Susanna Maria, Essack, Sabiha Y, Farida, Helmia, Farooqi, Joveria, Feasey, Nicholas, Ferreyra, Cecilia, Fifer, Helen, Finlayson, Heather, Frick, Mike, Gales, Ana Cristina, Galli, Luisa, Gandra, Sumanth, Gerber, Jeffrey S, Giske, Christian, Gordon, Bruce, Govender, Nelesh, Guessennd, Nathalie, Guindo, Ibrehima, Gurbanova, Elmira, Gwee, Amanda, Hagen, Ferry, Harbarth, Stephan, Haze, John, Heim, Jutta, Hendriksen, Rene, Heyderman, Robert Simon, Holt, Kathryn Elizabeth, Hönigl, Martin, Hook, Edward W, Hope, William, Hopkins, Heidi, Hughes, Gwenda, Ismail, Ghada, Issack, Mohammad Iqbal, Jacobs, Jan, Jasovský, Dušan, Jehan, Fyeza, Pearson, Antonieta Jimenez, Jones, Makoto, Joshi, Mohan P, Kapil, Arti, Kariuki, Samuel, Karkey, Abhilasha, Kearns, Gregory L, Keddy, Karen Helena, Khanna, Nina, Kitamura, Akiko, Kolho, Kaija-Leena, Kontoyiannis, Dimitrios P, Kotwani, Anita, Kozlov, Roman S, Kranzer, Katharina, Kularatne, Ranmini, Lahra, Monica M, Langford, Bradley J, Laniado-Laborin, Rafael, Larsson, Joakim, Lass-Flörl, Cornelia, Le Doare, Kirsty, Lee, Hyukmin, Lessa, Fernanda, Levin, Anna S, Limmathurotsakul, Direk, Lincopan, Nilton, Lo Vecchio, Andrea, Lodha, Rakesh, Loeb, Mark, Longtin, Yves, Lye, David Chien, Mahmud, Asif Mujtaba, Manaia, Célia, Manderson, Lenore, Mareković, Ivana, Marimuthu, Kalisvar, Martin, Irene, Mashe, Tapfumanei, Mei, Zeng, Meis, Jacques F, Lyra Tavares De Melo, Flávio Augusto, Mendelson, Marc, Miranda, Angelica Espinosa, Moore, David, Morel, Chantal, Moremi, Nyambura, Moro, Maria Luisa, Moussy, Francis, Mshana, Stephen, Mueller, Arno, Ndow, Francis J, Nicol, Mark, Nunn, Andrew, Obaro, Stephen, Obiero, Christina W, Okeke, Iruka N, Okomo, Uduak, Okwor, Tochi J, Oladele, Rita, Omulo, Sylvia, Ondoa, Pascale, Ortellado de Canese, Juana Medarda, Ostrosky-Zeichner, Luis, Padoveze, Maria Clara, Pai, Madhukar, Park, Benjamin, Parkhill, Julian, Parry, Christopher M, Peeling, Rosanna, Sobreira Vieira Peixe, Luísa Maria, Perovic, Olga, Pettigrew, Melinda M, Principi, Nicola, Pulcini, Céline, Puspandari, Nelly, Rawson, Timothy, Reddy, Denasha Lavanya, Reddy, Kessendri, Redner, Paulo, Rodríguez Tudela, Juan Luis, Rodríguez-Baño, Jesús, Van Katwyk, Susan Rogers, Roilides, Emmanuel, Rollier, Christine, Rollock, Leslie, Ronat, Jean-Baptiste, Ruppe, Etienne, Sadarangani, Manish, Salisbury, David, Salou, Mounerou, Samison, Luc Hervé, Sanguinetti, Maurizio, Sartelli, Massimo, Schellack, Natalie, Schouten, Jeroen, Schwaber, Mitchell J, Seni, Jeremiah, Senok, Abiola, Shafer, William M, Shakoor, Sadia, Sheppard, Donald, Shin, Jong-Hee, Sia, Sonia, Sievert, Dawn, Singh, Ishwar, Singla, Rupak, Skov, Robert Leo, Soge, Olusegun O, Sprute, Rosanne, Srinivasan, Arjun, Srinivasan, Subasree, Sundsfjord, Arnfinn, Tacconelli, Evelina, Tahseen, Sabira, Tangcharoensathien, Viroj, Tängdén, Thomas, Thursky, Karin, Thwaites, Guy, Tigulini de Souza Peral, Renata, Tong, Deborah, Tootla, Hafsah Deepa, Tsioutis, Constantinos, Turner, Katy M, Turner, Paul, Omar, Shaheed Vally, van de Sande, Wendy WJ, van den Hof, Susan, van Doorn, Rogier, Veeraraghavan, Balaji, Verweij, Paul, Wahyuningsih, Retno, Wang, Hui, Warris, Adilia, Weinstock, Hillard, Wesangula, Evelyn, Whiley, David, White, Peter J, Williams, Phoebe, Xiao, Yonghong, Moscoso, Martin Yagui, Yang, Hsu Li, Yoshida, Sachiyo, Yu, Yunsong, Żabicka, Dorota, Zignol, Matteo, Rudan, Igor, Bertagnolio, Silvia, Dobreva, Zlatina, Centner, Chad M, Olaru, Ioana Diana, Donà, Daniele, Burzo, Stefano, Huttner, Benedikt D, Chaillon, Antoine, Gebreselassie, Nebiat, Wi, Teodora, Hasso-Agopsowicz, Mateusz, Allegranzi, Benedetta, Sati, Hatim, Ivanovska, Verica, Kothari, Kavita U, Balkhy, Hanan H, Cassini, Alessandro, Hamers, Raph L, and Weezenbeek, Kitty Van

Published
2024
Full Text
View/download PDF

14. COVID-19 infection among patients with cancer in Australia from 2020 to 2022: a national multicentre cohort study

Author

Hall, Victoria G., Sim, Beatrice Z., Lim, Chhay, Hocking, Christopher, Teo, Teddy, Runnegar, Naomi, Boan, Peter, Heath, Christopher H., Rainey, Natalie, Lyle, Megan, Steer, Christopher, Liu, Eunice, Doig, Cassandra, Drummond, Kate, Charles, Patrick G.P., See, Katharine, Lim, Lyn-Li, Shum, Omar, Bak, Narin, Mclachlan, Sue-Anne, Singh, Kasha P., Laundy, Nicholas, Gallagher, Jenny, Stewart, Marcelle, Saunders, Natalie R., Klimevski, Emily, Demajo, Jessica, Reynolds, Gemma, Thursky, Karin A., Worth, Leon J., Spelman, Timothy, Yong, Michelle K., Slavin, Monica A., and Teh, Benjamin W.

Published
2023
Full Text
View/download PDF

16. Robust SARS-CoV-2 T cell responses with common TCRαβ motifs toward COVID-19 vaccines in patients with hematological malignancy impacting B cells

Author

Nguyen, Thi H.O., Rowntree, Louise C., Allen, Lilith F., Chua, Brendon Y., Kedzierski, Lukasz, Lim, Chhay, Lasica, Masa, Tennakoon, G. Surekha, Saunders, Natalie R., Crane, Megan, Chee, Lynette, Seymour, John F., Anderson, Mary Ann, Whitechurch, Ashley, Clemens, E. Bridie, Zhang, Wuji, Chang, So Young, Habel, Jennifer R., Jia, Xiaoxiao, McQuilten, Hayley A., Minervina, Anastasia A., Pogorelyy, Mikhail V., Chaurasia, Priyanka, Petersen, Jan, Menon, Tejas, Hensen, Luca, Neil, Jessica A., Mordant, Francesca L., Tan, Hyon-Xhi, Cabug, Aira F., Wheatley, Adam K., Kent, Stephen J., Subbarao, Kanta, Karapanagiotidis, Theo, Huang, Han, Vo, Lynn K., Cain, Natalie L., Nicholson, Suellen, Krammer, Florian, Gibney, Grace, James, Fiona, Trevillyan, Janine M., Trubiano, Jason A., Mitchell, Jeni, Christensen, Britt, Bond, Katherine A., Williamson, Deborah A., Rossjohn, Jamie, Crawford, Jeremy Chase, Thomas, Paul G., Thursky, Karin A., Slavin, Monica A., Tam, Constantine S., Teh, Benjamin W., and Kedzierska, Katherine

Published
2023
Full Text
View/download PDF

19. [18F]FDG-PET-CT compared with CT for persistent or recurrent neutropenic fever in high-risk patients (PIPPIN): a multicentre, open-label, phase 3, randomised, controlled trial

Author

Douglas, Abby, Thursky, Karin, Spelman, Timothy, Szer, Jeff, Bajel, Ashish, Harrison, Simon, Tio, Shio Yen, Bupha-Intr, Olivia, Tew, Michelle, Worth, Leon, Teh, Benjamin, Chee, Lynette, Ng, Ashley, Carney, Dennis, Khot, Amit, Haeusler, Gabrielle, Yong, Michelle, Trubiano, Jason, Chen, Sharon, Hicks, Rodney, Ritchie, David, and Slavin, Monica

Published
2022
Full Text
View/download PDF

21. Adult penicillin allergy programmes in Australian hospitals: a practical guide from the National Antibiotic Allergy Network.

Author

Hannah, Rory, Mitri, Elise, Katelaris, Constance H., O'Hern, Jennifer, Avent, Minyon, Valoppi, Glenn, Rawlins, Matthew, Frith, Catherine, McMullan, Brendan, Kong, David, Chua, Kyra, Legg, Amy, James, Rod, Janson, Sonja, Hawkins, Carolyn, Randall, Katrina, Ierano, Courtney, Thursky, Karin, and Trubiano, Jason A.

Subjects
DRUG allergy, MEDICAL protocols, INAPPROPRIATE prescribing (Medicine), PATIENT safety, EVALUATION of human services programs, ANTIMICROBIAL stewardship, EVALUATION of medical care, ORAL drug administration, ATTITUDES of medical personnel, HOSPITAL health promotion programs, BETA lactamases, HEALTH promotion, POINT-of-care testing, PENICILLIN, DRUG labeling, PHENOTYPES, HEALTH care teams, ADULTS
Abstract

Penicillin allergy is a significant burden on patient, prescribing and hospital outcomes. There has been increasing interest in the incorporation of penicillin allergy testing (i.e. delabelling) into antimicrobial stewardship (AMS) programmes to reduce the burden of penicillin allergy labels and improve prescribing. In particular, there has been a focus on point‐of‐care penicillin allergy assessment and direct oral challenge for low‐risk phenotypes. The National Antibiotic Allergy Network has provided a guide to assist AMS clinicians with the incorporation of penicillin allergy programmes, in particular direct oral challenge, into Australian hospitals. [ABSTRACT FROM AUTHOR]

Published
2024
Full Text
View/download PDF

22. Intravenous amoxicillin‐clavulanic acid: prescribing practices in Australian hospitals.

Author

Chronas, Alexandros, Thursky, Karin, Mo, Simone, Hall, Lisa, James, Rodney, and Ierano, Courtney

Subjects
*MEDICAL protocols, *MEDICAL prescriptions, *CLAVULANIC acid, *ANTIMICROBIAL stewardship, *DRUG resistance in microorganisms, *AMOXICILLIN, *HOSPITALS, *DESCRIPTIVE statistics, *RETROSPECTIVE studies, *INTRAVENOUS therapy, *ANTI-infective agents, *PHYSICIAN practice patterns, *DRUG prescribing
Abstract

Background: Oral amoxicillin‐clavulanic acid, a broad‐spectrum antimicrobial and one of the most commonly prescribed antimicrobials in Australia, has demonstrated poor prescribing guideline compliance and appropriateness. This may have inadvertent impacts on patient care and safety, from adverse drug reactions to antimicrobial resistance. Intravenous (IV) amoxicillin‐clavulanic acid was first registered in Australia in 2017, reflecting a subsequent and immediate increase in use. There is a need to assess the quality of such prescribing. Aim: To describe the quality of IV amoxicillin‐clavulanic acid prescriptions through assessing guideline compliance and appropriateness of use in Australian hospitals. Method: A retrospective data analysis of IV amoxicillin‐clavulanic acid prescriptions from the Hospital National Antimicrobial Prescribing Survey database between 2013 and 2021. The main outcomes measured were guideline compliance and appropriateness. Ethical approval was granted by the Melbourne Health Human Research Ethics Committee (HREC/74195/MH‐2022). Results: The proportion of prescriptions for IV amoxicillin‐clavulanic acid, compared to all other antimicrobials, increased from 0.02% (2013) to 2.3% (2021). Guideline compliance and appropriateness have overall decreased (by 18.9% and 16.7%, respectively). Over time, national guidelines predominantly replaced local guidelines as the primary guideline source for prescribing. The most common reason for inappropriateness was unnecessarily broad spectrum of activity (39.5%). Conclusion: Intravenous amoxicillin‐clavulanic acid prescribing continues to increase throughout Australian hospitals, with notable reductions in guideline compliance and appropriateness. Since 2019, the increase in these outcomes coincided with updated national prescribing guidelines, evident by prescribers utilising national over local guidelines. These findings reinforce the concept that antimicrobial stewardship initiatives, including auditing, robust national guidelines and education, are crucial to optimise IV amoxicillin‐clavulanic acid prescribing. [ABSTRACT FROM AUTHOR]

Published
2024
Full Text
View/download PDF

26. Preneutropenic Fever in Patients With Hematological Malignancies: A Novel Target for Antimicrobial Stewardship.

Author

Chiodo-Reidy, Jessica, Slavin, Monica A, Tio, Shio Yen, Ng, Gywneth, Bajel, Ashish, Thursky, Karin A, and Douglas, Abby P

Subjects
BONE marrow transplantation, ACUTE myeloid leukemia, HEMATOLOGIC malignancies, ANTIMICROBIAL stewardship, NEUTROPENIA
Abstract

Background Many patients with hematological malignancy develop fever after chemotherapy/conditioning but before chemotherapy-induced neutropenia (preneutropenic fever [PNF]). The proportion of PNF with an infectious etiology is not well established. Methods We conducted a single-center, prospective observational substudy of PNF (neutrophils >0.5 cells/μL, ≥38.0°C) in adults receiving acute myeloid leukemia (AML) chemotherapy, or allogeneic hematopoietic cell transplant (allo-HCT) conditioning enrolled in a neutropenic fever randomized controlled trial between 1 January and 31 October 2018. Eligible patients had anticipated neutropenia ≥10 days and exclusions included concurrent infection and/or neutropenia prior to chemotherapy or conditioning. PNF rates and infections encountered were described. Associations between noninfectious etiologies and fever were explored. Antimicrobial therapy prescription across preneutropenic and neutropenic periods was examined. Results Of 62 consecutive patients included (43 allo-HCT, 19 AML), 27 had PNF (44%) and 5 (19%) had an infective cause. Among allo-HCT, PNF occurred in 14 of 17 (82%) who received thymoglobulin; only 1 of 14 (7%) had infection. During AML chemotherapy, 18 of 19 received cytarabine, of which 8 of 18 (44%) had PNF and 3 of 8 (38%) had infection. Most patients with PNF had antimicrobial therapy continued into the neutropenic period (19/27 [70%]). Those with PNF were more likely to be escalated to broader antimicrobial therapy at onset/during neutropenic fever (5/24 [21%] vs 2/30 [7%]). Conclusions Rates of PNF were high, and documented infection low, leading to prolonged and escalating antimicrobial therapy. In the absence of infection, early cessation of empiric therapy after PNF is recommended as an important stewardship intervention. [ABSTRACT FROM AUTHOR]

Published
2024
Full Text
View/download PDF

34. Assessment of antimicrobial prescribing patterns, guidelines compliance, and appropriateness of antimicrobial prescribing in surgical-practice units: point prevalence survey in Malaysian teaching hospitals.

Author

Jamaluddin, Nurul Adilla Hayat, Periyasamy, Petrick, Chee Lan Lau, Ponnampalavanar, Sasheela, Siew Mei Lai, Pauline, Ly Sia Loong, Sidik, Tg Mohd Ikhwan Tg Abu Bakar, Ramli, Ramliza, Toh Leong Tan, Kori, Najma, Mei Kuen Yin, Azman, Nur Jannah, James, Rodney, Thursky, Karin, and Mohamed, Isa Naina

Subjects
DRUG prescribing, TEACHING hospitals, INAPPROPRIATE prescribing (Medicine), PUBLIC hospitals, CONSCIOUSNESS raising, CEFAZOLIN
Abstract

Objectives: This study sought to investigate the quality of antimicrobial prescribing among adult surgical inpatients besides exploring the determinants of non-compliance and inappropriate prescribing to inform stewardship activities. Methods: A cross-sectional point prevalence study employing Hospital National Antimicrobial Prescribing Survey (Hospital NAPS) was conducted in April 2019 at two teaching hospitals in Malaysia. Results: Among 566 surgical inpatients, 44.2% were receiving at least one antimicrobial, for a total of 339 prescriptions. Antimicrobials belonging to the World Health Organization's Watch group were observed in 57.8% of cases. Both hospitals exhibited similar types of antimicrobial treatments prescribed and administration routes. A significant difference in antimicrobial choice was observed between hospitals (p < 0.001). Hospital with electronic prescribing demonstrated better documentation practice (p < 0.001). Guidelines compliance, 32.8% (p = 0.952) and appropriateness, 55.2% (p = 0.561) did not significantly differ. The major contributors of inappropriateness were incorrect duration, (15%) and unnecessary broad-spectrum coverage, (15.6%). Non-compliance and inappropriate prescribing were found to be 2 to 4 times significantly higher with antimicrobial prophylaxis prescription compared to empirical therapy. Conclusion: Antimicrobial stewardship efforts to improve appropriate surgical prescribing are essential. These initiatives should prioritize surgical prophylaxis prescribing, focusing on reducing unnecessarily prolonged use and broadspectrum antimicrobials, raising awareness among prescribers and promoting proper documentation. [ABSTRACT FROM AUTHOR]

Published
2024
Full Text
View/download PDF

43. Antimicrobial use and appropriateness in neutropenic fever: a study of the Hospital National Antimicrobial Prescribing Survey data.

Author

Singh, Nikhil, Douglas, Abby P, Slavin, Monica A, Haeusler, Gabrielle M, and Thursky, Karin A

Subjects
PUBLIC hospitals, DRUG prescribing, HEALTH facilities, INAPPROPRIATE prescribing (Medicine), PATIENT compliance, CEFEPIME, MEROPENEM
Abstract

Background Neutropenic fever (NF) is a common complication in patients receiving chemotherapy. Judicious antimicrobial use is paramount to minimize morbidity and mortality and to avoid antimicrobial-related harms. Objectives To use an Australian national dataset of antimicrobial prescriptions for the treatment of NF to describe antimicrobial use, prescription guideline compliance and appropriateness; and to compare these findings across different healthcare settings and patient demographics. We also aimed to identify trends and practice changes over time. Methods Data were extracted from the Hospital National Antimicrobial Prescribing Survey (Hospital NAPS) database from August 2013 to May 2022. Antimicrobial prescriptions with a NF indication were analysed for antimicrobial use, guideline compliance and appropriateness according to the Hospital NAPS methodology. Demographic factors, hospital classifications and disease characteristics were compared. Results A total of 2887 (n = 2441 adults, n = 441 paediatric) NF prescriptions from 254 health facilities were included. Piperacillin-tazobactam was the most prescribed antimicrobial. Overall, 87.4% of prescriptions were appropriate. Piperacillin-tazobactam and cefepime had the highest appropriateness though incorrect piperacillin-tazobactam dosing was observed. Lower appropriateness was identified for meropenem, vancomycin, and gentamicin prescribing particularly in the private hospital and paediatric cohorts. The most common reasons for inappropriate prescribing were spectrum too broad, incorrect dosing or frequency, and incorrect duration. Conclusions This study provides insights into antimicrobial prescribing practices for NF in Australia. We have identified three key areas for improvement: piperacillin-tazobactam dosing, paediatric NF prescribing and private hospital NF prescribing. Findings from this study will inform the updated Australian and New Zealand consensus guidelines for the management of neutropenic fever in patients with cancer. [ABSTRACT FROM AUTHOR]

Published
2024
Full Text
View/download PDF

47. Recommendations on prevention of infections in patients with T-cell lymphomas: a narrative review and synthesis.

Author

Reynolds, Gemma, Anderson, Mary Ann, Thursky, Karin, Teh, Benjamin W., and Slavin, Monica A.

Subjects
INFECTION prevention, LYMPHOMAS, T cells, NON-Hodgkin's lymphoma, MEDICAL screening
Abstract

T/Natural killer (NK) cell lymphomas (TCL) represent a heterogenous subgroup of non-Hodgkin lymphoma, associated with poorer prognosis and higher treatment toxicity. A cohesive synthesis of infection outcomes among TCL patients is lacking. International guidelines offer no specific recommendations regarding prophylaxis or supportive infection care for TCL patients. This systematic narrative review highlights infection outcomes in TCL patients treated with conventional, and novel therapies. Recommendations for infection screening, antimicrobial prophylaxis and vaccination strategies are outined. [ABSTRACT FROM AUTHOR]

Published
2023
Full Text
View/download PDF

48. Fluoroquinolone prophylaxis in patients with neutropenia at high risk of serious infections: Exploring pros and cons.

Author

Singh, Nikhil, Thursky, Karin, Maron, Gabriela, and Wolf, Joshua

Subjects
*HEMATOPOIETIC stem cell transplantation, *PREVENTIVE medicine, *NEUTROPENIA
Abstract

Background: The use of fluoroquinolones to prevent infections in neutropenic patients with cancer or undergoing hematopoietic stem cell transplantation (HSCT) is a controversial issue, with international guidelines providing conflicting recommendations. Although potential benefits are clear, concerns revolve around efficacy, potential harms, and antimicrobial resistance (AMR) implications. Discussion: Fluoroquinolone prophylaxis reduces neutropenic fever (NF) bloodstream infections and other serious bacterial infections, based on evidence from systematic reviews, randomized controlled trials, and observational studies in adults and children. Fluoroquinolone prophylaxis may also reduce infection‐related morbidity and healthcare costs; however, evidence is conflicting. Adverse effects of fluoroquinolones are well recognized in the general population; however, studies in the cancer cohort where it is used for a defined period of neutropenia have not reflected this. The largest concern for routine use of fluoroquinolone prophylaxis remains AMR, as many, but not all, observational studies have found that fluoroquinolone prophylaxis might increase the risk of AMR, and some studies have suggested negative impacts on patient outcomes as a result. Conclusions: The debate surrounding fluoroquinolone prophylaxis calls for individualized risk assessment based on patient characteristics and local AMR patterns, and prophylaxis should be restricted to patients at the highest risk of serious infection during the highest risk periods to ensure that the risk‐benefit analysis is in favor of individual and community benefit. More research is needed to address important unanswered questions about fluoroquinolone prophylaxis in neutropenic patients with cancer or receiving HSCT. [ABSTRACT FROM AUTHOR]

Published
2023
Full Text
View/download PDF

50. Evolution of Humoral and Cellular Immunity Post–Breakthrough Coronavirus Disease 2019 in Vaccinated Patients With Hematologic Malignancy Receiving Tixagevimab-Cilgavimab.

Author

Hall, Victoria G, Nguyen, Thi H O, Allen, Lilith F, Rowntree, Louise C, Kedzierski, Lukasz, Chua, Brendon Y, Lim, Chhay, Saunders, Natalie R, Klimevski, Emily, Tennakoon, Gayani S, Seymour, John F, Wadhwa, Vikas, Cain, Natalie, Vo, Kim L, Nicholson, Suellen, Karapanagiotidis, Theo, Williamson, Deborah A, Thursky, Karin A, Spelman, Timothy, and Yong, Michelle K

Subjects
COVID-19, CELLULAR immunity, CELLULAR evolution, HEMATOLOGIC malignancies, SARS-CoV-2 Omicron variant, CORONAVIRUS diseases
Abstract

Background In-depth immunogenicity studies of tixagevimab-cilgavimab (T-C) are lacking, including following breakthrough coronavirus disease 2019 (COVID-19) in vaccinated patients with hematologic malignancy (HM) receiving T-C as pre-exposure prophylaxis. Methods We performed a prospective, observational cohort study and detailed immunological analyses of 93 patients with HM who received T-C from May 2022, with and without breakthrough infection, during a follow-up period of 6 months and dominant Omicron BA.5 variant. Results In 93 patients who received T-C, there was an increase in Omicron BA.4/5 receptor-binding domain (RBD) immunoglobulin G (IgG) antibody titers that persisted for 6 months and was equivalent to 3-dose-vaccinated uninfected healthy controls at 1 month postinjection. Omicron BA.4/5 neutralizing antibody was lower in patients receiving B-cell–depleting therapy within 12 months despite receipt of T-C. COVID-19 vaccination during T-C treatment did not incrementally improve RBD or neutralizing antibody levels. In 16 patients with predominantly mild breakthrough infection, no change in serum neutralization of Omicron BA.4/5 postinfection was detected. Activation-induced marker assay revealed an increase in CD4+ (but not CD8+) T cells post infection, comparable to previously infected healthy controls. Conclusions Our study provides proof-of-principle for a pre-exposure prophylaxis strategy and highlights the importance of humoral and cellular immunity post–breakthrough COVID-19 in vaccinated patients with HM. [ABSTRACT FROM AUTHOR]

Published
2023
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results