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1. When to change treatment of acute invasive aspergillosis: an expert viewpoint

Author

Slavin, Monica A, Chen, Yee-Chun, Cordonnier, Catherine, Cornely, Oliver A, Cuenca-Estrella, Manuel, Donnelly, J Peter, Groll, Andreas H, Lortholary, Olivier, Marty, Francisco M, Nucci, Marcio, Rex, John H, Rijnders, Bart JA, Thompson, George R, Verweij, Paul E, White, P Lewis, Hargreaves, Ruth, Harvey, Emma, and Maertens, Johan A

Subjects
Infectious Diseases, Clinical Trials and Supportive Activities, Rare Diseases, Clinical Research, Evaluation of treatments and therapeutic interventions, 6.1 Pharmaceuticals, Infection, Antifungal Agents, Aspergillosis, Bronchoalveolar Lavage Fluid, Humans, Immunocompromised Host, Invasive Fungal Infections, Invasive Pulmonary Aspergillosis, Mannans, Microbiology, Medical Microbiology, Pharmacology and Pharmaceutical Sciences
Abstract

Invasive aspergillosis (IA) is an acute infection affecting patients who are immunocompromised, as a result of receiving chemotherapy for malignancy, or immunosuppressant agents for transplantation or autoimmune disease. Whilst criteria exist to define the probability of infection for clinical trials, there is little evidence in the literature or clinical guidelines on when to change antifungal treatment in patients who are receiving prophylaxis or treatment for IA. To try and address this significant gap, an advisory board of experts was convened to develop criteria for the management of IA for use in designing clinical trials, which could also be used in clinical practice. For primary treatment failure, a change in antifungal therapy should be made: (i) when mycological susceptibility testing identifies an organism from a confirmed site of infection, which is resistant to the antifungal given for primary therapy, or a resistance mutation is identified by molecular testing; (ii) at, or after, 8 days of primary antifungal treatment if there is increasing serum galactomannan, or galactomannan positivity in serum, or bronchoalveolar lavage fluid when the antigen was previously undetectable, or there is sudden clinical deterioration, or a new clearly distinct site of infection is detected; and (iii) at, or after, 15 days of primary antifungal treatment if the patient is clinically stable but with ≥2 serum galactomannan measurements persistently elevated compared with baseline or increasing, or if the original lesions on CT or other imaging, show progression by >25% in size in the context of no apparent change in immune status.

Published
2021

2. When to change treatment of acute invasive aspergillosis: an expert viewpoint

Author

Slavin, Monica A., Chen, Yee-Chun, Cordonnier, Catherine, Cornely, Oliver A., Cuenca-Estrella, Manuel, Donnelly, J. Peter, Groll, Andreas H., Lortholary, Olivier, Marty, Francisco M., Nucci, Marcio, Rex, John H., Rijnders, Bart J. A., Thompson, George R., Verweij, Paul E., White, P. Lewis, Hargreaves, Ruth, Harvey, Emma, Maertens, Johan A., Slavin, Monica A., Chen, Yee-Chun, Cordonnier, Catherine, Cornely, Oliver A., Cuenca-Estrella, Manuel, Donnelly, J. Peter, Groll, Andreas H., Lortholary, Olivier, Marty, Francisco M., Nucci, Marcio, Rex, John H., Rijnders, Bart J. A., Thompson, George R., Verweij, Paul E., White, P. Lewis, Hargreaves, Ruth, Harvey, Emma, and Maertens, Johan A.

Abstract

Invasive aspergillosis (IA) is an acute infection affecting patients who are immunocompromised, as a result of receiving chemotherapy for malignancy, or immunosuppressant agents for transplantation or autoimmune disease. Whilst criteria exist to define the probability of infection for clinical trials, there is little evidence in the literature or clinical guidelines on when to change antifungal treatment in patients who are receiving prophylaxis or treatment for IA. To try and address this significant gap, an advisory board of experts was convened to develop criteria for the management of IA for use in designing clinical trials, which could also be used in clinical practice. For primary treatment failure, a change in antifungal therapy should be made: (i) when mycological susceptibility testing identifies an organism from a confirmed site of infection, which is resistant to the antifungal given for primary therapy, or a resistance mutation is identified by molecular testing; (ii) at, or after, 8 days of primary antifungal treatment if there is increasing serum galactomannan, or galactomannan positivity in serum, or bronchoalveolar lavage fluid when the antigen was previously undetectable, or there is sudden clinical deterioration, or a new clearly distinct site of infection is detected; and (iii) at, or after, 15 days of primary antifungal treatment if the patient is clinically stable but with >= 2 serum galactomannan measurements persistently elevated compared with baseline or increasing, or if the original lesions on CT or other imaging, show progression by >25% in size in the context of no apparent change in immune status.

Published
2022

3. When to change treatment of acute invasive aspergillosis:an expert viewpoint

Author

Slavin, Monica A., Chen, Yee Chun, Cordonnier, Catherine, Cornely, Oliver A., Cuenca-Estrella, Manuel, Donnelly, J. Peter, Groll, Andreas H., Lortholary, Olivier, Marty, Francisco M., Nucci, Marcio, Rex, John H., Rijnders, Bart J.A., Thompson, George R., Verweij, Paul E., White, P. Lewis, Hargreaves, Ruth, Harvey, Emma, Maertens, Johan A., Slavin, Monica A., Chen, Yee Chun, Cordonnier, Catherine, Cornely, Oliver A., Cuenca-Estrella, Manuel, Donnelly, J. Peter, Groll, Andreas H., Lortholary, Olivier, Marty, Francisco M., Nucci, Marcio, Rex, John H., Rijnders, Bart J.A., Thompson, George R., Verweij, Paul E., White, P. Lewis, Hargreaves, Ruth, Harvey, Emma, and Maertens, Johan A.

Abstract

Invasive aspergillosis (IA) is an acute infection affecting patients who are immunocompromised, as a result of receiving chemotherapy for malignancy, or immunosuppressant agents for transplantation or autoimmune disease. Whilst criteria exist to define the probability of infection for clinical trials, there is little evidence in the literature or clinical guidelines on when to change antifungal treatment in patients who are receiving prophylaxis or treatment for IA. To try and address this significant gap, an advisory board of experts was convened to develop criteria for the management of IA for use in designing clinical trials, which could also be used in clinical practice. For primary treatment failure, a change in antifungal therapy should be made: (i) when mycological susceptibility testing identifies an organism from a confirmed site of infection, which is resistant to the antifungal given for primary therapy, or a resistance mutation is identified by molecular testing; (ii) at, or after, 8 days of primary antifungal treatment if there is increasing serum galactomannan, or galactomannan positivity in serum, or bronchoalveolar lavage fluid when the antigen was previously undetectable, or there is sudden clinical deterioration, or a new clearly distinct site of infection is detected; and (iii) at, or after, 15 days of primary antifungal treatment if the patient is clinically stable but with ≥2 serum galactomannan measurements persistently elevated compared with baseline or increasing, or if the original lesions on CT or other imaging, show progression by >25% in size in the context of no apparent change in immune status.

Published
2022

5. When to change treatment of acute invasive aspergillosis: an expert viewpoint.

Author

Slavin, Monica A, Chen, Yee-Chun, Cordonnier, Catherine, Cornely, Oliver A, Cuenca-Estrella, Manuel, Donnelly, J Peter, Groll, Andreas H, Lortholary, Olivier, Marty, Francisco M, Nucci, Marcio, Rex, John H, Rijnders, Bart J A, Thompson, George R, Verweij, Paul E, White, P Lewis, Hargreaves, Ruth, Harvey, Emma, and Maertens, Johan A

Subjects
ASPERGILLOSIS, IMMUNOSUPPRESSIVE agents, BRONCHOALVEOLAR lavage, CLINICAL deterioration, COMPUTED tomography, IMMUNITY, ASPERGILLOSIS diagnosis, POLYSACCHARIDES, ANTIFUNGAL agents, RESEARCH, BODY fluids, IMMUNOCOMPROMISED patients, EVALUATION research, PULMONARY aspergillosis, COMPARATIVE studies, RESEARCH funding
Abstract

Invasive aspergillosis (IA) is an acute infection affecting patients who are immunocompromised, as a result of receiving chemotherapy for malignancy, or immunosuppressant agents for transplantation or autoimmune disease. Whilst criteria exist to define the probability of infection for clinical trials, there is little evidence in the literature or clinical guidelines on when to change antifungal treatment in patients who are receiving prophylaxis or treatment for IA. To try and address this significant gap, an advisory board of experts was convened to develop criteria for the management of IA for use in designing clinical trials, which could also be used in clinical practice. For primary treatment failure, a change in antifungal therapy should be made: (i) when mycological susceptibility testing identifies an organism from a confirmed site of infection, which is resistant to the antifungal given for primary therapy, or a resistance mutation is identified by molecular testing; (ii) at, or after, 8 days of primary antifungal treatment if there is increasing serum galactomannan, or galactomannan positivity in serum, or bronchoalveolar lavage fluid when the antigen was previously undetectable, or there is sudden clinical deterioration, or a new clearly distinct site of infection is detected; and (iii) at, or after, 15 days of primary antifungal treatment if the patient is clinically stable but with ≥2 serum galactomannan measurements persistently elevated compared with baseline or increasing, or if the original lesions on CT or other imaging, show progression by >25% in size in the context of no apparent change in immune status. [ABSTRACT FROM AUTHOR]

Published
2022
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6. Pneumocystis jirovecii pneumonia: still a concern in patients with haematological malignancies and stem cell transplant recipients

Author

Cordonnier, Catherine, Cesaro, Simone, Maschmeyer, Georg, Einsele, Hermann, Peter Donnelly, J., Alanio, Alexandre, Hauser, Philippe M., Lagrou, Katrien, Melchers, Willem J. G., Helweg-Larsen, Jannik, Matos, Olga, Bretagne, Stephane, Maertens, Johan, Agrawal, Samir, Kibbler, Christopher, Pagliuca, Antonio, Ward, Katherine, Akova, Murat, Herbrecht, Raoul, Mallet, Vincent, Ribaud, Patricia, Aljurf, Mahmoud, Averbuch, Dina, Engelhard, Dan, Berg, Thomas, Cornely, Oliver, Penack, Olaf, van Boemmel, Florian, von Lilienfeld-Toal, Marie, Blennow, Ola, Ljungman, Per, Bruggemann, Roger, Donnelly, Peter, Kullberg, Bart-Jan, Melchers, Willem, Calandra, Thierry, Hirsch, Hans, Marchetti, Oscar, Orasch, Christina, Tissot, Frederic, Castagnola, Elio, Girmenia, Corrado, Mikulska, Malgorzata, Pagano, Livio, Viscoli, Claudio, De La Camara, Rafael, Duarte, Rafael, Munoz, Patricia, Drgona, Lubos, Hargreaves, Ruth, Hubacek, Petr, Kouba, Michal, Racil, Zdenek, Klyasova, Galina, Pettrikos, George, Roilides, Emmanuel, Skiada, Anna, Rizzi-Puechal, Valã©rie, Sinko, Janos, Slavin, Monica, Styczynski, Jan, Tweddle, Lorraine, Wood, Craig, Service d'hématologie clinique, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Department of Haematology, Oncoematologia Pediatrica, Policlinico G. B. Rossi, Medizinische Klinik, Hämatologie und Onkologie, Klinikum Ernst von Bergmann, Julius-Maximilians-Universität Würzburg [Wurtzbourg, Allemagne] (JMU), Radboud university [Nijmegen], Université Sorbonne Paris Cité (USPC), Laboratoire de Parasitologie-Mycologie [CHU Saint Louis, Paris], Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Mycologie moléculaire, Institut Pasteur [Paris]-Centre National de la Recherche Scientifique (CNRS), Lausanne University Hospital, Catholic University of Leuven - Katholieke Universiteit Leuven (KU Leuven), Rigshospitalet [Copenhagen], Copenhagen University Hospital, Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa = NOVA University Lisbon (NOVA), Department of Hematology, University Hospital Gasthuisberg, The ECIL-5 meeting was supported by unrestricted educational grants from Astellas Pharma, Gilead Sciences, Merck, and Pfizer. The ECIL-6 meeting was supported by unrestricted educational grants from Basilea, Gilead Sciences, Merck, and Pfizer, on behalf of the Fifth European Conference on Infections in Leukemia (ECIL-5†), a joint venture of The European Group for Blood and Marrow Transplantation (EBMT), The European Organization for Research and Treatment of Cancer (EORTC), the Immunocompromised Host Society (ICHS) and The European Leukemia Net (ELN) (61 collabrators), Radboud University [Nijmegen], University Hospital Gasthuisberg [Leuven], Julius-Maximilians-Universität Würzburg (JMU), and Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS)

Subjects
0301 basic medicine, Microbiology (medical), medicine.medical_specialty, Antifungal Agents, [SDV]Life Sciences [q-bio], medicine.medical_treatment, 030106 microbiology, Disease, Hematopoietic stem cell transplantation, Pneumocystis carinii, Chemoprevention, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Immunocompromised Host, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Humans, Pneumocystis jirovecii, Pharmacology (medical), Intensive care medicine, Hematologic Neoplasms, Pneumonia, Pneumocystis, Stem Cell Transplantation, Transplant Recipients, Pharmacology, Infectious Diseases, Women's cancers Radboud Institute for Molecular Life Sciences [Radboudumc 17], Hematology, biology, Pneumocystis, business.industry, Mortality rate, Pneumonia, biology.organism_classification, medicine.disease, Penumocytis pneumonia, 3. Good health, Leukemia, lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4], 030220 oncology & carcinogenesis, immunocomrpomised host, Pnemocystis jirovecii, Stem cell, immunocomrpomised host, Penumocytis pneumonia, Pnemocystis jirovecii, business, Inflammatory diseases Radboud Institute for Molecular Life Sciences [Radboudumc 5]
Abstract

Contains fulltext : 171209.pdf (Publisher’s version ) (Closed access) Pneumocystis jirovecii can cause life-threatening pneumonia following treatment for haematological malignancies or after HSCT. The mortality rate of P. jirovecii pneumonia (PCP) in these patients is 30%-60%, especially after HSCT. The clinical presentation of PCP in haematology differs from that associated with HIV infection, with the disease being acute and more often severe, having a lower fungal burden and being more frequently linked to treatment with corticosteroids. Most cases occur in patients not receiving adequate prophylaxis. The development of new therapies, including targeted treatments and monoclonal antibodies in various haematological diseases, justifies constant vigilance in order to identify new at-risk populations and give prophylaxis accordingly. The fifth and sixth European Conferences on Infections in Leukaemia (ECIL-5 and ECIL-6) aimed to review risk factors for PCP in haematology patients and to establish evidence-based recommendations for PCP diagnosis, prophylaxis and treatment. This article focuses on the magnitude of the problem, the main differences in clinical presentation between haematology patients and other immunocompromised populations, especially HIV-infected patients, and the main risk factors.

Published
2016

7. still a concern in patients with haematological malignancies and stem cell transplant recipients-authors' response

Author

Cordonnier, Catherine, Alanio, Alexandre, Cesaro, Simone, Maschmeyer, Georg, Einsele, Hermann, Donnelly, J. Peter, Hauser, Philippe M., Lagrou, Katrien, Melchers, Willem J.G., Helweg-Larsen, Jannik, Matos, Olga, Bretagne, Stephane, Maertens, Johan, Agrawal, Samir, Akova, Murat, Aljurf, Mahmoud, Averbuch, Dina, Berg, Thomas, Blennow, Ola, Bruggemann, Roger, Calandra, Thierry, Castagnola, Elio, Cornely, Oliver, De La Camara, Rafael, Drgona, Lubos, Duarte, Rafael, Engelhard, Dan, Girmenia, Corrado, Hargreaves, Ruth, Herbrecht, Raoul, Hirsch, Hans, Hubacek, Petr, Kibbler, Christopher, Klyasova, Galina, Kouba, Michal, Kullberg, Bart Jan, Ljungman, Per, Mallet, Vincent, Marchetti, Oscar, Mikulska, Malgorzata, Munoz, Patricia, Orasch, Christina, Pagano, Livio, Pagliuca, Antonio, Penack, Olaf, Pettrikos, George, Racil, Zdenek, Ribaud, Patricia, Rizzi-Puechal, Valerie, Roilides, Emmanuel, on behalf of the Fifth European Conference on Infections in Leukemia (ECIL-5), The European Group for Blood and Marrow Transplantation (EBMT), The European Organization for Research and Treatment of Cancer (EORTC), Immunocompromised Host Society (ICHS) and The European LeukemiaNet (ELN), Instituto de Higiene e Medicina Tropical (IHMT), Global Health and Tropical Medicine (GHTM), and TB, HIV and opportunistic diseases and pathogens (THOP)

Subjects
Carinii-pneumonia, Aids, Infectious Diseases, ECIL guidelines, SDG 3 - Good Health and Well-being, Outbreaks, Infection, Infants, Management
Abstract

Made available in DSpace on 2021-09-24T00:56:32Z (GMT). No. of bitstreams: 0 Previous issue date: 2017-04-01 publishersversion published

Published
2017

8. Pneumocystis jirovecii pneumonia: still a concern in patients with haematological malignancies and stem cell transplant recipients-authors' response

Author

Cordonnier, Catherine, Alanio, Alexandre, Cesaro, Simone, Maschmeyer, Georg, Einsele, Hermann, Donnelly, J. Peter, Hauser, Philippe M., Lagrou, Katrien, Melchers, Willem J. G., Helweg-Larsen, Jannik, Matos, Olga, Bretagne, Stéphane, Maertens, Johan, Agrawal, Samir, Akova, Murat, Aljurf, Mahmoud, Averbuch, Dina, Berg, Thomas, Blennow, Ola, Brüggemann, Roger, Calandra, Thierry, Castagnola, Elio, Cornely, Oliver, De La Camara, Rafael, Drgona, Lubos, Duarte, Rafael, Engelhard, Dan, Girmenia, Corrado, Hargreaves, Ruth, Herbrecht, Raoul, Hirsch, Hans, Hubacek, Petr, Kibbler, Christopher, Klyasova, Galina, Kouba, Michal, Kullberg, Bart-Jan, Ljungman, Per, Mallet, Vincent, Marchetti, Oscar, Mikulska, Malgorzata, Munoz, Patricia, Orasch, Christina, Pagano, Livio, Pagliuca, Antonio, Penack, Olaf, Pettrikos, George, Racil, Zdenek, Ribaud, Patricia, Rizzi-Puechal, Valérie, Roilides, Emmanuel, Sinko, Janos, Skiada, Anna, Slavin, Monica, Styczynski, Jan, Tissot, Frederic, Tweddle, Lorraine, van Boemmel, Florian, von Lilienfeld-Toal, Marie, Viscoli, Claudio, Ward, Katherine, and Wood, Craig

Subjects
0301 basic medicine, Microbiology (medical), medicine.medical_specialty, 030106 microbiology, HIV Infections, Pneumocystis carinii, 03 medical and health sciences, Acquired immunodeficiency syndrome (AIDS), Hematologic Neoplasms, Humans, Pneumonia, Pneumocystis, Stem Cell Transplantation, Pharmacology, Pharmacology (medical), Infectious Diseases, Medicine, In patient, Intensive care medicine, hematopoietic stem cell transplant, business.industry, Pneumocystis, PNEUMOCYSTIS JIROVECI, Pneumocystis jiroveci, infection, hematopoietic stem cell transplant, Pneumocystis jirovecii Pneumonia, Pneumocystis jiroveci, Pneumonia, medicine.disease, infection, Women's cancers Radboud Institute for Health Sciences [Radboudumc 17], Stem cell, business, Inflammatory diseases Radboud Institute for Molecular Life Sciences [Radboudumc 5]
Abstract

Contains fulltext : 169784.pdf (Publisher’s version ) (Closed access)

Published
2017

9. ECIL guidelines for preventing Pneumocystis jirovecii pneumonia in patients with haematological malignancies and stem cell transplant recipients

Author

Maertens, Johan, Cesaro, Simone, Maschmeyer, Georg, Einsele, Hermann, Donnelly, J. Peter, Alanio, Alexandre, Hauser, Philippe M., Lagrou, Katrien, Melchers, Willem J. G., Helweg-Larsen, Jannik, Matos, Olga, Bretagne, Stã©phane, Cordonnier, Catherine, Agrawal, Samir, Kibbler, Christopher, Pagliuca, SIMONE ANTONIO, Ward, Katherine, Akova, Murat, Herbrecht, Raoul, Mallet, Vincent, Ribaud, Patricia, Aljurf, Mahmoud, Averbuch, Dina, Engelhard, Dan, Berg, Thomas, Cornely, Oliver, Penack, Olaf, van Boemmel, Florian, von Lilienfeld-Toal, Marie, Blennow, Ola, Ljungman, Per, Bruggemann, Roger, Donnelly, Peter, Kullberg, Bart-Jan, Melchers, Willem, Calandra, Thierry, Hirsch, Hans, Marchetti, Oscar, Orasch, Christina, Tissot, Frederic, Castagnola, Elio, Girmenia, Corrado, Mikulska, Malgorzata, Pagano, Livio, Viscoli, Claudio, De La Camara, Rafael, Duarte, Rafael, Munoz, Patricia, Drgona, Lubos, Hargreaves, Ruth, Hubacek, Petr, Kouba, Michal, Racil, Zdenek, Klyasova, Galina, Pettrikos, George, Roilides, Emmanuel, Skiada, Anna, Rizzi-Puechal, Valã©rie, Sinko, Janos, Slavin, Monica, Styczynski, Jan, Tweddle, Lorraine, Wood, Craig, Department of Hematology, University Hospital Gasthuisberg, G.B. Rossi Hospital, Verona University, Medizinische Klinik, Hämatologie und Onkologie, Klinikum Ernst von Bergmann, Julius-Maximilians-Universität Würzburg [Wurtzbourg, Allemagne] (JMU), Radboud university [Nijmegen], Laboratoire de Parasitologie-Mycologie [CHU Saint Louis, Paris], Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Mycologie moléculaire, Institut Pasteur [Paris]-Centre National de la Recherche Scientifique (CNRS), Lausanne University Hospital, Catholic University of Leuven - Katholieke Universiteit Leuven (KU Leuven), Rigshospitalet [Copenhagen], Copenhagen University Hospital, Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa = NOVA University Lisbon (NOVA), Centre National de Référence Mycologie et Antifongiques-Mycologie Moléculaire (CNRMA), Institut Pasteur [Paris], Service d'hématologie clinique, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), The ECIL-5 meeting was supported by unrestricted educational grants from Astellas Pharma, Gilead Sciences, Merck, and Pfizer., University Hospital Gasthuisberg [Leuven], Università degli studi di Verona = University of Verona (UNIVR), Radboud University [Nijmegen], Julius-Maximilians-Universität Würzburg (JMU), Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS), and Institut Pasteur [Paris] (IP)

Subjects
0301 basic medicine, Microbiology (medical), Antifungal Agents, [SDV]Life Sciences [q-bio], 030106 microbiology, Pneumocitis jirovecii, Chemoprevention, Trimethoprim, Immunocompromised Host, 03 medical and health sciences, 0302 clinical medicine, Trimethoprim, Sulfamethoxazole Drug Combination, Humans, Pharmacology (medical), Pharmacology, Women's cancers Radboud Institute for Molecular Life Sciences [Radboudumc 17], Sulfamethoxazole Drug Combination, Pneumocystis, Hematologic Neoplasms, Pneumonia, Pneumocystis, Stem Cell Transplantation, Transplant Recipients, Infectious Diseases, immunocomrpomised host, pneumonia, Pneumocitis jirovecii, Pneumonia, 3. Good health, lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4], 030220 oncology & carcinogenesis, immunocomrpomised host, Inflammatory diseases Radboud Institute for Molecular Life Sciences [Radboudumc 5], [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

Contains fulltext : 172373.pdf (Publisher’s version ) (Closed access) The 5th European Conference on Infections in Leukaemia (ECIL-5) meeting aimed to establish evidence-based recommendations for the prophylaxis of Pneumocystis jirovecii pneumonia (PCP) in non-HIV-infected patients with an underlying haematological condition, including allogeneic HSCT recipients. Recommendations were based on the grading system of the IDSA. Trimethoprim/sulfamethoxazole given 2-3 times weekly is the drug of choice for the primary prophylaxis of PCP in adults ( A-II: ) and children ( A-I: ) and should be given during the entire period at risk. Recent data indicate that children may benefit equally from a once-weekly regimen ( B-II: ). All other drugs, including pentamidine, atovaquone and dapsone, are considered second-line alternatives when trimethoprim/sulfamethoxazole is poorly tolerated or contraindicated. The main indications of PCP prophylaxis are ALL, allogeneic HSCT, treatment with alemtuzumab, fludarabine/cyclophosphamide/rituximab combinations, >4 weeks of treatment with corticosteroids and well-defined primary immune deficiencies in children. Additional indications are proposed depending on the treatment regimen.

Published
2016

10. ECIL guidelines for the diagnosis of Pneumocystis jirovecii pneumonia in patients with haematological malignancies and stem cell transplant recipients

Author

Alanio, Alexandre, Hauser, Philippe M., Lagrou, Katrien, Melchers, Willem J. G., Helweg Larsen, Jannik, Matos, Olga, Cesaro, Simone, Maschmeyer, Georg, Einsele, Hermann, Donnelly, J. Peter, Cordonnier, Catherine, Maertens, Johan, Bretagne, Stã©phane, Agrawal, Samir, Kibbler, Christopher, Pagliuca, Antonio, Ward, Katherine, Akova, Murat, Herbrecht, Raoul, Mallet, Vincent, Ribaud, Patricia, Aljurf, Mahmoud, Averbuch, Dina, Engelhard, Dan, Berg, Thomas, Cornely, Oliver, Penack, Olaf, van Boemmel, Florian, von Lilienfeld Toal, Marie, Blennow, Ola, Ljungman, Per, Bruggemann, Roger, Donnelly, Peter, Kullberg, Bart Jan, Melchers, Willem, Calandra, Thierry, Hirsch, Hans, Marchetti, Oscar, Orasch, Christina, Tissot, Frederic, Castagnola, Elio, Girmenia, Corrado, Mikulska, MALGORZATA KAROLINA, Pagano, Livio, Viscoli, Claudio, De La Camara, Rafael, Duarte, Rafael, Munoz, Patricia, Drgona, Lubos, Hargreaves, Ruth, Hubacek, Petr, Kouba, Michal, Racil, Zdenek, Klyasova, Galina, Pettrikos, George, Roilides, Emmanuel, Skiada, Anna, Rizzi Puechal, Valã©rie, Sinko, Janos, Slavin, Monica, Styczynski, Jan, Tweddle, Lorraine, Wood, Craig, Centre National de Référence des Mycoses invasives et antifongiques - Mycologie moléculaire (CNRMA), Institut Pasteur [Paris]-Centre National de la Recherche Scientifique (CNRS), Université Paris Diderot - Paris 7 (UPD7), Laboratoire de Parasitologie-Mycologie [CHU Saint Louis, Paris], Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Mycologie moléculaire, Université de Lausanne = University of Lausanne (UNIL), Université Catholique de Louvain = Catholic University of Louvain (UCL), Radboud University [Nijmegen], Rigshospitalet [Copenhagen], Copenhagen University Hospital, Universidade Nova de Lisboa = NOVA University Lisbon (NOVA), Università degli studi di Verona = University of Verona (UNIVR), Medizinische Klinik, Hämatologie und Onkologie, Klinikum Ernst von Bergmann, Julius Maximilians University Wurzburg, Julius-Maximilians-Universität Würzburg [Wurtzbourg, Allemagne] (JMU), Service d'hématologie clinique, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Department of Hematology, University Hospital Gasthuisberg [Leuven], The ECIL-5 meeting was supported by unrestricted educational grants from Astellas Pharma, Gilead Sciences, Merck, and Pfizer, Université de Lausanne (UNIL), Radboud university [Nijmegen], G.B. Rossi Hospital, Verona University, University Hospital Gasthuisberg, Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS), and Julius-Maximilians-Universität Würzburg (JMU)

Subjects
0301 basic medicine, Microbiology (medical), medicine.medical_specialty, [SDV]Life Sciences [q-bio], 030106 microbiology, Dapsone, Pneumocystis carinii, 03 medical and health sciences, Immunocompromised Host, 0302 clinical medicine, Diagnostic Tests, Internal medicine, medicine, Pneumocistis jirovecii, Humans, Routine, Pharmacology (medical), 030212 general & internal medicine, Intensive care medicine, Pharmacology, Women's cancers Radboud Institute for Molecular Life Sciences [Radboudumc 17], business.industry, Diagnostic Tests, Routine, Pneumocystis, Pneumonia, Pneumocystis, Pneumonia, medicine.disease, Trimethoprim, Transplant Recipients, 3. Good health, Fludarabine, Regimen, lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4], Infectious Diseases, Hematologic Neoplasms, Alemtuzumab, Rituximab, business, Inflammatory diseases Radboud Institute for Molecular Life Sciences [Radboudumc 5], [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Pentamidine, medicine.drug, immunocompromised host, pneumonia, Pneumocistis jirovecii, Stem Cell Transplantation
Abstract

Item does not contain fulltext The Fifth European Conference on Infections in Leukaemia (ECIL-5) convened a meeting to establish evidence-based recommendations for using tests to diagnose Pneumocystis jirovecii pneumonia (PCP) in adult patients with haematological malignancies. Immunofluorescence assays are recommended as the most sensitive microscopic method (recommendation A-II: ). Real-time PCR is recommended for the routine diagnosis of PCP ( A-II: ). Bronchoalveolar lavage (BAL) fluid is recommended as the best specimen as it yields good negative predictive value ( A-II: ). Non-invasive specimens can be suitable alternatives ( B-II: ), acknowledging that PCP cannot be ruled out in case of a negative PCR result ( A-II: ). Detecting beta-d-glucan in serum can contribute to the diagnosis but not the follow-up of PCP ( A-II: ). A negative serum beta-d-glucan result can exclude PCP in a patient at risk ( A-II: ), whereas a positive test result may indicate other fungal infections. Genotyping using multilocus sequence markers can be used to investigate suspected outbreaks ( A-II: ). The routine detection of dihydropteroate synthase mutations in cases of treatment failure is not recommended ( B-II: ) since these mutations do not affect response to high-dose co-trimoxazole. The clinical utility of these diagnostic tests for the early management of PCP should be further assessed in prospective, randomized interventional studies.

Published
2016

14. Resistance to antibiotics in general practice.

Author

Hargreaves, Ruth

Subjects
DRUG resistance in microorganisms
Abstract

Discusses the potential problem of antimicrobial resistance in general practice. Identification of bacterial strains that are resistant to antibiotics; Importance of antimicrobial prescribing policies; Changing a practice's prescribing habits; Ways by which the community can help ease the problem.

Published
1995

15. Enhanced surveillance of invasive Haemophilus influenzaedisease in England, 1990 to 1996: impact of conjugate vaccines

Author

SLACK, MARY P. E., AZZOPARDI, HELEN J., HARGREAVES, RUTH M., and RAMSAY, MARY E.

Abstract

We report an enhanced prospective survey of invasive Haemophilus influenzaeinfections that has defined the pattern of invasive disease in five English regions for 2 years before and 4 years after the introduction of the H. influenzaetype b (Hib) vaccination program. During the prevaccination period the majority of cases of invasive H. influenzaewere caused by type b; most (89%) of these infections occurred in children <5 years of age and the most common presentation was meningitis. Since the introduction of routine immunization of infants with conjugate Hib vaccine, there has been a 16-fold reduction in the annual attack rate of invasive Hib disease recorded in children <5 years of age. This reduction is of a magnitude similar to that observed in other countries with Hib vaccination programs. The number of infections caused by non-type b H. influenzaehas shown a small but progressive increase over the same period, emphasizing the need for continued surveillance. There was no increase in the number of infections caused by other serotypes.

Published
1998

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