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1. Oral challenge vs routine care to assess low-risk penicillin allergy in critically ill hospital patients (ORACLE): a pilot safety and feasibility randomised controlled trial

Author

Rose, Morgan T., Holmes, Natasha E., Eastwood, Glenn M., Vogrin, Sara, James, Fiona, De Luca, Joseph F., Bellomo, Rinaldo, Warrillow, Stephen J., Phung, Michelle, Barnes, Sara L., Murfin, Brendan, Rogers, Ben, Lambros, Belinda, Collis, Brennan, Peel, Trisha N., Slavin, Monica A., and Trubiano, Jason A.

Published
2024
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2. Antibody titres elicited by the 2018 seasonal inactivated influenza vaccine decline by 3 months post-vaccination but persist for at least 6 months.

Author

Mordant, Francesca, Price, Olivia, Rudraraju, Rajeev, Slavin, Monica, Marshall, Caroline, Worth, Leon, Peck, Heidi, Barr, Ian, Sullivan, Sheena, and Subbarao, Kanta

Subjects
antibody, influenza, kinetics, serosurvey, vaccine, Humans, Aged, Influenza, Human, Influenza Vaccines, Seasons, Vaccines, Inactivated, Influenza A Virus, H1N1 Subtype, Influenza A Virus, H3N2 Subtype, Prospective Studies, Antibodies, Viral, Vaccination, Hemagglutination Inhibition Tests
Abstract

BACKGROUND: In Australia, seasonal inactivated influenza vaccine is typically offered in April. However, the onset, peak and end of a typical influenza season vary, and optimal timing for vaccination remains unclear. Here, we investigated vaccine-induced antibody response kinetics over 6 months in different age groups. METHODS: We conducted a prospective serosurvey among 71 adults aged 18-50 years, 15 community-dwelling (healthy) and 16 aged-care facility resident (frail) older adults aged ≥65 years who received the 2018 southern hemisphere vaccines. Sera were collected at baseline, and 1, 2, 4, and 6 months post-vaccination. Antibody titres were measured by haemagglutination inhibition or microneutralisation assays. Geometric mean titres were estimated using random effects regression modelling and superimposed on 2014-2018 influenza season epidemic curves. RESULTS: Antibody titres peaked 1.2-1.3 months post-vaccination for all viruses, declined by 3 months post-vaccination but, notably, persisted above baseline after 6 months in all age groups by 1.3- to 1.5-fold against A(H1N1)pdm09, 1.7- to 2-fold against A(H3N2), 1.7- to 2.1-fold against B/Yamagata and 1.8-fold against B/Victoria. Antibody kinetics were similar among different age groups. Antibody responses were poor against cell-culture grown compared to egg-grown viruses. CONCLUSIONS: These results suggest subtype-specific antibody-mediated protection persists for at least 6 months, which corresponds to the duration of a typical influenza season.

Published
2023

7. Guidelines for the management of Toxoplasma gondii infection and disease in patients with haematological malignancies and after haematopoietic stem-cell transplantation: guidelines from the 9th European Conference on Infections in Leukaemia, 2022

Author

Aerts, Robina, Mehra, Varun, Groll, Andreas H, Martino, Rodrigo, Lagrou, Katrien, Robin, Christine, Perruccio, Katia, Blijlevens, Nicole, Nucci, Marcio, Slavin, Monica, Bretagne, Stéphane, and Cordonnier, Catherine

Published
2024
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9. 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

10. Consensus position statement on advancing the standardised reporting of infection events in immunocompromised patients

Author

Teh, Benjamin W, Mikulska, Malgorzata, Averbuch, Dina, de la Camara, Rafael, Hirsch, Hans H, Akova, Murat, Ostrosky-Zeichner, Luis, Baddley, John W, Tan, Ban Hock, Mularoni, Alessandra, Subramanian, Aruna K, La Hoz, Ricardo M, Marinelli, Tina, Boan, Peter, Aguado, Jose Maria, Grossi, Paolo A, Maertens, Johan, Mueller, Nicolas J, and Slavin, Monica A

Published
2024
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12. Invasive aspergillosis in adult patients in Australia and New Zealand: 2017–2020

Author

Tio, Shio Yen, Chen, Sharon C.-A., Hamilton, Kate, Heath, Christopher H., Pradhan, Alyssa, Morris, Arthur J., Korman, Tony M., Morrissey, Orla, Halliday, Catriona L., Kidd, Sarah, Spelman, Timothy, Brell, Nadiya, McMullan, Brendan, Clark, Julia E., Mitsakos, Katerina, Hardiman, Robyn P., Williams, Phoebe, Campbell, Anita J., Beardsley, Justin, Van Hal, Sebastiaan, Yong, Michelle K., Worth, Leon J., and Slavin, Monica A.

Published
2023
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15. 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
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18. Revision and Update of the Consensus Definitions of Invasive Fungal Disease From the European Organization for Research and Treatment of Cancer and the Mycoses Study Group Education and Research Consortium

Author

Donnelly, J Peter, Chen, Sharon C, Kauffman, Carol A, Steinbach, William J, Baddley, John W, Verweij, Paul E, Clancy, Cornelius J, Wingard, John R, Lockhart, Shawn R, Groll, Andreas H, Sorrell, Tania C, Bassetti, Matteo, Akan, Hamdi, Alexander, Barbara D, Andes, David, Azoulay, Elie, Bialek, Ralf, Bradsher, Robert W, Bretagne, Stephane, Calandra, Thierry, Caliendo, Angela M, Castagnola, Elio, Cruciani, Mario, Cuenca-Estrella, Manuel, Decker, Catherine F, Desai, Sujal R, Fisher, Brian, Harrison, Thomas, Heussel, Claus Peter, Jensen, Henrik E, Kibbler, Christopher C, Kontoyiannis, Dimitrios P, Kullberg, Bart-Jan, Lagrou, Katrien, Lamoth, Frédéric, Lehrnbecher, Thomas, Loeffler, Jurgen, Lortholary, Olivier, Maertens, Johan, Marchetti, Oscar, Marr, Kieren A, Masur, Henry, Meis, Jacques F, Morrisey, C Orla, Nucci, Marcio, Ostrosky-Zeichner, Luis, Pagano, Livio, Patterson, Thomas F, Perfect, John R, Racil, Zdenek, Roilides, Emmanuel, Ruhnke, Marcus, Prokop, Cornelia Schaefer, Shoham, Shmuel, Slavin, Monica A, Stevens, David A, Thompson, George R, Vazquez, Jose A, Viscoli, Claudio, Walsh, Thomas J, Warris, Adilia, Wheat, L Joseph, White, P Lewis, Zaoutis, Theoklis E, and Pappas, Peter G

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Cancer, Prevention, Clinical Research, Good Health and Well Being, Antifungal Agents, Consensus, Humans, Immunocompromised Host, Invasive Fungal Infections, Mycoses, Neoplasms, consensus, definitions, invasive fungal diseases, diagnosis, research, Biological Sciences, Medical and Health Sciences, Microbiology, Clinical sciences
Abstract

BackgroundInvasive fungal diseases (IFDs) remain important causes of morbidity and mortality. The consensus definitions of the Infectious Diseases Group of the European Organization for Research and Treatment of Cancer and the Mycoses Study Group have been of immense value to researchers who conduct clinical trials of antifungals, assess diagnostic tests, and undertake epidemiologic studies. However, their utility has not extended beyond patients with cancer or recipients of stem cell or solid organ transplants. With newer diagnostic techniques available, it was clear that an update of these definitions was essential.MethodsTo achieve this, 10 working groups looked closely at imaging, laboratory diagnosis, and special populations at risk of IFD. A final version of the manuscript was agreed upon after the groups' findings were presented at a scientific symposium and after a 3-month period for public comment. There were several rounds of discussion before a final version of the manuscript was approved.ResultsThere is no change in the classifications of "proven," "probable," and "possible" IFD, although the definition of "probable" has been expanded and the scope of the category "possible" has been diminished. The category of proven IFD can apply to any patient, regardless of whether the patient is immunocompromised. The probable and possible categories are proposed for immunocompromised patients only, except for endemic mycoses.ConclusionsThese updated definitions of IFDs should prove applicable in clinical, diagnostic, and epidemiologic research of a broader range of patients at high-risk.

Published
2020

19. 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
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22. A protocol for an international, multicentre pharmacokinetic study for Screening Antifungal Exposure in Intensive Care Units: The SAFE-ICU study

Author

Roberts, Jason A., Sime, Fekade, Lipman, Jeffrey, Hernández-Mitre, Maria Patricia, Baptista, João Pedro, Brüggemann, Roger J., Darvall, Jai, De Waele, Jan J., Dimopoulos, George, Lefrant, Jean-Yves, Mat Nor, Mohd Basri, Rello, Jordi, Seoane, Leonardo, Slavin, Monica A., Valkonen, Miia, Venditti, Mario, Wong, Wai Tat, Zeitlinger, Markus, and Roger, Claire

Published
2023
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25. Global guideline for the diagnosis and management of mucormycosis: an initiative of the European Confederation of Medical Mycology in cooperation with the Mycoses Study Group Education and Research Consortium

Author

Cornely, Oliver A, Alastruey-Izquierdo, Ana, Arenz, Dorothee, Chen, Sharon CA, Dannaoui, Eric, Hochhegger, Bruno, Hoenigl, Martin, Jensen, Henrik E, Lagrou, Katrien, Lewis, Russell E, Mellinghoff, Sibylle C, Mer, Mervyn, Pana, Zoi D, Seidel, Danila, Sheppard, Donald C, Wahba, Roger, Akova, Murat, Alanio, Alexandre, Al-Hatmi, Abdullah MS, Arikan-Akdagli, Sevtap, Badali, Hamid, Ben-Ami, Ronen, Bonifaz, Alexandro, Bretagne, Stéphane, Castagnola, Elio, Chayakulkeeree, Methee, Colombo, Arnaldo L, Corzo-León, Dora E, Drgona, Lubos, Groll, Andreas H, Guinea, Jesus, Heussel, Claus-Peter, Ibrahim, Ashraf S, Kanj, Souha S, Klimko, Nikolay, Lackner, Michaela, Lamoth, Frederic, Lanternier, Fanny, Lass-Floerl, Cornelia, Lee, Dong-Gun, Lehrnbecher, Thomas, Lmimouni, Badre E, Mares, Mihai, Maschmeyer, Georg, Meis, Jacques F, Meletiadis, Joseph, Morrissey, C Orla, Nucci, Marcio, Oladele, Rita, Pagano, Livio, Pasqualotto, Alessandro, Patel, Atul, Racil, Zdenek, Richardson, Malcolm, Roilides, Emmanuel, Ruhnke, Markus, Seyedmousavi, Seyedmojtaba, Sidharthan, Neeraj, Singh, Nina, Sinko, János, Skiada, Anna, Slavin, Monica, Soman, Rajeev, Spellberg, Brad, Steinbach, William, Tan, Ban Hock, Ullmann, Andrew J, Vehreschild, Jörg J, Vehreschild, Maria JGT, Walsh, Thomas J, White, P Lewis, Wiederhold, Nathan P, Zaoutis, Theoklis, Chakrabarti, Arunaloke, and Group, Mucormycosis ECMM MSG Global Guideline Writing

Subjects
Clinical Research, Good Health and Well Being, Disease Management, Humans, Mucormycosis, Mucormycosis ECMM MSG Global Guideline Writing Group, Clinical Sciences, Medical Microbiology, Public Health and Health Services, Microbiology
Abstract

Mucormycosis is a difficult to diagnose rare disease with high morbidity and mortality. Diagnosis is often delayed, and disease tends to progress rapidly. Urgent surgical and medical intervention is lifesaving. Guidance on the complex multidisciplinary management has potential to improve prognosis, but approaches differ between health-care settings. From January, 2018, authors from 33 countries in all United Nations regions analysed the published evidence on mucormycosis management and provided consensus recommendations addressing differences between the regions of the world as part of the "One World One Guideline" initiative of the European Confederation of Medical Mycology (ECMM). Diagnostic management does not differ greatly between world regions. Upon suspicion of mucormycosis appropriate imaging is strongly recommended to document extent of disease and is followed by strongly recommended surgical intervention. First-line treatment with high-dose liposomal amphotericin B is strongly recommended, while intravenous isavuconazole and intravenous or delayed release tablet posaconazole are recommended with moderate strength. Both triazoles are strongly recommended salvage treatments. Amphotericin B deoxycholate is recommended against, because of substantial toxicity, but may be the only option in resource limited settings. Management of mucormycosis depends on recognising disease patterns and on early diagnosis. Limited availability of contemporary treatments burdens patients in low and middle income settings. Areas of uncertainty were identified and future research directions specified.

Published
2019

26. Rezafungin versus caspofungin for treatment of candidaemia and invasive candidiasis (ReSTORE): a multicentre, double-blind, double-dummy, randomised phase 3 trial

Author

Akova, Murat, AlAgha, Rawan, Alangaden, George, Albrecht, Svenja J, Alexander, Barbara, Al-Obaidi, Mohanad, Ambasch, German, Armestar Rodriguez, Fernando, Azap, Alpay, Baffoe-Bonnie, Anthony, Belkhir, Leila, Ben-Ami, Ronen, Boutoille, David, Cascio, Antonio, Chai, Louis YA, Chaiwarith, Romanee, Chayakulkeeree, Methee, Chen, Sharon, Chen, Yee-Chun, Chen, Yen-Hsu, Choi, Jun Yong, Choi, Young Hwa, Chotiprasitsakul, Darunee, Chung, Jin Won, Danion, François, Denis, Blandine, Diaz Santos, Emilio, Dictar, Miguel O, Diltoer, Marc, Dupont, Herve, Feng, Sizhou, Ferre Colomer, Maria Angeles, Ferrer, Ricard, Forel, Jean-Marie Fernand Roger, Fortún-Abete, Jesús, Garcia-Diaz, Julia, Girardis, Massimo, He, Fang, Hites, Maya, Ho, Mao-Wang, Honore, Patrick, Horcajada Gallego, Juan Pablo, Huang, Haihui, Huang, Po-Yen, Huang, Yong, Hussein, Osamah, Intalapaporn, Poj, Jaruratanasirikul, Sutep, Jauregui-Peredo, Luis, Johnson, Misty, Jung, Dong Sik, Jutivorakool, Kamonwan, Kern, Winfried V, Kett, Daniel H, Khawcharoenporn, Thana, Kim, Young Keun, Koehler, Philipp, Kotanidou, Anastasia, Lachiewicz, Anne, Lin, Qinhan, Lopez Cortes, Luis Eduardo, Luo, Hong, Luzzati, Roberto, Maor, Yasmin, McCarty, Todd, Merelli, Maria, Merino Amador, Paloma, Midturi, John, Migliorino, Guglielmo Marco, Mira, Jean-Paul, Mootsikapun, Piroon, Morrissey, Orla, Munoz Garcia de Paredes, Patricia, Mussini, Cristina, Mylonakis, Eleftherios, Nseir, Saadalla, Nseir, William, Odabasi, Zekaver, Papastamopoulos, Vasileios, Paterson, David, Patterson, Thomas F, Peck, Kyong Ran, Peng, Zhiyong, Permpalung, Nitipong, Plantefeve, Gaetan J, Poromanski, Ivan G, Powell, Debra, Psichogiou, Mina, Puah, Ser Hon, Pullman, John, Rahav, Galia, Martinez, Antonio Ramos, Ramos Ramos, Juan Carlos, Raz-Pasteur, Ayelet, Restrepo Castro, Carlos A, Riera, Fernando, Roblot, France, Rodriguez Alvarez, Regino Jose, Rogers, Benjamin, Roilides, Emmanuel, Sanchez Vallejo, Gregorio, Sganga, Gabriele, Sipsas, Nikolaos, Slavin, Monica, Soriano, Alex, Spec, Andrej, Strahilevitz, Jacob, Tancheva, Dora M, Tao, Zhen, Teschner, Daniel, Thompson, George R, Van Wijngaerden, Eric, Vazquez, Jose, Vergidis, Paschalis, Viale, Pierluigi, Wang, Fu-Der, Wang, Shifu, Weber, Gabriel, Weng, Jianyu, Xu, Jinfu, Yao, Li, Yavuz, Serap, Yilmaz, Mesut, Young, Jo-Anne, Zarate, Abel H, Zeng, Jun, Zhang, Yong, Thompson, George R, III, Cornely, Oliver A, Kullberg, Bart Jan, Kollef, Marin, Honore, Patrick M, Bassetti, Matteo, Poromanski, Ivan, Dignani, Cecilia, Das, Anita F, Sandison, Taylor, and Pappas, Peter G

Published
2023
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29. Mycobacterial infections in adults with haematological malignancies and haematopoietic stem cell transplants: guidelines from the 8th European Conference on Infections in Leukaemia

Author

Greinix, Hildegard, Maertens, Johan, De Greef, Julien, Slavin, Monica, Spriet, Isabel, Hubacek, Petr, Bergeron, Anne, Cordonnier, Catherine, Kanerva, Jukka, Herbrecht, Raoul, Herrmann, Jean-Louis, Lanternier, Fanny, Bondeelle, Louise, Robin, Christine, Einsele, Hermann, Lehrnbecher, Thomas, Groll, Andreas, Maschmeyer, Georg, Lange, Christoph, von Lilienfeld-Toal, Marie, Pana, Dorothea, Roilides, Emmanuel, Kassa, Csaba, Averbuch, Diana, Engelhard, Dan, Cesaro, Simone, Mikulska, Malgorzata, Pagano, Livio, Castagnola, Elio, Compagno, Francesca, Goletti, Delia, Mesini, Alessio, Donnelly, Peter J, Styczynski, Jan, Botelho de Sousa, Aida, Aljurf, Mahmoud, de la Camara, Rafael, Navarro, David, Rovira, Montserrat, Franquet, Tomas, Garcia-Vidal, Carol, Ljungman, Per, Paukssen, Karlis, Ammann, Roland, Lamoth, Frédéric, Hirsch, Hans, Ritz, Nicole, Akova, Murat, Ceesay, Mansour, Warris, Adilia, Chemaly, Roy, and Donnelly, J Peter

Published
2022
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34. A Pilot RCT of Direct Oral Challenge (DOC) vs Routine Care for Low-Risk Penicillin Allergy in Critical Illness: The ORACLE Study

Author

Rose, Morgan, primary, Trubiano, Jason, additional, Holmes, Natasha, additional, Slavin, Monica, additional, Vogrin, Sara, additional, Bellomo, Rinaldo, additional, Warrillow, Stephen, additional, Eastwood, Glenn, additional, Peel, Trisha, additional, Phung, Michelle, additional, Barnes, Sara, additional, Rogers, Benjamin, additional, Collis, Brennan, additional, Lambros, Belinda, additional, Murfin, Brendan, additional, James, Fiona, additional, Cox, Fionnuala, additional, and De Luca, Joseph, additional

Published
2024
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36. [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
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37. Multi-site implementation of whole genome sequencing for hospital infection control: A prospective genomic epidemiological analysis

Author

Sherry, Norelle L., Gorrie, Claire L., Kwong, Jason C., Higgs, Charlie, Stuart, Rhonda L., Marshall, Caroline, Ballard, Susan A., Sait, Michelle, Korman, Tony M., Slavin, Monica A., Lee, Robyn S., Graham, Maryza, Leroi, Marcel, Worth, Leon J., Chan, Hiu Tat, Seemann, Torsten, Grayson, M. Lindsay, and Howden, Benjamin P.

Published
2022
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41. Neutropenic Sepsis in the Intensive Care Unit: Differences in Clinical Profile and Outcomes According to the Cause of Neutropenia.

Author

MacPhail, Aleece, Dendle, Claire, Slavin, Monica, Weinkove, Robert, Bailey, Michael, Pilcher, David, and McQuilten, Zoe

Subjects
INTENSIVE care units, SEPSIS, NEUTROPENIA, TREATMENT effectiveness, HEMATOLOGIC malignancies
Abstract

Background Neutropenic sepsis frequently requires admission to an intensive care unit (ICU). Differences between subgroups of patients with neutropenic sepsis are not well characterized. Aims To investigate clinical outcomes among patients with neutropenic sepsis and hematological malignancy, metastatic solid cancer, or no cancer diagnosis. Methods Retrospective cohort study of all patients admitted to ICU in Australia or New Zealand between January 2000 and December 2022 with a primary admission diagnosis of sepsis and total white cell count <1.0 × 109 cells/L. Results We identified 8617 ICU admissions with neutropenic sepsis (hematological malignancy n = 4660; metastatic solid cancer n = 1034; no cancer n = 2800). Patients with hematological malignancy were younger (median, 61.5 years) with low rates of chronic comorbidities (4.7%) and were usually admitted to ICU from the ward (67.4%). Mechanical ventilation rates were 20.2% and in-hospital mortality was 30.6%. Patients with metastatic solid cancers were older (median, 66.3 years), with higher rates of chronic comorbidities (9.9%), and were usually admitted to the ICU from the emergency department (50.8%). Mechanical ventilation rates were 16.9% and in-hospital mortality was 42.4%. Patients with no documented cancer had highest rates of mechanical ventilation (41.7%) and mortality (46.3%). Neutropenia was independently associated with mortality among patients with solid cancers or no cancer but did not confer increased risk among patients with hematological malignancy (odds ratio, 0.98; 95% confidence interval,.90–1.06; P =.60). Conclusions Patients with neutropenic sepsis and hematological malignancy, metastatic solid cancer, or no cancer diagnosis constitute 3 distinct clinical groups. Management approaches should be tailored accordingly. [ABSTRACT FROM AUTHOR]

Published
2024
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42. Infective complications in cancer patients treated with subcutaneous versus intravenous trastuzumab and rituximab: An individual patient data meta-analysis.

Author

Alexander, Marliese, Jachno, Kim, Phillips, Kelly-Anne, Seymour, John F, Slavin, Monica A, Cheung, Ada, Shen, Vivian, Maarouf, Dana, Wolfe, Rory, and Lingaratnam, Senthil

Subjects
RISK assessment, DRUG administration routes, TRASTUZUMAB, CANCER patient medical care, CANCER patients, INFECTION, RITUXIMAB, DESCRIPTIVE statistics, META-analysis, INTRAVENOUS therapy, MONOCLONAL antibodies, CONFIDENCE intervals, SUBCUTANEOUS injections, DISEASE complications
Abstract

Background: Investigation of infection risk with subcutaneous versus intravenous trastuzumab and rituximab administration in an individual patient data (IPD) and published data meta-analysis of randomised controlled trials (RCTs). Methods: Databases were searched to September 2021. Primary outcomes were serious and high-grade infection. Relative-risk (RR) and 95% confidence intervals (95%CI) were calculated using random-effects models. Results: IPD meta-analysis (6 RCTs, 2971 participants, 2320 infections) demonstrated higher infection incidence with subcutaneous versus intravenous administration, without reaching statistical significance (serious: 12.2% versus 9.3%, RR 1.28, 95%CI 0.93to1.77, P = 0.13; high-grade: 12.2% versus 9.9%, RR 1.32, 95%CI 0.98to1.77, P = 0.07). With exclusion of an outlying study in post-hoc analysis, increased risks were statistically significant (serious: 13.1% versus 8.4%, RR 1.53, 95%CI 1.14to2.06, P = 0.01; high-grade: 13.2% versus 9.3%, RR 1.56, 95%CI 1.16to2.11, P < 0.01). Published data meta-analysis (8 RCTs, 3745 participants, 648 infections) demonstrated higher incidence of serious (HR 1.31, 95%CI 1.02to1.68, P = 0.04) and high-grade (HR 1.52, 95%CI 1.17to1.98, P < 0.01) infection with subcutaneous versus intravenous administration. Conclusions: Results suggest increased infection risk with subcutaneous versus intravenous administration, although IPD findings are sensitive to exclusion of one trial with inconsistent results and identified risk-of-bias. Ongoing trials may confirm findings. Clinical surveillance should be considered when switching to subcutaneous administration. PROSPERO registration CRD42020221866/CRD42020125376. [ABSTRACT FROM AUTHOR]

Published
2024
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47. A Mycoses Study Group international prospective study of phaeohyphomycosis: an analysis of 99 proven/probable cases

Author

Revankar, Sanjay G, Baddley, John W, Chen, Sharon C-A, Kauffman, Carol A, Slavin, Monica, Vazquez, Jose A, Seas, Carlos, Morris, Michele I, Nguyen, M Hong, Shoham, Shmuel, Thompson, George R, Alexander, Barbara D, Simkins, Jacques, Ostrosky-Zeichner, Luis, Mullane, Kathleen, Alangaden, George, Andes, David R, Cornely, Oliver A, Wahlers, Kerstin, Lockhart, Shawn R, and Pappas, Peter G

Subjects
Infectious Diseases, Infection, Good Health and Well Being, dematiaceous fungus, itraconazole, phaeohyphomycosis, voriconazole
Abstract

BackgroundPhaeohyphomycosis is infection caused by dematiaceous, or darkly pigmented, fungi. The spectrum of disease is broad, and optimal therapy remains poorly defined. The Mycoses Study Group established an international case registry of patients with proven/probable phaeohyphomycosis with the goal of improving the recognition and management of these infections.MethodsPatients from 18 sites in 3 countries were enrolled from 2009-2015. Cases were categorized as local superficial, local deep (pulmonary, sinus, osteoarticular infections), and disseminated infections. End points were clinical response (partial and complete) and all-cause mortality at 30 days and end of follow-up.ResultsOf 99 patients, 32 had local superficial infection, 41 had local deep infection, and 26 had disseminated infection. The most common risk factors were corticosteroids, solid organ transplantation, malignancy, and diabetes. Cultures were positive in 98% of cases. All-cause mortality was 16% at 30 days and 33% at end of follow-up, and 18 of 26 (69%) with dissemination died. Itraconazole was most commonly used for local infections, and voriconazole was used for more severe infections, often in combination with terbinafine or amphotericin B.ConclusionsPhaeohyphomycosis is an increasingly recognized infection. Culture remains the most frequently used diagnostic method. Triazoles are currently the drugs of choice, often combined with other agents. Further studies are needed to develop optimal therapies for disseminated infections.

Published
2017

49. Global guideline for the diagnosis and management of rare mould infections: an initiative of the European Confederation of Medical Mycology in cooperation with the International Society for Human and Animal Mycology and the American Society for Microbiology

Author

Hoenigl, Martin, Salmanton-García, Jon, Walsh, Thomas J, Nucci, Marcio, Neoh, Chin Fen, Jenks, Jeffrey D, Lackner, Michaela, Sprute, Rosanne, Al-Hatmi, Abdullah M S, Bassetti, Matteo, Carlesse, Fabianne, Freiberger, Tomas, Koehler, Philipp, Lehrnbecher, Thomas, Kumar, Anil, Prattes, Juergen, Richardson, Malcolm, Revankar, Sanjay, Slavin, Monica A, Stemler, Jannik, Spiess, Birgit, Taj-Aldeen, Saad J, Warris, Adilia, Woo, Patrick C Y, Young, Jo-Anne H, Albus, Kerstin, Arenz, Dorothee, Arsic-Arsenijevic, Valentina, Bouchara, Jean-Philippe, Chinniah, Terrence Rohan, Chowdhary, Anuradha, de Hoog, G Sybren, Dimopoulos, George, Duarte, Rafael F, Hamal, Petr, Meis, Jacques F, Mfinanga, Sayoki, Queiroz-Telles, Flavio, Patterson, Thomas F, Rahav, Galia, Rogers, Thomas R, Rotstein, Coleman, Wahyuningsih, Retno, Seidel, Danila, and Cornely, Oliver A

Published
2021
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