المؤلفون: Sassine, Joseph¹ (AUTHOR), Hirsch, Hans H.² (AUTHOR), Chemaly, Roy F.^1,3 (AUTHOR) rfchemaly@mdanderson.org

المصدر: Clinical Microbiology & Infection. Mar2024, Vol. 30 Issue 3, p270-275. 6p.

مصطلحات موضوعية: *CELL transplantation, *CELLULAR therapy, *VIRUS diseases, *RESPIRATORY infections, *CLINICAL trials

المؤلفون: Jahn, Kathleen¹ (AUTHOR), Karakioulaki, Meropi^1,2 (AUTHOR), Schumann, Desiree M.¹ (AUTHOR), Hirsch, Hans H.^3,4,5 (AUTHOR), Leuzinger, Karoline^3,4 (AUTHOR), Grize, Leticia¹ (AUTHOR), Aliberti, Stefano^6,7 (AUTHOR), Sotgiu, Giovanni⁸ (AUTHOR), Tamm, Michael¹ (AUTHOR), Stolz, Daiana^1,2 (AUTHOR) daiana.stolz@uniklinik-freiburg.de

المصدر: European Journal of Internal Medicine. Feb2024, Vol. 120, p52-61. 10p.

مصطلحات موضوعية: *IMMUNOCOMPROMISED patients, *BRONCHOALVEOLAR lavage, *RESPIRATORY infections, *RESPIRATORY agents, *C-reactive protein

مستخلص: • BAL influences management and affects survival in immunosuppressed patients. • The origin of immunosuppression plays a significant role. • Individual virus infection is associated with different risk of negative outcome. Respiratory infections are an important cause of morbidity and mortality in immunocompromised individuals. Fiberoptic bronchoscopy with bronchoalveolar lavage (BAL) is an important tool to detect infectious agents in immunocompromised patients with low respiratory tract infections (LRTI). BAL changes the management of immunocompromised patients with suspected LRTI. Immunocompromised patients with a suspicion of LRTI underwent diagnostic BAL. The primary composite outcome consisted of pre-defined modifications in the management of the immunocompromised patients following BAL. We quantified the impact of bronchoscopy up to 30 days after the procedure. A total of 2666 visits from 1301 patients were included in the study and immunosuppression was classified as haematological (n = 1040; 544 patients), solid organ transplantation (n = 666; 107 patients) and other causes (n = 960; 650 patients). BAL led to a change in management in 52.36% (n = 1396) of all cases. This percentage, as well as the 30-day mortality differed significantly amongst the three groups. Age, C-reactive protein and aetiology of infection determined significantly the risk of 30-day mortality in all patients. In 1.89% (n = 50) of all cases, a combination of 2 respiratory viral agents was identified and 24.23% (n = 646) were diagnosed with a single respiratory viral agent. BAL leads to changes in management in the majority of immunosuppressed patients. There is a high prevalence of multimicrobial infections and respiratory viral infections in immunocompromised patients with respiratory symptoms. Individual virus infection is associated with diverse risk of a negative outcome. [ABSTRACT FROM AUTHOR]

المؤلفون: Teh, Benjamin W^1,2 (AUTHOR) ben.teh@petermac.org, Mikulska, Malgorzata^1,3,4 (AUTHOR), Averbuch, Dina^5,6 (AUTHOR), de la Camara, Rafael⁷ (AUTHOR), Hirsch, Hans H^8,9 (AUTHOR), Akova, Murat¹⁰ (AUTHOR), Ostrosky-Zeichner, Luis¹¹ (AUTHOR), Baddley, John W¹² (AUTHOR), Tan, Ban Hock¹³ (AUTHOR), Mularoni, Alessandra¹⁴ (AUTHOR), Subramanian, Aruna K¹⁵ (AUTHOR), La Hoz, Ricardo M¹⁶ (AUTHOR), Marinelli, Tina¹⁷ (AUTHOR), Boan, Peter^18,19 (AUTHOR), Aguado, Jose Maria²⁰ (AUTHOR), Grossi, Paolo A²¹ (AUTHOR), Maertens, Johan²² (AUTHOR), Mueller, Nicolas J^1,23 (AUTHOR), Slavin, Monica A^1,2,24 (AUTHOR)

المصدر: Lancet Infectious Diseases. Jan2024, Vol. 24 Issue 1, pe59-e68. 10p.

مصطلحات موضوعية: *IMMUNOCOMPROMISED patients, *STEM cell transplantation, *THERAPEUTICS, *TRANSPLANTATION of organs, tissues, etc., *INFECTION

مستخلص: Patients can be immunocompromised from a diverse range of disease and treatment factors, including malignancies, autoimmune disorders and their treatments, and organ and stem-cell transplantation. Infections are a leading cause of morbidity and mortality in immunocompromised patients, and the disease treatment landscape is continually evolving. Despite being a critical but preventable and curable adverse event, the reporting of infection events in randomised trials lacks sufficient detail while inconsistency of categorisation and definition of infections in observational and registry studies limits comparability and future pooling of data. A core reporting dataset consisting of category, site, severity, organism, and endpoints was developed as a minimum standard for reporting of infection events in immunocompromised patients across study types. Further additional information is recommended depending on study type. The standardised reporting of infectious events and attributable complications in immunocompromised patients will improve diagnostic, treatment, and prevention approaches and facilitate future research in this patient group. [ABSTRACT FROM AUTHOR]

المؤلفون: Kardas, Piotr¹, Leboeuf, Céline¹, Hirsch, Hans H.^1,2,3 hans.hirsch@unibas.ch

المصدر: Journal of Clinical Virology. Oct2015, Vol. 71, p28-33. 6p.

مصطلحات موضوعية: *BK virus, *IMMUNOCOMPROMISED patients, *POLYOMAVIRUSES, *HEALTH counseling, *IMMUNOGLOBULIN G, *EPIDEMIOLOGY

مستخلص: Background Polyomavirus JC (JCPyV) and BK (BKPyV) can cause significant diseases in immunocompromised patients including nephropathy, hemorrhagic cystitis, and leukoencephalopathy. Recently, JCPyV and BKPyV IgG have been explored as risk predictors in multiple sclerosis and transplant patients, but sensitivity, specificity and quantification issues limit current performance. Objective To improve JCPyV and BKPyV-specific antibody testing. Study design Healthy blood donor sera ( N = 400) were tested at dilutions 1:100, 1:200, and 1:400 for JCPyV- and BKPyV-specific IgG using VP1 virus-like particle (VLP)-based ELISAs normalized to a laboratory reference serum. Normalized optical density 492 nm greater or equal 0.1 in all 3 dilutions was regarded as reactive. Sera with discordant reactivity in at least one dilution were retested after VLP preadsorption. Results At dilutions 1:100, 1:200, and 1:400, IgG reactivity was 74%, 60% and 53% for JCPyV, and 93%, 86% and 74% for BKPyV, respectively. At these dilutions, JCPyV-VLP preadsorption identified 56, 4 and 0 false-positives and 0, 4 and 27 false-negatives, respectively. Dilution-dependent sensitivity was 100%, 98%, and 89%, and specificity 65, 98%, and 100%, respectively. For sera diluted 100-, 200-, and 400-fold, BKPyV-VLP preadsorption identified 28, 1 and 0 false-positives, and 0, 0 and 46 false-negatives, and sensitivity was 100%, 100%, 86%, and specificity 50%, 98%, 100%, respectively. Conclusion For seroepidemiology studies, normalized JCPyV and BKPyV IgG ELISA at 1:200 serum dilution provides optimal sensitivity and specificity with the lowest false-positive and false-negative rate. For individual risk assessment, dilutions of 100, 200, and 400 combined with preadsorption for low-reactive sera may be most appropriate. [ABSTRACT FROM AUTHOR]

المؤلفون: Giesen, Nicola¹ (AUTHOR) nicola.giesen@med.uni-heidelberg.de, Sprute, Rosanne^2,3 (AUTHOR), Rüthrich, Maria^4,5 (AUTHOR), Khodamoradi, Yascha⁶ (AUTHOR), Mellinghoff, Sibylle C.^2,3,7 (AUTHOR), Beutel, Gernot^8,9 (AUTHOR), Lueck, Catherina^8,9 (AUTHOR), Koldehoff, Michael^9,10 (AUTHOR), Hentrich, Marcus¹¹ (AUTHOR), Sandherr, Michael¹² (AUTHOR), von Bergwelt-Baildon, Michael^9,13 (AUTHOR), Wolf, Hans-Heinrich¹⁴ (AUTHOR), Hirsch, Hans H.^15,16,17 (AUTHOR), Wörmann, Bernhard¹⁸ (AUTHOR), Cornely, Oliver A.^2,3 (AUTHOR), Köhler, Philipp^2,3 (AUTHOR), Schalk, Enrico^9,19 (AUTHOR), von Lilienfeld-Toal, Marie^4,5 (AUTHOR)

المصدر: European Journal of Cancer. Apr2021, Vol. 147, p154-160. 7p.

مصطلحات موضوعية: *COVID-19, *IMMUNIZATION, *IMMUNOCOMPROMISED patients, *CANCER patients, *MEDICAL protocols

مستخلص: The worldwide spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the associated infectious coronavirus disease (COVID-19) has posed a unique challenge to medical staff, patients and their families. Patients with cancer, particularly those with haematologic malignancies, have been identified to be at high risk to develop severe COVID-19. Since publication of our previous guideline on evidence-based management of COVID-19 in patients with cancer, research efforts have continued and new relevant data has come to light, maybe most importantly in the field of vaccination studies. Therefore, an update of our guideline on several clinically important topics is warranted. Here, we provide a concise update of evidence-based recommendations for rapid diagnostics, viral shedding, vaccination and therapy of COVID-19 in patients with cancer. This guideline update was prepared by the Infectious Diseases Working Party (AGIHO) of the German Society for Haematology and Medical Oncology by critically reviewing the currently available data on these topics applying evidence-based medicine criteria. • Immunocompromised patients are at risk of prolonged viral shedding of SARS-CoV-2. • Remdesivir still has a role in COVID-19 therapy in patients with cancer. • Vaccination of patients with cancer against COVID-19 is recommended. • Patients with cancer with active disease should be prioritised for vaccination. [ABSTRACT FROM AUTHOR]