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Salmanton-García J, Marchesi F, Farina F, Weinbergerová B, Itri F, Dávila-Valls J, Martín-Pérez S, Glenthøj A, Hersby DS, Gomes da Silva M, Nunes Rodrigues R, López-García A, Córdoba R, Bilgin YM, Falces-Romero I, El-Ashwah S, Emarah Z, Besson C, Kohn M, Van Doesum J, Ammatuna E, Marchetti M, Labrador J, Zambrotta GPM, Verga L, Jaksic O, Nucci M, Piukovics K, Cabirta-Touzón A, Jiménez M, Arellano E, Espigado I, Blennow O, Nordlander A, Meers S, van Praet J, Aiello TF, Garcia-Vidal C, Fracchiolla N, Sciumè M, Seval GC, Žák P, Buquicchio C, Tascini C, Gräfe SK, Schönlein M, Adžić-Vukičević T, Bonuomo V, Cattaneo C, Nizamuddin S, Čerňan M, Plantefeve G, Prin R, Szotkovski T, Collins GP, Dargenio M, Petzer V, Wolf D, Čolović N, Prezioso L, Valković T, Passamonti F, Méndez GA, Sili U, Vena A, Bavastro M, Limongelli A, Duarte RF, Ledoux MP, Cvetanoski M, Stojanoski Z, Machado M, Batinić J, Magliano G, Biernat MM, Pantić N, Poulsen CB, Cuccaro A, Del Principe MI, Kulasekararaj A, Ormazabal-Vélez I, Busca A, Demirkan F, Ijaz M, Klimko N, Stoma I, Khostelidi S, Fernández N, Omrani AS, Bergantim R, De Jonge N, Fouquet G, Navrátil M, Abu-Zeinah G, Samarkos M, Maertens J, De Ramón C, Guidetti A, Magyari F, González-López TJ, Lahmer T, Finizio O, Ali N, Pinczés LI, Lavilla-Rubira E, Romano A, Merelli M, Delia M, Calbacho M, Meletiadis J, Antić D, Hernández-Rivas JÁ, Marques de Almeida J, Al-Khabori M, Hoenigl M, Tisi MC, Khanna N, Barać A, Eisa N, Di Blasi R, Liévin R, Miranda-Castillo C, Bahr NC, Lamure S, Papa MV, Yahya A, Aujayeb A, Novák J, Erben N, Fernández-Galán M, Ribera-Santa Susana JM, Rinaldi I, Fazzi R, Piedimonte M, Duléry R, Gonzaga Y, Soto-Silva A, Sapienza G, Serris A, Drgoňa Ľ, Groh A, Serrano L, Gavriilaki E, Tragiannidis A, Prattes J, Coppola N, Otašević V, Mladenović M, Mitrović M, Mišković B, Jindra P, Zompi S, Sacchi MV, Krekeler C, Infante MS, García-Bordallo D, Çolak GM, Mayer J, Nygaard M, Hanáková M, Ráčil Z, Bonanni M, Koehler P, Rahimli L, Cornely OA, Pagano L. Decoding the historical tale: COVID-19 impact on haematological malignancy patients-EPICOVIDEHA insights from 2020 to 2022. EClinicalMedicine 2024; 71:102553. [PMID: 38533127 PMCID: PMC10963230 DOI: 10.1016/j.eclinm.2024.102553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 02/29/2024] [Accepted: 03/01/2024] [Indexed: 03/28/2024] Open
Abstract
Background The COVID-19 pandemic heightened risks for individuals with hematological malignancies due to compromised immune systems, leading to more severe outcomes and increased mortality. While interventions like vaccines, targeted antivirals, and monoclonal antibodies have been effective for the general population, their benefits for these patients may not be as pronounced. Methods The EPICOVIDEHA registry (National Clinical Trials Identifier, NCT04733729) gathers COVID-19 data from hematological malignancy patients since the pandemic's start worldwide. It spans various global locations, allowing comprehensive analysis over the first three years (2020-2022). Findings The EPICOVIDEHA registry collected data from January 2020 to December 2022, involving 8767 COVID-19 cases in hematological malignancy patients from 152 centers across 41 countries, with 42% being female. Over this period, there was a significant reduction in critical infections and an overall decrease in mortality from 29% to 4%. However, hospitalization, particularly in the ICU, remained associated with higher mortality rates. Factors contributing to increased mortality included age, multiple comorbidities, active malignancy at COVID-19 onset, pulmonary symptoms, and hospitalization. On the positive side, vaccination with one to two doses or three or more doses, as well as encountering COVID-19 in 2022, were associated with improved survival. Interpretation Patients with hematological malignancies still face elevated risks, despite reductions in critical infections and overall mortality rates over time. Hospitalization, especially in ICUs, remains a significant concern. The study underscores the importance of vaccination and the timing of COVID-19 exposure in 2022 for enhanced survival in this patient group. Ongoing monitoring and targeted interventions are essential to support this vulnerable population, emphasizing the critical role of timely diagnosis and prompt treatment in preventing severe COVID-19 cases. Funding Not applicable.
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Affiliation(s)
- Jon Salmanton-García
- University of Cologne, Faculty of Medicine, and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany
- University of Cologne, Faculty of Medicine, University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany
- German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - Francesco Marchesi
- Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | | | - Barbora Weinbergerová
- Masaryk University and University Hospital Brno - Department of Internal Medicine, Hematology and Oncology, Brno, Czech Republic
| | - Federico Itri
- San Luigi Gonzaga Hospital - Orbassano, Orbassano, Italy
| | | | | | - Andreas Glenthøj
- Department of Hematology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Ditte Stampe Hersby
- Department of Hematology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | | | | | - Alberto López-García
- Fundación Jimenez Diaz University Hospital, Health Research Institute IIS-FJD, Madrid, Spain
| | - Raúl Córdoba
- Fundación Jimenez Diaz University Hospital, Health Research Institute IIS-FJD, Madrid, Spain
| | | | - Iker Falces-Romero
- Microbiology and Parasitology Department, University Hospital La Paz, Madrid, Spain
- CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
| | | | - Ziad Emarah
- Oncology Center, Mansoura University, Mansoura, Egypt
- King Abdullah Medical City, Makkah, Saudi Arabia
| | - Caroline Besson
- Centre Hospitalier de Versailles, Le Chesnay, France
- Université Paris-Saclay, UVSQ, Inserm, Équipe “Exposome et Hérédité”, CESP, Villejuif, France
| | - Milena Kohn
- Centre Hospitalier de Versailles, Le Chesnay, France
- Université Paris-Saclay, UVSQ, Inserm, Équipe “Exposome et Hérédité”, CESP, Villejuif, France
| | | | | | - Monia Marchetti
- Hematology and Transplant Unit, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Jorge Labrador
- Department of Hematology, Research Unit, Hospital Universitario de Burgos, Burgos, Spain
| | | | - Luisa Verga
- Azienda Ospedaliera San Gerardo - Monza, Monza, Italy
- Università Milano-Bicocca, Milan, Italy
| | | | - Marcio Nucci
- Department of Internal Medicine, Federal University of Rio de Janeiro and Grupo Oncoclinicas, Rio de Janeiro, Brazil
| | - Klára Piukovics
- Department of Internal Medicine, South Division Faculty of Medicine University of Szeged, Szeged, Hungary
| | - Alba Cabirta-Touzón
- Department of Hematology, Vall d’Hebron Hospital Universitari, Experimental Hematology, Vall d’Hebron Institute of Oncology (VHIO), Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Moraima Jiménez
- Department of Hematology, Vall d’Hebron Hospital Universitari, Experimental Hematology, Vall d’Hebron Institute of Oncology (VHIO), Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Elena Arellano
- Department of Hematology, University Hospital Virgen Macarena - University Hospital Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS/CSIC), Universidad de Sevilla (Departamento de Medicina), Seville, Spain
| | - Ildefonso Espigado
- Department of Hematology, University Hospital Virgen Macarena - University Hospital Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS/CSIC), Universidad de Sevilla (Departamento de Medicina), Seville, Spain
| | - Ola Blennow
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Anna Nordlander
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | | | - Jens van Praet
- Department of Nephrology and Infectious diseases, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium
| | - Tommaso Francesco Aiello
- Department of Infectious Diseases, Hospital Clinic de Barcelona, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Carolina Garcia-Vidal
- Department of Infectious Diseases, Hospital Clinic de Barcelona, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Nicola Fracchiolla
- Hematology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Mariarita Sciumè
- Hematology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Pavel Žák
- University Hospital Hradec Králové, Hradec Králové, Czech Republic
| | | | - Carlo Tascini
- Azienda Sanitaria Universitaria del Friuli Centrale, Udine, Italy
| | | | - Martin Schönlein
- Department of Oncology, Hematology and Bone Marrow Transplantation with Section of Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | | | | | - Summiya Nizamuddin
- Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
| | - Martin Čerňan
- University Hospital Olomouc, Olomouc, Czech Republic
| | - Gaëtan Plantefeve
- Head ICU and CRC, Centre Hospitalier Victor DUPOUY, Argenteuil, France
| | - Romane Prin
- CRA from CRC Centre Hospitalier Victor DUPOUY, Argenteuil, France
| | | | | | | | - Verena Petzer
- Department of Hematology and Oncology, Comprehensive Cancer Center Innsbruck (CCCI), Medical University of Innsbruck (MUI), Innsbruck, Austria
| | - Dominik Wolf
- Department of Hematology and Oncology, Comprehensive Cancer Center Innsbruck (CCCI), Medical University of Innsbruck (MUI), Innsbruck, Austria
| | | | - Lucia Prezioso
- Hospital University of Parma - Hematology and Bone Marrow Unit, Parma, Italy
| | - Toni Valković
- University Hospital Centre Rijeka, Rijeka, Croatia
- Croatian Cooperative Group for Hematological Diseases (CROHEM), Croatia
- Faculty of Medicine and Faculty of Health Studies of University of Rijeka, Rijeka, Croatia
| | - Francesco Passamonti
- Department of Medicine and Surgery, University of Insubria and ASST Sette Laghi, Ospedale di Circolo of Varese, Varese, Italy
| | | | - Uluhan Sili
- Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Marmara University, Istanbul, Turkey
| | | | | | | | | | | | | | | | - Marina Machado
- Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Josip Batinić
- Croatian Cooperative Group for Hematological Diseases (CROHEM), Croatia
- University Hospital Centre Zagreb, Zagreb, Croatia
- Faculty of Medicine University of Zagreb, Zagreb, Croatia
| | | | | | - Nikola Pantić
- University Clinical Center of Serbia, Belgrade, Serbia
| | | | - Annarosa Cuccaro
- Hematology Unit, Center for Translational Medicine, Azienda USL Toscana NordOvest, Livorno, Italy
- National Cancer Institute, Fondazione ‘G. Pascale’, IRCCS, Hematology-Oncology and Stem Cell Transplantation Unit, Naples, Italy
| | | | - Austin Kulasekararaj
- Department of Hematological Medicine, King's College Hospital NHS Foundation Trust, London, United Kingdom
| | | | - Alessandro Busca
- Stem Cell Transplant Center, AOU Citta’ della Salute e della Scienza, Turin, Italy
| | - Fatih Demirkan
- Dokuz Eylul University, Division of Hematology, Izmir, Turkey
| | - Marriyam Ijaz
- Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
| | - Nikolai Klimko
- North-Western State Medical University Named after Iliá Ilich Méchnikov, Saint-Petersburg, Russia
| | - Igor Stoma
- Gomel State Medical University, Gomel, Belarus
| | - Sofya Khostelidi
- North-Western State Medical University Named after Iliá Ilich Méchnikov, Saint-Petersburg, Russia
| | - Noemí Fernández
- Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | | | - Rui Bergantim
- Centro Hospitalar e Universitário São João, Porto, Portugal
| | - Nick De Jonge
- Amsterdam UMC, Location VUmc, Amsterdam, Netherlands
| | | | | | | | - Michail Samarkos
- Laikon Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | | | - Anna Guidetti
- University of Milan and Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - Ferenc Magyari
- Division of Hematology, Department of Internal Medicine, University of Debrecen, Debrecen, Hungary
| | | | - Tobias Lahmer
- Medizinische Klinik II, Klinikum Rechts der Isar, TU München, Munich, Germany
| | | | | | - László Imre Pinczés
- Division of Hematology, Department of Internal Medicine, University of Debrecen, Debrecen, Hungary
| | | | | | - Maria Merelli
- Azienda Sanitaria Universitaria del Friuli Centrale, Udine, Italy
| | - Mario Delia
- Hematology and Stem Cell Transplantation Unit, AOUC Policlinico, Bari, Italy
| | | | - Joseph Meletiadis
- Clinical Microbiology Laboratory, Medical School, “Attikon” University General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Darko Antić
- University Clinical Center of Serbia, Belgrade, Serbia
| | | | | | | | - Martin Hoenigl
- Division of Infectious Diseases, ECMM Excellence Center for Clinical Mycology, Department of Internal Medicine, Medical University of Graz, Austria
- BioTechMed, Graz, Austria
| | | | - Nina Khanna
- University Hospital of Basel, Basel, Switzerland
| | | | - Noha Eisa
- Aseer Central Hospital, Abha, Saudi Arabia
- Oncology Center Mansoura University, Mansoura, Egypt
| | | | | | | | - Nathan C. Bahr
- University of Kansas Medical Center, Kansas City, United States
| | - Sylvain Lamure
- Department of Clinical Hematology, Montpellier University Hospital, IGMM UMR5535 CNRS, University of Montpellier, Montpellier, France
| | | | - Ayel Yahya
- Aseer Central Hospital, Abha, Saudi Arabia
| | | | - Jan Novák
- University Hospital of Královské Vinohrady, Prague, Czech Republic
| | - Nurettin Erben
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine Eskisehir Osmangazi University, Eskisehir, Turkey
| | | | | | | | - Rita Fazzi
- Hematology and Stem Cell Transplant Unit, Osperadiela University Pisana Company, Pisa, Italy
| | | | - Rémy Duléry
- Service d'Hématologie Clinique et de Thérapie Cellulaire, Hôpital Saint Antoine, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Inserm UMRs 938, Paris, France
| | - Yung Gonzaga
- Instituto Nacional do Cancer, Rio de Janeiro, Brazil
| | - Andrés Soto-Silva
- Faculty of Medicine, University of Chile. Infectious Diseases Unity, Salvador Hospital of Santiago, Santiago de Chile, Chile
| | - Giuseppe Sapienza
- Azienda Ospedaliera “Ospedali Riuniti Villa Sofia-Cervello”, Palermo, Italy
| | | | - Ľuboš Drgoňa
- Comenius University and National Cancer Institute, Bratislava, Slovakia
| | - Ana Groh
- Universitätsklinikum Frankfurt am Main, Frankfurt am Main, Germany
| | | | - Eleni Gavriilaki
- General Hospital of Thessaloniki “George Papanikolaou”, Thessaloniki, Greece
| | | | | | - Nicola Coppola
- Department of Mental Health and Public Medicine, University of Campania, Naples, Italy
| | | | | | | | - Bojana Mišković
- Center for Radiology, University Clinical Center of Serbia, Belgrade, Serbia
| | - Pavel Jindra
- University Hospital Pilsen, Pilsen, Czech Republic
| | - Sofia Zompi
- Stem Cell Transplant Center, AOU Citta’ della Salute e della Scienza, Turin, Italy
| | - Maria Vittoria Sacchi
- Hematology and Transplant Unit, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Carolin Krekeler
- Department of Medicine A for Hematology, Oncology and Pneumology, University Hospital Münster, Münster, Germany
| | | | | | - Gökçe Melis Çolak
- Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Jiří Mayer
- Masaryk University and University Hospital Brno - Department of Internal Medicine, Hematology and Oncology, Brno, Czech Republic
| | | | - Michaela Hanáková
- Institute of Hematology and Blood Transfusion, Prague, Czech Republic
- Department of Physiology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Zdeněk Ráčil
- Institute of Hematology and Blood Transfusion, Prague, Czech Republic
- Department of Physiology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Matteo Bonanni
- Hematology Unit, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Rome, Italy
- Hematology Unit, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Philipp Koehler
- University of Cologne, Faculty of Medicine, and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany
- University of Cologne, Faculty of Medicine, University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany
| | - Laman Rahimli
- University of Cologne, Faculty of Medicine, and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany
- University of Cologne, Faculty of Medicine, University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany
| | - Oliver A. Cornely
- University of Cologne, Faculty of Medicine, and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany
- University of Cologne, Faculty of Medicine, University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany
- German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Clinical Trials Centre Cologne (ZKS Köln), Cologne, Germany
| | - Livio Pagano
- Hematology Unit, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Rome, Italy
- Hematology Unit, Università Cattolica del Sacro Cuore, Rome, Italy
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De Greef J, Averbuch D, Tondeur L, Duréault A, Zuckerman T, Roussel X, Robin C, Xhaard A, Pagliuca S, Beguin Y, Botella-Garcia C, Khanna N, Le Bourgeois A, Van Praet J, Ho A, Kröger N, Ducastelle Leprêtre S, Roos-Weil D, Aljurf M, Blijlevens N, Blau IW, Carlson K, Collin M, Ganser A, Villate A, Lakner J, Martin S, Nagler A, Ram R, Torrent A, Stamouli M, Mikulska M, Gil L, Wendel L, Tridello G, Knelange N, de la Camara R, Lortholary O, Fontanet A, Styczynski J, Maertens J, Coussement J, Lebeaux D. Risk factors for Nocardia infection among allogeneic hematopoietic cell transplant recipients: A case-control study of the Infectious Diseases Working Party of the European Society for Blood and Marrow Transplantation. J Infect 2024; 88:106162. [PMID: 38663756 DOI: 10.1016/j.jinf.2024.106162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 04/15/2024] [Accepted: 04/15/2024] [Indexed: 05/03/2024]
Abstract
OBJECTIVES Nocardiosis is a rare but life-threatening infection after hematopoietic cell transplantation (HCT). We aimed at identifying risk factors for nocardiosis after allogeneic HCT and clarifying the effect of trimethoprim-sulfamethoxazole prophylaxis on its occurrence. METHODS We performed a retrospective multicenter case-control study of patients diagnosed with nocardiosis after allogeneic HCT between January 2000 and December 2018. For each case, two controls were matched by center, transplant date, and age group. Multivariable analysis was conducted using conditional logistic regression to identify potential risk factors for nocardiosis. Kaplan-Meier survival curves of cases and controls were compared using log-rank tests. RESULTS Sixty-four cases and 128 controls were included. Nocardiosis occurred at a median of 9 months after allogeneic HCT (interquartile range: 5-18). After adjustment for potential confounders in a multivariable model, Nocardia infection was associated with tacrolimus use (adjusted odds ratio [aOR] 9.9, 95 % confidence interval [95 % CI]: 1.6-62.7), lymphocyte count < 500/µL (aOR 8.9, 95 % CI: 2.3-34.7), male sex (aOR 8.1, 95 % CI: 2.1-31.5), recent use of systemic corticosteroids (aOR 7.9, 95 % CI: 2.2-28.2), and recent CMV infection (aOR 4.3, 95 % CI: 1.2-15.9). Conversely, use of trimethoprim-sulfamethoxazole prophylaxis was associated with a significantly decreased risk of nocardiosis (aOR 0.2, 95 % CI: 0.1-0.8). HCT recipients who developed nocardiosis had a significantly decreased survival, as compared with controls (12-month survival: 58 % and 90 %, respectively; p < 0.0001). CONCLUSIONS We identified six factors independently associated with the occurrence of nocardiosis among allogeneic HCT recipients. In particular, trimethoprim-sulfamethoxazole prophylaxis was found to protect against nocardiosis.
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Affiliation(s)
- Julien De Greef
- Department of Internal Medicine and Infectious Diseases, Cliniques universitaires Saint-Luc, Université catholique de Louvain (UCLouvain), Brussels, Belgium
| | - Dina Averbuch
- Pediatric Infectious Diseases, Faculty of Medicine, Hebrew University of Jerusalem, Hadassah Medical Center, Jerusalem, Israel
| | - Laura Tondeur
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Université Paris Cité, 75015 Paris, France
| | - Amélie Duréault
- Centre d'Infectiologie Necker Pasteur, Hôpital Necker-Enfants Malades, Assistance Publique - Hôpitaux de Paris, Université Paris Descartes, Paris, France
| | - Tsila Zuckerman
- Rambam Health Care Campus, Haifa, Israel; Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Xavier Roussel
- Department of Hematology, University of Franche-Comte, INSERM UMR1098, Besançon University Hospital, Besançon, France
| | - Christine Robin
- Department of Hematology, Henri Mondor University Hospital, Creteil, France
| | - Alienor Xhaard
- Hematology-Transplantation, Hospital St-Louis, Paris Diderot University, Paris, France
| | - Simona Pagliuca
- Hematology Department, Nancy University Hospital, Vandoeuvre-lès-Nancy, France
| | - Yves Beguin
- Centre Hospitalier Universitaire of Liège and University of Liège, Liège, Belgium
| | | | - Nina Khanna
- Division of Infectious Diseases and Hospital Epidemiology, University and University Hospital of Basel, Basel, Switzerland
| | | | - Jens Van Praet
- Department of Nephrology and Infectious Diseases, Algemeen Ziekenhuis Sint-Jan Brugge-Oostende, Brugge, Belgium
| | | | - Nicolaus Kröger
- Department of Stem Cell Transplantation, University Medical Center, Hamburg, Germany
| | | | | | - Mahmoud Aljurf
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Nicole Blijlevens
- Department of Hematology, Radboud University Medical Center, Nijmegen, the Netherlands
| | | | | | - Matthew Collin
- Nordern Centre for Bone Marrow Transplantation Freeman Hospital - Adult HSCT Unit, Newcastle, United Kingdom
| | - Arnold Ganser
- Department of Hematology Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
| | - Alban Villate
- Service d'hématologie et thérapie cellulaire, Centre Hospitalier Universitaire de Tours, Université de Tours, Tours, France
| | - Johannes Lakner
- Medical Clinic III, University Medical Center, Rostock, Germany
| | | | - Arnon Nagler
- Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Ron Ram
- Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Anna Torrent
- ICO-Hospital Germans Trias i Pujol, Josep Carreras Research Institute, Badalona, Spain
| | | | - Malgorzata Mikulska
- Division of Infectious Diseases, Department of Health Sciences, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Lidia Gil
- European Society for Blood and Marrow Transplantation (EBMT), Leiden Study Unit, Leiden, the Netherlands
| | - Lotus Wendel
- European Society for Blood and Marrow Transplantation (EBMT), Leiden Study Unit, Leiden, the Netherlands
| | - Gloria Tridello
- European Society for Blood and Marrow Transplantation (EBMT), Leiden Study Unit, Leiden, the Netherlands
| | - Nina Knelange
- European Society for Blood and Marrow Transplantation (EBMT), Leiden Study Unit, Leiden, the Netherlands
| | - Rafael de la Camara
- Hospital de la Princesa, Madrid, Spain; Infectious Diseases Working Party, EBMT, Spain
| | - Olivier Lortholary
- Centre d'Infectiologie Necker Pasteur, Hôpital Necker-Enfants Malades, Assistance Publique - Hôpitaux de Paris, Université Paris Descartes, Paris, France
| | - Arnaud Fontanet
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Université Paris Cité, 75015 Paris, France; Unité PACRI, Conservatoire National des Arts et Métiers, 75003 Paris, France
| | - Jan Styczynski
- Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz, Poland
| | - Johan Maertens
- Department of Hematology, Universitaire Ziekenhuizen Leuven, Leuven, Belgium
| | - Julien Coussement
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Victoria, Australia; Service de Maladies Infectieuses et Tropicales, Centre Hospitalier universitaire de Guadeloupe, Les Abymes, Guadeloupe, France.
| | - David Lebeaux
- Institut Pasteur, Université Paris Cité, CNRS UMR 6047, Genetics of Biofilms Laboratory, 75015 Paris, France; Département de Maladies Infectieuses et Tropicales, AP-HP, Hôpital Saint-Louis, Lariboisière, F-75010 Paris, France
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Jantarug K, Tripathi V, Morin B, Iizuka A, Kuehl R, Morgenstern M, Clauss M, Khanna N, Bumann D, Rivera-Fuentes P. A Far-Red Fluorescent Probe to Visualize Gram-Positive Bacteria in Patient Samples. ACS Infect Dis 2024. [PMID: 38632685 DOI: 10.1021/acsinfecdis.4c00060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
Gram-positive bacteria, in particular Staphylococcus aureus (S. aureus), are the leading bacterial cause of death in high-income countries and can cause invasive infections at various body sites. These infections are associated with prolonged hospital stays, a large economic burden, considerable treatment failure, and high mortality rates. So far, there is only limited knowledge about the specific locations where S. aureus resides in the human body during various infections. Hence, the visualization of S. aureus holds significant importance in microbiological research. Herein, we report the development and validation of a far-red fluorescent probe to detect Gram-positive bacteria, with a focus on staphylococci, in human biopsies from deep-seated infections. This probe displays strong fluorescence and low background in human tissues, outperforming current tools for S. aureus detection. Several applications are demonstrated, including fixed- and live-cell imaging, flow cytometry, and super-resolution bacterial imaging.
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Affiliation(s)
| | | | - Benedict Morin
- Department of Biomedicine, University of Basel, Basel 4031, Switzerland
| | - Aya Iizuka
- Department of Biomedicine, University of Basel, Basel 4031, Switzerland
| | - Richard Kuehl
- Department of Biomedicine, University of Basel, Basel 4031, Switzerland
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel 4031, Switzerland
- Center for Musculoskeletal Infections (ZMSI), Department for Orthopaedics and Trauma Surgery, University Hospital Basel, Basel 4031, Switzerland
| | - Mario Morgenstern
- Center for Musculoskeletal Infections (ZMSI), Department for Orthopaedics and Trauma Surgery, University Hospital Basel, Basel 4031, Switzerland
| | - Martin Clauss
- Center for Musculoskeletal Infections (ZMSI), Department for Orthopaedics and Trauma Surgery, University Hospital Basel, Basel 4031, Switzerland
| | - Nina Khanna
- Department of Biomedicine, University of Basel, Basel 4031, Switzerland
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel 4031, Switzerland
- Department of Clinical Research, University Hospital of Basel, Basel 4031, Switzerland
| | - Dirk Bumann
- Biozentrum, University of Basel, Basel 4056, Switzerland
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4
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König D, Sandholzer M, Uzun S, Zingg A, Ritschard R, Thut H, Glatz K, Kappos EA, Schaefer DJ, Kettelhack C, Passweg JR, Holbro A, Baur K, Medinger M, Buser A, Lardinois D, Jeker LT, Khanna N, Stenner F, Kasenda B, Homicsko K, Matter M, Rodrigues Mantuano N, Zippelius A, Läubli H. Melanoma clonal heterogeneity leads to secondary resistance after adoptive cell therapy with tumor-infiltrating lymphocytes. Cancer Immunol Res 2024:743089. [PMID: 38631025 DOI: 10.1158/2326-6066.cir-23-0757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 12/19/2023] [Accepted: 04/11/2024] [Indexed: 04/19/2024]
Abstract
Adoptive cell therapy (ACT) with tumor-infiltrating lymphocytes (TIL) is effective in melanoma patients, although long-term responses seem restricted to patients who have complete remissions. Many patients develop secondary resistance to TIL-ACT but the involved mechanisms are unclear. Here, we describe a case of secondary resistance to TIL-ACT likely due to intratumoral heterogeneity and selection of a resistant tumor cell clone by the transferred T cells. To our knowledge, this is the first case of clonal selection of a pre-existing non-dominant tumor cell clone and it demonstrates a mechanism involved in secondary resistance to TIL-ACT that could potentially change current clinical practice, because it advocates for T-cell collection from multiple tumor sites and analysis of tumor heterogeneity before the treatment with TIL-ACT.
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Affiliation(s)
| | | | - Sarp Uzun
- University of Basel, Basel, Switzerland
| | | | | | | | | | | | | | | | - Jakob R Passweg
- Department of Haematology, University Hospital, Basel, Switzerland
| | | | | | | | | | | | - Lukas T Jeker
- Basel University Hospital and University of Basel, Basel, Switzerland
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5
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Hosseini-Moghaddam SM, Kothari S, Humar A, Albasata H, Yetmar ZA, Razonable RR, Neofytos D, D'Asaro M, Boggian K, Hirzel C, Khanna N, Manuel O, Mueller NJ, Imlay H, Kabbani D, Tyagi V, Smibert OC, Nasra M, Fontana L, Obeid KM, Apostolopoulou A, Zhang SX, Permpalung N, Alhatimi H, Silverman MS, Guo H, Rogers BA, MacKenzie E, Pisano J, Gioia F, Rapi L, Prasad GVR, Banegas M, Alonso CD, Doss K, Rakita RM, Fishman JA. Adjunctive glucocorticoid therapy for Pneumocystis jirovecii pneumonia in solid organ transplant recipients: A multicenter cohort, 2015-2020. Am J Transplant 2024; 24:653-668. [PMID: 37977229 DOI: 10.1016/j.ajt.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 09/21/2023] [Accepted: 11/06/2023] [Indexed: 11/19/2023]
Abstract
Solid organ transplant recipients (SOTRs) frequently receive adjunctive glucocorticoid therapy (AGT) for Pneumocystis jirovecii pneumonia (PJP). This multicenter cohort of SOTRs with PJP admitted to 20 transplant centers in Canada, the United States, Europe, and Australia, was examined for whether AGT was associated with a lower rate of all-cause intensive care unit (ICU) admission, 90-day death, or a composite outcome (ICU admission or death). Of 172 SOTRs with PJP (median [IQR] age: 60 (51.5-67.0) years; 58 female [33.7%]), the ICU admission and death rates were 43.4%, and 20.8%, respectively. AGT was not associated with a reduced risk of ICU admission (adjusted odds ratio [aOR] [95% CI]: 0.49 [0.21-1.12]), death (aOR [95% CI]: 0.80 [0.30-2.17]), or the composite outcome (aOR [95% CI]: 0.97 [0.71-1.31]) in the propensity score-adjusted analysis. AGT was not significantly associated with at least 1 unit of the respiratory portion of the Sequential Organ Failure Assessment score improvement by day 5 (12/37 [32.4%] vs 39/111 [35.1%]; P = .78). We did not observe significant associations between AGT and ICU admission or death in SOTRs with PJP. Our findings should prompt a reevaluation of routine AGT administration in posttransplant PJP treatment and highlight the need for interventional studies.
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Affiliation(s)
- Seyed M Hosseini-Moghaddam
- Transplant Infectious Diseases and Ajmera Transplant Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Sagar Kothari
- Transplant Infectious Diseases and Ajmera Transplant Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Atul Humar
- Transplant Infectious Diseases and Ajmera Transplant Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Hanan Albasata
- Transplant Infectious Diseases and Ajmera Transplant Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Zachary A Yetmar
- Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Raymund R Razonable
- Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Dionysios Neofytos
- Transplant Infectious Diseases Unit, Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland
| | - Matilde D'Asaro
- Transplant Infectious Diseases Unit, Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland
| | - Katia Boggian
- Division of Infectious Diseases, Cantonal Hospital St Gallen, St Gallen, Switzerland
| | - Cedric Hirzel
- Department of Infectious Diseases, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Nina Khanna
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Basel, Basel, Switzerland
| | - Oriol Manuel
- Division of Infectious Diseases, University Hospital of Vaud, Lausanne, Switzerland
| | - Nicolas J Mueller
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Zurich, Switzerland
| | - Hannah Imlay
- Department of Internal Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Dima Kabbani
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Varalika Tyagi
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Olivia C Smibert
- Department of Infectious Diseases, Austin Health, Heidelberg, Victoria, Australia; Department of Medicine, The University of Melbourne at Austin Health, Heidelberg, Victoria, Australia; Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Victoria, Australia; The National Centre for Infections in Cancer, Peter MacCallum Cancer Centre, Parkville, Victoria, Australia
| | - Mohamed Nasra
- Department of Infectious Diseases, Austin Health, Heidelberg, Victoria, Australia; Department of Medicine, The University of Melbourne at Austin Health, Heidelberg, Victoria, Australia; Monash Health, Melbourne, Victoria, Australia
| | - Lauren Fontana
- Division of Infectious Diseases and International Medicine, University of Minnesota, Minneapolis, Minnesota, USA
| | - Karam M Obeid
- Division of Infectious Diseases and International Medicine, University of Minnesota, Minneapolis, Minnesota, USA
| | - Anna Apostolopoulou
- Transplant Infectious Disease Program and Transplant Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Sean X Zhang
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Nitipong Permpalung
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Hind Alhatimi
- Division of Infectious Diseases, Department of Medicine, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Michael S Silverman
- Division of Infectious Diseases, Department of Medicine, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Henry Guo
- Monash Health, Melbourne, Victoria, Australia
| | - Benjamin A Rogers
- Monash Health, Melbourne, Victoria, Australia; School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Erica MacKenzie
- Section of Infectious Diseases and Global Health, Department of Medicine, University of Chicago Medicine, Chicago, Illinois, USA
| | - Jennifer Pisano
- Section of Infectious Diseases and Global Health, Department of Medicine, University of Chicago Medicine, Chicago, Illinois, USA
| | - Francesca Gioia
- Department of Infectious Diseases, Hospital Roman y Cajal, Madrid, Spain
| | - Lindita Rapi
- Kidney Transplant Program, St. Michael Hospital, University of Toronto, Toronto, Ontario, Canada
| | - G V Ramesh Prasad
- Kidney Transplant Program, St. Michael Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Marcela Banegas
- Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Carolyn D Alonso
- Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Kathleen Doss
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Robert M Rakita
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Jay A Fishman
- Transplant Infectious Disease Program and Transplant Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
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6
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Brune JE, Dickenmann M, Sidler D, Walti LN, Golshayan D, Manuel O, Haidar F, Neofytos D, Schnyder A, Boggian K, Mueller TF, Schachtner T, Khanna N, Schaub S, Wehmeier C. Frequency and impact on renal transplant outcomes of urinary tract infections due to extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella species. Front Med (Lausanne) 2024; 11:1329778. [PMID: 38426162 PMCID: PMC10902035 DOI: 10.3389/fmed.2024.1329778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 01/02/2024] [Indexed: 03/02/2024] Open
Abstract
Background Enterobacterales are often responsible for urinary tract infection (UTI) in kidney transplant recipients. Among these, Escherichia coli or Klebsiella species producing extended-spectrum beta-lactamase (ESBL) are emerging. However, there are only scarce data on frequency and impact of ESBL-UTI on transplant outcomes. Methods We investigated frequency and impact of first-year UTI events with ESBL Escherichia coli and/or Klebsiella species in a prospective multicenter cohort consisting of 1,482 kidney transplants performed between 2012 and 2017, focusing only on 389 kidney transplants having at least one UTI with Escherichia coli and/or Klebsiella species. The cohort had a median follow-up of four years. Results In total, 139/825 (17%) first-year UTI events in 69/389 (18%) transplant recipients were caused by ESBL-producing strains. Both UTI phenotypes and proportion among all UTI events over time were not different compared with UTI caused by non-ESBL-producing strains. However, hospitalizations in UTI with ESBL-producing strains were more often observed (39% versus 26%, p = 0.04). Transplant recipients with first-year UTI events with an ESBL-producing strain had more frequently recurrent UTI (33% versus 18%, p = 0.02) but there was no significant difference in one-year kidney function as well as longer-term graft and patient survival between patients with and without ESBL-UTI. Conclusion First-year UTI events with ESBL-producing Escherichia coli and/or Klebsiella species are associated with a higher need for hospitalization but do neither impact allograft function nor allograft and patient survival.
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Affiliation(s)
- Jakob E. Brune
- Clinic for Transplantation Immunology and Nephrology, University Hospital Basel, Basel, Switzerland
| | - Michael Dickenmann
- Clinic for Transplantation Immunology and Nephrology, University Hospital Basel, Basel, Switzerland
| | - Daniel Sidler
- Clinic for Nephrology, Bern University Hospital, Bern, Switzerland
| | - Laura N. Walti
- Department of Infectious Diseases, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Déla Golshayan
- Transplantation Center, Lausanne University Hospital, Lausanne, Switzerland
| | - Oriol Manuel
- Transplantation Center, Lausanne University Hospital, Lausanne, Switzerland
- Infectious Diseases Service, Lausanne University Hospital, Lausanne, Switzerland
| | - Fadi Haidar
- Nephrology and Hypertension Service, Division of Medicine, University Hospital Geneva, Geneva, Switzerland
| | - Dionysios Neofytos
- Transplant Infectious Disease Service, Division of Infectious Diseases, University Hospital Geneva, Geneva, Switzerland
| | - Aurelia Schnyder
- Clinic for Nephrology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Katia Boggian
- Division of Infectious Diseases and Hospital Epidemiology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Thomas F. Mueller
- Clinic for Nephrology, University Hospital Zürich, Zürich, Switzerland
| | - Thomas Schachtner
- Clinic for Nephrology, University Hospital Zürich, Zürich, Switzerland
| | - Nina Khanna
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
| | - Stefan Schaub
- Clinic for Transplantation Immunology and Nephrology, University Hospital Basel, Basel, Switzerland
- Transplantation Immunology, Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Caroline Wehmeier
- Clinic for Transplantation Immunology and Nephrology, University Hospital Basel, Basel, Switzerland
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7
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Ragozzino S, Mueller NJ, Neofytos D, Passweg J, Müller A, Medinger M, Van Delden C, Masouridi-Levrat S, Chalandon Y, Tschudin-Sutter S, Khanna N. Epidemiology, outcomes and risk factors for recurrence of Clostridioides difficile infections following allogeneic hematopoietic cell transplantation: a longitudinal retrospective multicenter study. Bone Marrow Transplant 2024; 59:278-281. [PMID: 38036657 PMCID: PMC10849940 DOI: 10.1038/s41409-023-02157-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 11/07/2023] [Accepted: 11/16/2023] [Indexed: 12/02/2023]
Affiliation(s)
- Silvio Ragozzino
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
| | - Nicolas J Mueller
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland
| | - Dionysios Neofytos
- Transplant Infectious Diseases Unit, University Hospitals Geneva, Geneva, Switzerland
| | - Jakob Passweg
- Division of Hematology, University Hospital Basel, Basel, Switzerland
| | - Antonia Müller
- Department of Medical Oncology and Hematology, University Hospital Zurich, Zurich, Switzerland
- Department of Transfusion Medicine and Cell Therapy, Medical University of Vienna, Vienna, Austria
| | - Michael Medinger
- Division of Hematology, University Hospital Basel, Basel, Switzerland
| | - Christian Van Delden
- Transplant Infectious Diseases Unit, University Hospitals Geneva, Geneva, Switzerland
| | - Stavroula Masouridi-Levrat
- Division of Hematology, University Hospitals Geneva and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Yves Chalandon
- Division of Hematology, University Hospitals Geneva and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Sarah Tschudin-Sutter
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
| | - Nina Khanna
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland.
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8
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Søgaard KK, Hinic V, Goldenberger D, Gensch A, Schweitzer M, Bättig V, Siegemund M, Bassetti S, Bingisser R, Tamm M, Battegay M, Weisser M, Stolz D, Khanna N, Egli A. Evaluation of the clinical relevance of the Biofire © FilmArray pneumonia panel among hospitalized patients. Infection 2024; 52:173-181. [PMID: 37572241 PMCID: PMC10810975 DOI: 10.1007/s15010-023-02080-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 07/27/2023] [Indexed: 08/14/2023]
Abstract
PURPOSE Panel PCR tests provide rapid pathogen identification. However, their diagnostic performance is unclear. We assessed the performance of the Biofire© FilmArray pneumonia (PN)-panel against standard culture in broncho-alveolar lavage (BAL) samples. METHODS Setting: University Hospital Basel (February 2019 to July 2020), including hospitalized patients with a BAL (± pneumonia). We determined sensitivity and specificity of the PN-panel against standard culture. Using univariate logistic regression, we calculated odds ratios (OR) for pneumonia according to PN-panel and culture status, stratifying by chronic pulmonary disease. We calculated ORs for pneumonia for different pathogens to estimate the clinical relevance. RESULTS We included 840 adult patients, 60% were males, median age was 68 years, 35% had chronic pulmonary disease, 21% had pneumonia, and 36% had recent antibiotic use. In 1078 BAL samples, bacterial pathogens were detected in 36% and 16% with PN-panel and culture, respectively. The overall sensitivity and specificity of the PN-panel was high, whereas the positive predictive value was low. The OR of pneumonia was 1.1 (95% CI 0.7-1.6) for PN-panel-positive only; 2.6 (95% CI 1.3-5.3) for culture-positive only, and 1.6 (95% CI 1.0-2.4) for PN-panel and culture-positive. The detection rate of Haemophilus influenzae, Staphylococcus aureus, and Moraxella catarrhalis in the PN-panel was high but not associated with pneumonia. CONCLUSION While sensitivity and specificity of PN-panel are high compared to culture, pathogen detection did not correlate well with a pneumonia diagnosis. Patients with culture-positive BAL had the highest OR for pneumonia-thus the impact of the PN-panel on clinical management needs further evaluation in randomized controlled trials.
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Affiliation(s)
- Kirstine K Søgaard
- Clinical Bacteriology and Mycology, University Hospital Basel, 4031, Basel, Switzerland
- Department of Biomedicine, Applied Microbiology Research, University of Basel, Basel, Switzerland
- Department of Clinical Microbiology, Aalborg University Hospital, Aalborg, Denmark
| | - Vladimira Hinic
- Clinical Bacteriology and Mycology, University Hospital Basel, 4031, Basel, Switzerland
- Institute of Medical Microbiology, University of Zurich, Gloriastrasse 28/30 8006, Zurich, Switzerland
| | - Daniel Goldenberger
- Clinical Bacteriology and Mycology, University Hospital Basel, 4031, Basel, Switzerland
| | - Alexander Gensch
- Clinical Bacteriology and Mycology, University Hospital Basel, 4031, Basel, Switzerland
- Department of Biomedicine, Applied Microbiology Research, University of Basel, Basel, Switzerland
| | - Michael Schweitzer
- Clinical Bacteriology and Mycology, University Hospital Basel, 4031, Basel, Switzerland
- Department of Biomedicine, Applied Microbiology Research, University of Basel, Basel, Switzerland
| | - Veronika Bättig
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Martin Siegemund
- Intensive Care Medicine, University Hospital Basel, Basel, Switzerland
| | - Stefano Bassetti
- Internal Medicine, University Hospital Basel, Basel, Switzerland
| | - Roland Bingisser
- Emergency Medicine, University Hospital Basel, Basel, Switzerland
| | - Michael Tamm
- Pneumology, University Hospital Basel, Basel, Switzerland
| | - Manuel Battegay
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Maja Weisser
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Daiana Stolz
- Pneumology, University Hospital Basel, Basel, Switzerland
| | - Nina Khanna
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Adrian Egli
- Clinical Bacteriology and Mycology, University Hospital Basel, 4031, Basel, Switzerland.
- Department of Biomedicine, Applied Microbiology Research, University of Basel, Basel, Switzerland.
- Institute of Medical Microbiology, University of Zurich, Gloriastrasse 28/30 8006, Zurich, Switzerland.
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9
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Maffei E, Woischnig AK, Burkolter MR, Heyer Y, Humolli D, Thürkauf N, Bock T, Schmidt A, Manfredi P, Egli A, Khanna N, Jenal U, Harms A. Phage Paride can kill dormant, antibiotic-tolerant cells of Pseudomonas aeruginosa by direct lytic replication. Nat Commun 2024; 15:175. [PMID: 38168031 PMCID: PMC10761892 DOI: 10.1038/s41467-023-44157-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 12/01/2023] [Indexed: 01/05/2024] Open
Abstract
Bacteriophages are ubiquitous viral predators that have primarily been studied using fast-growing laboratory cultures of their bacterial hosts. However, microbial life in nature is mostly in a slow- or non-growing, dormant state. Here, we show that diverse phages can infect deep-dormant bacteria and suspend their replication until the host resuscitates ("hibernation"). However, a newly isolated Pseudomonas aeruginosa phage, named Paride, can directly replicate and induce the lysis of deep-dormant hosts. While non-growing bacteria are notoriously tolerant to antibiotic drugs, the combination with Paride enables the carbapenem meropenem to eradicate deep-dormant cultures in vitro and to reduce a resilient bacterial infection of a tissue cage implant in mice. Our work might inspire new treatments for persistent bacterial infections and, more broadly, highlights two viral strategies to infect dormant bacteria (hibernation and direct replication) that will guide future studies on phage-host interactions.
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Affiliation(s)
- Enea Maffei
- Biozentrum, University of Basel, Basel, Switzerland
- Institute of Food, Nutrition and Health, D-HEST, ETH Zurich, Zurich, Switzerland
| | - Anne-Kathrin Woischnig
- Laboratory of Infection Biology, Department of Biomedicine, University and University Hospital Basel, Basel, Switzerland
| | - Marco R Burkolter
- Biozentrum, University of Basel, Basel, Switzerland
- Institute of Food, Nutrition and Health, D-HEST, ETH Zurich, Zurich, Switzerland
| | - Yannik Heyer
- Biozentrum, University of Basel, Basel, Switzerland
| | - Dorentina Humolli
- Institute of Food, Nutrition and Health, D-HEST, ETH Zurich, Zurich, Switzerland
| | | | - Thomas Bock
- Biozentrum, University of Basel, Basel, Switzerland
| | | | | | - Adrian Egli
- Division of Clinical Bacteriology and Mycology, University Hospital Basel, Basel, Switzerland
- Applied Microbiology Research, Department of Biomedicine, University of Basel, Basel, Switzerland
- Division of Infectious Diseases and Hospital Epidemiology, University and University Hospital of Basel, Basel, Switzerland
| | - Nina Khanna
- Institute of Food, Nutrition and Health, D-HEST, ETH Zurich, Zurich, Switzerland
- Laboratory of Infection Biology, Department of Biomedicine, University and University Hospital Basel, Basel, Switzerland
| | - Urs Jenal
- Biozentrum, University of Basel, Basel, Switzerland
| | - Alexander Harms
- Biozentrum, University of Basel, Basel, Switzerland.
- Institute of Food, Nutrition and Health, D-HEST, ETH Zurich, Zurich, Switzerland.
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10
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Sollier J, Basler M, Broz P, Dittrich PS, Drescher K, Egli A, Harms A, Hierlemann A, Hiller S, King CG, McKinney JD, Moran-Gilad J, Neher RA, Page MGP, Panke S, Persat A, Picotti P, Rentsch KM, Rivera-Fuentes P, Sauer U, Stolz D, Tschudin-Sutter S, van Delden C, van Nimwegen E, Veening JW, Zampieri M, Zinkernagel AS, Khanna N, Bumann D, Jenal U, Dehio C. Revitalizing antibiotic discovery and development through in vitro modelling of in-patient conditions. Nat Microbiol 2024; 9:1-3. [PMID: 38177300 DOI: 10.1038/s41564-023-01566-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2024]
Affiliation(s)
| | - Marek Basler
- Biozentrum, University of Basel, Basel, Switzerland
| | - Petr Broz
- Department of Biochemistry, University of Lausanne, Epalinges, Switzerland
| | - Petra S Dittrich
- Department of Biosystems Science and Engineering, ETH Zurich, Basel, Switzerland
| | | | - Adrian Egli
- Institute of Medical Microbiology, University of Zurich, Zurich, Switzerland
| | - Alexander Harms
- Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Andreas Hierlemann
- Department of Biosystems Science and Engineering, ETH Zurich, Basel, Switzerland
| | | | - Carolyn G King
- Department of Biomedicine, University Basel, Basel, Switzerland
| | - John D McKinney
- School of Life Sciences, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Jacob Moran-Gilad
- Department of Health Policy and Management, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | | | | | - Sven Panke
- Department of Biosystems Science and Engineering, ETH Zurich, Basel, Switzerland
| | - Alexandre Persat
- School of Life Sciences, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Paola Picotti
- Institute of Molecular Systems Biology, Department of Biology, ETH Zurich, Zurich, Switzerland
| | | | | | - Uwe Sauer
- Institute of Molecular Systems Biology, Department of Biology, ETH Zurich, Zurich, Switzerland
| | - Daiana Stolz
- Clinic of Respiratory Medicine and Pulmonary Cell Research, University Hospital Basel, Basel, Switzerland
- Department of Pneumology, University Medical Center, Freiburg, Germany
| | - Sarah Tschudin-Sutter
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
- Department of Clinical Research, University Hospital Basel, Basel, Switzerland
| | | | | | - Jan-Willem Veening
- Department of Fundamental Microbiology, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Mattia Zampieri
- Department of Biomedicine, University Basel, Basel, Switzerland
| | - Annelies S Zinkernagel
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Nina Khanna
- Department of Biomedicine, University Basel, Basel, Switzerland
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
- Department of Clinical Research, University Hospital Basel, Basel, Switzerland
| | - Dirk Bumann
- Biozentrum, University of Basel, Basel, Switzerland
| | - Urs Jenal
- Biozentrum, University of Basel, Basel, Switzerland
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11
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Penack O, Tridello G, Salmenniemi U, Martino R, Khanna N, Perruccio K, Fagioli F, Richert-Przygonska M, Labussière-Wallet H, Maertens J, Jubert C, Aljurf M, Pichler H, Kriván G, Kunadt D, Popova M, Gabriel M, Calore E, Blau IW, Benedetti F, Itäla-Remes M, de Kort E, Russo D, Faraci M, Ménard AL, Borne PVD, Poiré X, Yesilipek A, Gozdzik J, Yeğin ZA, Yañez L, Facchini L, Van Gorkom G, Thurner L, Kocak U, Sampol A, Zuckerman T, Bierings M, Mielke S, Ciceri F, Wendel L, Knelange N, Mikulska M, Averbuch D, Styczynski J, Camara RDL, Cesaro S. Influence of invasive aspergillosis during acute leukaemia treatment on survival after allogeneic stem cell transplantation: a prospective study of the EBMT Infectious Diseases Working Party. EClinicalMedicine 2024; 67:102393. [PMID: 38152413 PMCID: PMC10751840 DOI: 10.1016/j.eclinm.2023.102393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 11/30/2023] [Accepted: 12/07/2023] [Indexed: 12/29/2023] Open
Abstract
Background Infections are the main reason for mortality during acute leukaemia treatment and invasive aspergillosis (IA) is a major concern. Allogeneic stem cell transplantation (alloSCT) is a standard therapy and often is the only live-saving procedure in leukaemia patients. The profound immunodeficiency occurring after alloSCT led to high IA-associated mortality in the past. Therefore, patients with IA were historically considered transplant-ineligible. Recently, there has been improvement of anti-fungal management including novel anti-fungal agents. As a result, more leukaemia patients with IA are undergoing alloSCT. Outcome has not been prospectively assessed. Methods We performed a prospective study in acute leukaemia patients undergoing alloSCT to analyse the impact of a prior history of probable or proven IA (pre-SCT IA). The primary endpoint was 1-year non-relapse mortality (NRM). Relapse free survival and overall survival were analysed as secondary endpoints. Findings 1439 patients were included between 2016 and 2021. The incidence of probable or proven pre-SCT IA was 6.0% (n = 87). The cumulative incidence of 1-year NRM was 17.3% (95% CI 10.2-26.0) and 11.2% (9.6-13.0) for patients with and without pre-SCT IA. In multivariate analyses the hazard ratio (HR) for 1-year NRM was 2.1 (1.2-3.6; p = 0.009) for patients with pre-SCT IA. One-year relapse-free survival was inferior in patients with pre-SCT IA (59.4% [48.3-68.9] vs. 70.4 [67.9-72.8]; multivariate HR 1.5 [1.1-2.1]; p = 0.02). Consequently, 1-year overall survival was lower in patients with pre-SCT IA: (68.8% [57.8-77.4] vs. 79.0% [76.7-81.1]; multivariate HR 1.7 [1.1-2.5]; p = 0.01). Interpretation Pre-SCT IA remains to be significantly associated with impaired alloSCT outcome. On the other hand, more than two thirds of patients with pre-SCT IA were alive at one year after alloSCT. IA is not anymore an absolute contraindication for alloSCT because the majority of patients with IA who undergo alloSCT benefit from this procedure. Funding There was no external funding source for this study.
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Affiliation(s)
- Olaf Penack
- Medizinische Klinik m. S. Hämatologie, Onkologie und Tumorimmunologie, Berlin, Germany
| | | | | | | | - Nina Khanna
- Division of Infectious Diseases, University Hospital, Basel, Switzerland
| | - Katia Perruccio
- Pediatric Oncology Hematology and Stem Cell Transplantation Program, Santa Maria Della Misericordia Hospital, Perugia
| | | | - Monika Richert-Przygonska
- Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz, Poland
| | | | | | - Charlotte Jubert
- CHU Bordeaux Groupe Hospitalier Pellegrin-Enfants, Bordeaux, France
| | - Mahmoud Aljurf
- King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia
| | - Herbert Pichler
- Department of Pediatrics and Adolescent Medicine, St. Anna Children's Hospital, Medical University of Vienna, Vienna, Austria
| | | | | | - Marina Popova
- RM Gorbacheva Research Institute, Pavlov University, St. Petersburg, Russian Federation
| | - Melissa Gabriel
- Cancer Centre for Children, The Children's Hospital at Westmead, Sydney, Australia
| | - Elisabetta Calore
- Pediatric Hematology Oncology and Stem Cell Transplant Division, Department of Women's and Children's Health, Azienda Ospedale-UniversitàPadova, Italy
| | - Igor Wolfgang Blau
- Medizinische Klinik m. S. Hämatologie, Onkologie und Tumorimmunologie, Berlin, Germany
| | | | | | - Elizabeth de Kort
- Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands
| | - Domenico Russo
- Unit of Blood Diseases and Bone Marrow Transplantation, Brescia University, Italy
| | - Maura Faraci
- HSCT Unit, Department of Hematology-Oncology, IRCCS Istituto G. Gaslini, Genova, Italy
| | | | | | - Xavier Poiré
- Cliniques Universitaires St. Luc, Brussels, Belgium
| | | | - Jolanta Gozdzik
- Department of Clinical Immunology and Transplantation, Jagiellonian University Medical Collage, University Children's Hospital in Krakow, Poland
| | | | - Lucrecia Yañez
- Hospital U. Marqués de Valdecilla-IDIVAL, Santander, Spain
| | | | | | - Lorenz Thurner
- Lorenz Thurner, University of Saarland, Homburg, Germany
| | - Ulker Kocak
- Gazi University School of Medicine, Ankara, Turkey
| | - Antònia Sampol
- Hospital Son Espases, Palma de Mallorca, Balearic Islands, Spain
| | - Tsila Zuckerman
- Rambam Medical Center, Technion –Faculty of Medicine. Haifa, Israel
| | - Marc Bierings
- Princess Maxima Center/ University Hospital for Children (WKZ), Utrecht, the Netherlands
| | | | - Fabio Ciceri
- Università Vita Salute San Raffaele, Milan, Italy
| | | | | | - Malgorzata Mikulska
- Division of Infectious Diseases, University of Genoa and Ospedale Policlinico San Martino, Genoa, Italy
| | - Dina Averbuch
- Pediatric Infectious Diseases, Faculty of Medicine, Hebrew University of Jerusalem, Hadassah Medical Center, Israel
| | - Jan Styczynski
- Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz, Poland
| | | | - Simone Cesaro
- Pediatric Hematology Oncology, Department of Mother and Child, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
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12
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Arendrup MC, Arikan-Akdagli S, Jørgensen KM, Barac A, Steinmann J, Toscano C, Arsenijevic VA, Sartor A, Lass-Flörl C, Hamprecht A, Matos T, Rogers BRS, Quiles I, Buil J, Özenci V, Krause R, Bassetti M, Loughlin L, Denis B, Grancini A, White PL, Lagrou K, Willinger B, Rautemaa-Richardson R, Hamal P, Ener B, Unalan-Altintop T, Evren E, Hilmioglu-Polat S, Oz Y, Ozyurt OK, Aydin F, Růžička F, Meijer EFJ, Gangneux JP, Lockhart DEA, Khanna N, Logan C, Scharmann U, Desoubeaux G, Roilides E, Talento AF, van Dijk K, Koehler P, Salmanton-García J, Cornely OA, Hoenigl M. European candidaemia is characterised by notable differential epidemiology and susceptibility pattern: Results from the ECMM Candida III study. J Infect 2023; 87:428-437. [PMID: 37549695 DOI: 10.1016/j.jinf.2023.08.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 07/25/2023] [Accepted: 08/03/2023] [Indexed: 08/09/2023]
Abstract
The objectives of this study were to assess Candida spp. distribution and antifungal resistance of candidaemia across Europe. Isolates were collected as part of the third ECMM Candida European multicentre observational study, conducted from 01 to 07-07-2018 to 31-03-2022. Each centre (maximum number/country determined by population size) included ∼10 consecutive cases. Isolates were referred to central laboratories and identified by morphology and MALDI-TOF, supplemented by ITS-sequencing when needed. EUCAST MICs were determined for five antifungals. fks sequencing was performed for echinocandin resistant isolates. The 399 isolates from 41 centres in 17 countries included C. albicans (47.1%), C. glabrata (22.3%), C. parapsilosis (15.0%), C. tropicalis (6.3%), C. dubliniensis and C. krusei (2.3% each) and other species (4.8%). Austria had the highest C. albicans proportion (77%), Czech Republic, France and UK the highest C. glabrata proportions (25-33%) while Italy and Turkey had the highest C. parapsilosis proportions (24-26%). All isolates were amphotericin B susceptible. Fluconazole resistance was found in 4% C. tropicalis, 12% C. glabrata (from six countries across Europe), 17% C. parapsilosis (from Greece, Italy, and Turkey) and 20% other Candida spp. Four isolates were anidulafungin and micafungin resistant/non-wild-type and five resistant to micafungin only. Three/3 and 2/5 of these were sequenced and harboured fks-alterations including a novel L657W in C. parapsilosis. The epidemiology varied among centres and countries. Acquired echinocandin resistance was rare but included differential susceptibility to anidulafungin and micafungin, and resistant C. parapsilosis. Fluconazole and voriconazole cross-resistance was common in C. glabrata and C. parapsilosis but with different geographical prevalence.
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Affiliation(s)
- Maiken Cavling Arendrup
- Unit of Mycology, Statens Serum Institut, Copenhagen, Denmark; Department of Clinical Microbiology, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
| | - Sevtap Arikan-Akdagli
- Department of Medical Microbiology, Hacettepe University Medical School, Ankara, Turkey
| | | | - Aleksandra Barac
- Clinic for Infectious and Tropical Diseases, University Clinical Center of Serbia, Belgrade, Serbia
| | - Jörg Steinmann
- Institute for Clincal Hygiene, Medical Microbiology and Infectiology, Paracelsus Medical University, Klinikum Nürnberg, Nuremberg, Germany
| | - Cristina Toscano
- Microbiology Laboratory, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal
| | - Valentina Arsic Arsenijevic
- Faculty of Medicine University of Belgrade, Institute of Microbiology and Immunology, Medical Mycology Reference Laboratory (MMRL), Belgrade, Serbia
| | - Assunta Sartor
- SC Microbiology, Department of Laboratory Medicine, Friuli Centrale University Health Authority, Udin, Italy
| | - Cornelia Lass-Flörl
- Institute of Hygiene and Medical Microbiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Axel Hamprecht
- University of Cologne, University Hospital Cologne, Institute for Medical Microbiology, Immunology and Hygiene, Cologne, Germany; University of Oldenburg, Institute for Medical Microbiology and Virology, Oldenburg, Germany
| | - Tadeja Matos
- Institute of Microbiology and Immunology, Medical Faculty, University of Ljubljana, Slovenia
| | - Benedict R S Rogers
- Department of Clinical Microbiology, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - Inmaculada Quiles
- Department of Microbiology, La Paz University Hospital, Madrid, Spain
| | - Jochem Buil
- Canisius Wilhelmina Hospital (CWZ), Medical Microbiology and Infectious Diseases, Nijmegen, the Netherlands; Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, the Netherlands; Center of Expertise in Mycology Radboudumc/CWZ, Nijmegen, the Netherlands
| | - Volkan Özenci
- Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, Sweden; Department of Clinical Microbiology, Karolinska University Hospital, Huddinge, Stockholm, Sweden
| | - Robert Krause
- Biotech Med, Graz, Austria; Division of Infectious Diseases, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Matteo Bassetti
- Infectious Diseases Unit, IRCCS San Martino Polyclinic Hospital, Genoa, Italy; Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Laura Loughlin
- Belfast Health and Social Care Trust, Belfast, United Kingdom
| | - Blandine Denis
- Department of Infectious Diseases, Hôpital Saint-Louis, Fernand Widal, Lariboisière, AP-HP, Paris, France
| | - Anna Grancini
- U.O.S Microbiology - Analysis Laboratory, IRCCS Foundation, Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - P Lewis White
- Public Health Wales Microbiology Cardiff and Cardiff University School of Medicine, United Kingdom
| | - Katrien Lagrou
- Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium; Department of Laboratory Medicine and National Reference Center for Mycosis University Hospitals Leuven, Leuven, Belgium
| | - Birgit Willinger
- Division of Clinical Microbiology, Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Riina Rautemaa-Richardson
- Mycology Reference Centre Manchester and Department of Infectious Diseases, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, United Kingdom; Division of Evolution, Infection and Genomics, Faculty of Biology, Medicine and Health, University of Manchester, United Kingdom
| | - Petr Hamal
- Department of Microbiology, Faculty of Medicine and Dentistry, Palacky University Olomouc, Olomouc, Czech Republic
| | - Beyza Ener
- Department of Medical Microbiology, Bursa Uludağ University Medical School, Bursa, Turkey
| | - Tugce Unalan-Altintop
- Department of Medical Microbiology, Hacettepe University Medical School, Ankara, Turkey
| | - Ebru Evren
- Department of Medical Microbiology, Ankara University Medical School, Ankara, Turkey
| | | | - Yasemin Oz
- Department of Medical Microbiology, Eskisehir Osmangazi University Medical School, Eskisehir, Turkey
| | - Ozlem Koyuncu Ozyurt
- Department of Medical Microbiology, Akdeniz University Medical School, Antalya, Turkey
| | - Faruk Aydin
- KTÜ Tıp Fakültesi Tıbbi Mikrobiyoloji AbD, Trabzon, Turkey
| | - Filip Růžička
- Masaryk University, Faculty of Medicine and St. Anne's Faculty Hospital, Department of Microbiology, Brno, Czech Republic
| | - Eelco F J Meijer
- Canisius Wilhelmina Hospital (CWZ), Medical Microbiology and Infectious Diseases, Nijmegen, the Netherlands; Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, the Netherlands; Center of Expertise in Mycology Radboudumc/CWZ, Nijmegen, the Netherlands
| | - Jean Pierre Gangneux
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail), UMR_S 1085, F-35000 Rennes, France
| | - Deborah E A Lockhart
- Department of Medical Microbiology, Aberdeen Royal Infirmary, Foresterhill, Aberdeen AB25 2ZN, United Kingdom; Institute of Medical Sciences, School of Medicine Medical Sciences & Nutrition, University of Aberdeen, Aberdeen AB25 2ZD, United Kingdom
| | - Nina Khanna
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Basel, Basel, Switzerland
| | - Clare Logan
- Clinical Infection Unit, St Georges University NHS Hospital Foundation Trust, Blackshaw Road, London, United Kingdom; Institute of Infection & Immunity, St Georges University London, Cranmer Terrace, London, United Kingdom
| | - Ulrike Scharmann
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Guillaume Desoubeaux
- Department of Parasitology-Mycology-Tropical medicine, CHRU Tours, Tours, France
| | - Emmanuel Roilides
- Hippokration General Hospital, Infectious Diseases Department, Medical School, Aristotle University of Thessaloniki, Greece
| | | | - Karin van Dijk
- Department of Medical Microbiology and Infection Control, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam Infection and Immunity Institute, Amsterdam, the Netherlands
| | - Philipp Koehler
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, and Excellence Center for Medical Mycology (ECMM), Cologne, Germany; University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Institute of Translational Research, Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany
| | - Jon Salmanton-García
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, and Excellence Center for Medical Mycology (ECMM), Cologne, Germany; University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Institute of Translational Research, Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany
| | - Oliver A Cornely
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, and Excellence Center for Medical Mycology (ECMM), Cologne, Germany; University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Institute of Translational Research, Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany
| | - Martin Hoenigl
- Biotech Med, Graz, Austria; Division of Infectious Diseases, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
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13
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Agnetti J, Büchler AC, Osthoff M, Helfenstein F, Weisser M, Siegemund M, Bassetti S, Bingisser R, Schaefer DJ, Clauss M, Hinic V, Tschudin-Sutter S, Bättig V, Khanna N, Egli A. Identification of microorganisms by a rapid PCR panel from positive blood cultures leads to faster optimal antimicrobial therapy - a before-after study. BMC Infect Dis 2023; 23:730. [PMID: 37884860 PMCID: PMC10601314 DOI: 10.1186/s12879-023-08732-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 10/20/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND The BioFire® FilmArray® Blood Culture Identification Panel 1 (BF-FA-BCIP) detects microorganisms with high accuracy in positive blood cultures (BC) - a key step in the management of patients with suspected bacteraemia. We aimed to compare the time to optimal antimicrobial therapy (OAT) for the BF-FA-BCIP vs. standard culture-based identification. METHODS In this retrospective single-centre study with a before-after design, 386 positive BC cases with identification by BF-FA-BCIP were compared to 414 controls with culture-based identification. The primary endpoint was the time from BC sampling to OAT. Secondary endpoints were time to effective therapy, length of stay, (re-)admission to ICU, in-hospital and 30-day mortality. Outcomes were assessed using Cox proportional hazard models and logistic regressions. RESULTS Baseline characteristics of included adult inpatients were comparable. Main sources of bacteraemia were urinary tract and intra-abdominal infection (19.2% vs. 22.0% and 16.8% vs. 15.7%, for cases and controls, respectively). Median (95%CI) time to OAT was 25.5 (21.0-31.2) hours with BF-FA-BCIP compared to 45.7 (37.7-51.4) hours with culture-based identification. We observed no significant difference for secondary outcomes. CONCLUSIONS Rapid microorganism identification by BF-FA-BCIP was associated with a median 20-h earlier initiation of OAT in patients with positive BC. No impact on length of stay and mortality was noted. TRIAL REGISTRATION Clinicaltrials.gov, NCT04156633, registered on November 5, 2019.
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Affiliation(s)
- Jessica Agnetti
- Clinical Bacteriology and Mycology, University Hospital Basel, Basel, Switzerland
- Department of Biomedicine, Applied Microbiology Research, University of Basel, Basel, Switzerland
| | - Andrea C Büchler
- Infectious Diseases and Hospital Epidemiology, University of Basel and University Hospital Basel, Basel, Switzerland
| | - Michael Osthoff
- Internal Medicine, University of Basel and University Hospital Basel, Basel, Switzerland
- Department of Clinical Research, University of Basel and University Hospital Basel, Basel, Switzerland
| | - Fabrice Helfenstein
- Department of Clinical Research, University of Basel and University Hospital Basel, Basel, Switzerland
| | - Maja Weisser
- Infectious Diseases and Hospital Epidemiology, University of Basel and University Hospital Basel, Basel, Switzerland
| | - Martin Siegemund
- Intensive Care Medicine, University Hospital Basel, Basel, Switzerland
| | - Stefano Bassetti
- Internal Medicine, University of Basel and University Hospital Basel, Basel, Switzerland
| | - Roland Bingisser
- Emergency Medicine, University Hospital Basel, Basel, Switzerland
| | - Dirk J Schaefer
- Plastic, Reconstructive, Aesthetic Surgery and Hand Surgery, University Hospital Basel, Basel, Switzerland
| | - Martin Clauss
- Center for Musculoskeletal Infections (ZMSI), University Hospital Basel, Basel, Switzerland
- Orthopaedics and Traumatology, University Hospital Basel, Basel, Switzerland
| | - Vladimira Hinic
- Clinical Bacteriology and Mycology, University Hospital Basel, Basel, Switzerland
- Present Address: Institute for Medical Microbiology, University of Zurich, Gloriastrasse 28/30, CH-8006, Zurich, Switzerland
| | - Sarah Tschudin-Sutter
- Infectious Diseases and Hospital Epidemiology, University of Basel and University Hospital Basel, Basel, Switzerland
| | - Veronika Bättig
- Infectious Diseases and Hospital Epidemiology, University of Basel and University Hospital Basel, Basel, Switzerland
| | - Nina Khanna
- Infectious Diseases and Hospital Epidemiology, University of Basel and University Hospital Basel, Basel, Switzerland
| | - Adrian Egli
- Clinical Bacteriology and Mycology, University Hospital Basel, Basel, Switzerland.
- Department of Biomedicine, Applied Microbiology Research, University of Basel, Basel, Switzerland.
- Present Address: Institute for Medical Microbiology, University of Zurich, Gloriastrasse 28/30, CH-8006, Zurich, Switzerland.
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14
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Abstract
Despite advances in monitoring and treatment, cytomegalovirus (CMV) infections remain one of the most common complications after solid organ transplantation (SOT). CMV infection may fail to respond to standard first- and second-line antiviral therapies with or without the presence of antiviral resistance to these therapies. This failure to respond after 14 days of appropriate treatment is referred to as "resistant/refractory CMV." Limited data on refractory CMV without antiviral resistance are available. Reported rates of resistant CMV are up to 18% in SOT recipients treated for CMV. Therapeutic options for treating these infections are limited due to the toxicity of the agent used or transplant-related complications. This is often the challenge with conventional agents such as ganciclovir, foscarnet and cidofovir. Recent introduction of new CMV agents including maribavir and letermovir as well as the use of adoptive T cell therapy may improve the outcome of these difficult-to-treat infections in SOT recipients. In this expert review, we focus on new treatment options for resistant/refractory CMV infection and disease in SOT recipients, with an emphasis on maribavir, letermovir, and adoptive T cell therapy.
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Affiliation(s)
- Carla Simone Walti
- Division of Infectious Diseases and Hospital Epidemiology, Departments of Biomedicine and Clinical Research, University and University Hospital of Basel, Basel, Switzerland
| | - Nina Khanna
- Division of Infectious Diseases and Hospital Epidemiology, Departments of Biomedicine and Clinical Research, University and University Hospital of Basel, Basel, Switzerland
| | - Robin K. Avery
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Ilkka Helanterä
- Department of Transplantation and Liver Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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15
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Palianina D, Di Roberto RB, Castellanos-Rueda R, Schlatter F, Reddy ST, Khanna N. A method for polyclonal antigen-specific T cell-targeted genome editing (TarGET) for adoptive cell transfer applications. Mol Ther Methods Clin Dev 2023; 30:147-160. [PMID: 37448595 PMCID: PMC10336339 DOI: 10.1016/j.omtm.2023.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 06/15/2023] [Indexed: 07/15/2023]
Abstract
Adoptive cell therapy of donor-derived, antigen-specific T cells expressing native T cell receptors (TCRs) is a powerful strategy to fight viral infections in immunocompromised patients. Determining the fate of T cells following patient infusion hinges on the ability to track them in vivo. While this is possible by genetic labeling of parent cells, the applicability of this approach has been limited by the non-specificity of the edited T cells. Here, we devised a method for CRISPR-targeted genome integration of a barcoded gene into Epstein-Barr virus-antigen-stimulated T cells and demonstrated its use for exclusively identifying expanded virus-specific cell lineages. Our method facilitated the enrichment of antigen-specific T cells, which then mediated improved cytotoxicity against Epstein-Barr virus-transformed target cells. Single-cell and deep sequencing for lineage tracing revealed the expansion profile of specific T cell clones and their corresponding gene expression signature. This approach has the potential to enhance the traceability and the monitoring capabilities during immunotherapeutic T cell regimens.
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Affiliation(s)
- Darya Palianina
- Department of Biomedicine, University and University Hospital of Basel, 4056 Basel, Switzerland
| | - Raphaël B. Di Roberto
- Department of Biosystems Science and Engineering, ETH Zürich, 4058 Basel, Switzerland
| | - Rocío Castellanos-Rueda
- Department of Biosystems Science and Engineering, ETH Zürich, 4058 Basel, Switzerland
- Life Science Zurich Graduate School, Systems Biology, ETH Zürich, University of Zurich, 8057 Zürich, Switzerland
| | - Fabrice Schlatter
- Department of Biosystems Science and Engineering, ETH Zürich, 4058 Basel, Switzerland
| | - Sai T. Reddy
- Department of Biosystems Science and Engineering, ETH Zürich, 4058 Basel, Switzerland
| | - Nina Khanna
- Department of Biomedicine, University and University Hospital of Basel, 4056 Basel, Switzerland
- Divsion of Infectious Diseases and Hospital Epidemiology, University Hospital of Basel, 4031 Basel, Switzerland
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16
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Baur K, Buser A, Jeker LT, Khanna N, Läubli H, Heim D, Dirks JC, Widmer CC, Volken T, Passweg JR, Holbro A. CD4+ CAR T-cell expansion is associated with response and therapy related toxicities in patients with B-cell lymphomas. Bone Marrow Transplant 2023; 58:1048-1050. [PMID: 37330601 PMCID: PMC10471494 DOI: 10.1038/s41409-023-02016-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 05/09/2023] [Accepted: 06/06/2023] [Indexed: 06/19/2023]
Affiliation(s)
- Katharina Baur
- Division of Hematology, University Hospital Basel, Basel, Switzerland.
- Innovation Focus on Cell Therapies, University Hospital Basel, Basel, Switzerland.
| | - Andreas Buser
- Division of Hematology, University Hospital Basel, Basel, Switzerland
- Innovation Focus on Cell Therapies, University Hospital Basel, Basel, Switzerland
- Blood Transfusion Service, Swiss Red Cross, Basel, Switzerland
| | - Lukas T Jeker
- Innovation Focus on Cell Therapies, University Hospital Basel, Basel, Switzerland
- Department of Biomedicine, University Hospital and University of Basel, Basel, Switzerland
- Transplantation Immunology & Nephrology, University Hospital Basel, Basel, Switzerland
| | - Nina Khanna
- Innovation Focus on Cell Therapies, University Hospital Basel, Basel, Switzerland
- Department of Biomedicine, University Hospital and University of Basel, Basel, Switzerland
- Division of Infectious Diseases and Hospital Epidemiology, University and University Hospital of Basel, Basel, Switzerland
| | - Heinz Läubli
- Innovation Focus on Cell Therapies, University Hospital Basel, Basel, Switzerland
- Department of Biomedicine, University Hospital and University of Basel, Basel, Switzerland
- Department of Internal Medicine, Division of Oncology, University Hospital Basel, Basel, Switzerland
| | - Dominik Heim
- Division of Hematology, University Hospital Basel, Basel, Switzerland
| | - Jan C Dirks
- Diagnostic Hematology, University Hospital, Basel, Switzerland
| | - Corinne C Widmer
- Division of Hematology, University Hospital Basel, Basel, Switzerland
- Diagnostic Hematology, University Hospital, Basel, Switzerland
| | - Thomas Volken
- Department of Health Institute for Public Health, ZHAW Zurich University of Applied Science, Winterthur, Switzerland
| | - Jakob R Passweg
- Division of Hematology, University Hospital Basel, Basel, Switzerland
- Innovation Focus on Cell Therapies, University Hospital Basel, Basel, Switzerland
| | - Andreas Holbro
- Division of Hematology, University Hospital Basel, Basel, Switzerland
- Innovation Focus on Cell Therapies, University Hospital Basel, Basel, Switzerland
- Blood Transfusion Service, Swiss Red Cross, Basel, Switzerland
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17
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Neofytos D, Stampf S, Hoessly LD, D’Asaro M, Tang GN, Boggian K, Hirzel C, Khanna N, Manuel O, Mueller NJ, Van Delden C. Bacteremia During the First Year After Solid Organ Transplantation: An Epidemiological Update. Open Forum Infect Dis 2023; 10:ofad247. [PMID: 37323422 PMCID: PMC10267299 DOI: 10.1093/ofid/ofad247] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 05/04/2023] [Indexed: 06/17/2023] Open
Abstract
Background There are limited contemporary data on the epidemiology and outcomes of bacteremia in solid organ transplant recipients (SOTr). Methods Using the Swiss Transplant Cohort Study registry from 2008 to 2019, we performed a retrospective nested multicenter cohort study to describe the epidemiology of bacteremia in SOTr during the first year post-transplant. Results Of 4383 patients, 415 (9.5%) with 557 cases of bacteremia due to 627 pathogens were identified. One-year incidence was 9.5%, 12.8%, 11.4%, 9.8%, 8.3%, and 5.9% for all, heart, liver, lung, kidney, and kidney-pancreas SOTr, respectively (P = .003). Incidence decreased during the study period (hazard ratio, 0.66; P < .001). One-year incidence due to gram-negative bacilli (GNB), gram-positive cocci (GPC), and gram-positive bacilli (GPB) was 5.62%, 2.81%, and 0.23%, respectively. Seven (of 28, 25%) Staphylococcus aureus isolates were methicillin-resistant, 2/67 (3%) enterococci were vancomycin-resistant, and 32/250 (12.8%) GNB produced extended-spectrum beta-lactamases. Risk factors for bacteremia within 1 year post-transplant included age, diabetes, cardiopulmonary diseases, surgical/medical post-transplant complications, rejection, and fungal infections. Predictors for bacteremia during the first 30 days post-transplant included surgical post-transplant complications, rejection, deceased donor, and liver and lung transplantation. Transplantation in 2014-2019, CMV donor-negative/recipient-negative serology, and cotrimoxazole Pneumocystis prophylaxis were protective against bacteremia. Thirty-day mortality in SOTr with bacteremia was 3% and did not differ by SOT type. Conclusions Almost 1/10 SOTr may develop bacteremia during the first year post-transplant associated with low mortality. Lower bacteremia rates have been observed since 2014 and in patients receiving cotrimoxazole prophylaxis. Variabilities in incidence, timing, and pathogen of bacteremia across different SOT types may be used to tailor prophylactic and clinical approaches.
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Affiliation(s)
- Dionysios Neofytos
- Correspondence: Dionysios Neofytos, MD, MPH, Service des Maladies Infectieuses, Hôpitaux Universitaires de Genève, Rue Gabrielle-Perret-Gentil 4, CH-1211 Genève 14, Switzerland (); or Christian van Delden, MD, Service des Maladies Infectieuses, Hôpitaux Universitaires de Genève, Rue Gabrielle-Perret-Gentil 4, CH-1211 Genève 14, Switzerland ()
| | - Susanne Stampf
- Clinic for Transplantation Immunology and Nephrology (Swiss Transplant Cohort Study), University Hospital of Basel, Basel, Switzerland
| | - Linard D Hoessly
- Clinic for Transplantation Immunology and Nephrology (Swiss Transplant Cohort Study), University Hospital of Basel, Basel, Switzerland
| | - Matilde D’Asaro
- Transplant Infectious Diseases Unit, Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland
| | - Gael Nguyen Tang
- Transplant Infectious Diseases Unit, Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland
| | - Katia Boggian
- Division of Infectious Diseases, Cantonal Hospital St Gallen, St Gallen, Switzerland
| | - Cedric Hirzel
- Department of Infectious Diseases, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Nina Khanna
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Basel, Basel, Switzerland
| | - Oriol Manuel
- Division of Infectious Diseases, University Hospital of Vaud, Lausanne, Switzerland
| | - Nicolas J Mueller
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Zurich, Switzerland
| | - Christian Van Delden
- Correspondence: Dionysios Neofytos, MD, MPH, Service des Maladies Infectieuses, Hôpitaux Universitaires de Genève, Rue Gabrielle-Perret-Gentil 4, CH-1211 Genève 14, Switzerland (); or Christian van Delden, MD, Service des Maladies Infectieuses, Hôpitaux Universitaires de Genève, Rue Gabrielle-Perret-Gentil 4, CH-1211 Genève 14, Switzerland ()
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18
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Walti LN, Mugglin C, Mombelli M, Manuel O, Hirsch HH, Khanna N, Mueller NJ, Berger C, Boggian K, Garzoni C, Neofytos D, van Delden C, Mäusezahl M, Hirzel C. Vaccine-Preventable Infections Among Solid Organ Transplant Recipients in Switzerland. JAMA Netw Open 2023; 6:e2310687. [PMID: 37115546 PMCID: PMC10148200 DOI: 10.1001/jamanetworkopen.2023.10687] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/29/2023] Open
Abstract
Importance Vaccine responses are decreased in solid organ transplant (SOT) recipients, and given the complexity of implementation, vaccination programs may be suboptimal. The actual burden of vaccine-preventable infections (VPIs) among SOT recipients remains unclear. Objectives To assess the incidence rate of VPIs among SOT recipients and to evaluate whether SOT recipients are at increased risk for specific VPIs compared with the general population. Design, Setting, and Participants This nationwide cohort study used data from the Swiss Transplant Cohort Study on VPIs in individuals who underwent SOT from May 2008 to June 2019 (follow-up until December 2019) and data from the Swiss Federal Office of Public Health on notifiable VPIs in the general population in the same period. Data were analyzed from January 2021 to June 2022. Exposures Solid organ transplant. Main Outcomes and Measures The main outcomes were the incidence rate of the following VPIs in SOT recipients: hepatitis A and B, diphtheria, Haemophilus influenzae infection, influenza, measles, mumps, pertussis, pneumococcal disease, poliomyelitis, meningococcal disease, rubella, tetanus, tick-borne encephalitis, and varicella zoster virus infection. Age-adjusted standardized incidence ratios were used to assess whether VPIs occurred more frequently in SOT recipients compared with the general population. For SOT recipients, factors associated with occurrence of VPIs were explored and the associated morbidity and mortality assessed. Results Of 4967 SOT recipients enrolled (median age, 54 years [IQR, 42-62 years]; 3191 [64.2%] male), 593 (11.9%) experienced at least 1 VPI. The overall VPI incidence rate was higher in the population that underwent SOT (30.57 per 1000 person-years [PY]; 95% CI, 28.24-33.10 per 1000 PY) compared with the general population (0.71 per 1000 PY). The standardized age-adjusted incidence ratio for notifiable VPIs in SOT recipients was higher compared with the general population (27.84; 95% CI, 25.00-31.00). In SOT recipients, influenza and varicella zoster virus infection accounted for most VPI episodes (16.55 per 1000 PY [95% CI, 14.85-18.46 per 1000 PY] and 12.83 per 1000 PY [95% CI, 11.40-14.44 per 1000 PY], respectively). A total of 198 of 575 VPI episodes in the population that underwent SOT (34.4%) led to hospital admission, and the occurrence of a VPI was associated with an increased risk for death and/or graft loss (hazard ratio, 2.44; 95% CI, 1.50-3.99; P = .002). In multivariable analysis, age 65 years or older at the time of transplant (incidence rate ratio [IRR], 1.29; 95% CI, 1.02-1.62) and receipt of a lung (IRR, 1.77; 95% CI, 1.38-2.26) or a heart (IRR, 1.40; 95% CI, 1.05-1.88) transplant were associated with an increased risk of VPI occurrence. Conclusions and Relevance In this study, 11.9% of SOT recipients experienced VPIs, and the incidence rate was higher than in the general population. There was significant morbidity and mortality associated with these infections in the population that underwent SOT, which highlights the need for optimizing immunization strategies.
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Affiliation(s)
- Laura N Walti
- Department of Infectious Diseases, Bern University Hospital, University of Bern, Bern, Switzerland
- Division of Infectious Diseases, Multi-Organ Transplant Program, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Catrina Mugglin
- Department of Infectious Diseases, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Matteo Mombelli
- Transplantation Center and Service of Infectious Diseases, Lausanne University Hospital, Lausanne, Switzerland
| | - Oriol Manuel
- Transplantation Center and Service of Infectious Diseases, Lausanne University Hospital, Lausanne, Switzerland
| | - Hans H Hirsch
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
| | - Nina Khanna
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
| | - Nicolas J Mueller
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich and University Zurich, Zurich, Switzerland
| | - Christoph Berger
- Division of Infectious Diseases and Hospital Epidemiology, University Children's Hospital Zurich, Zurich, Switzerland
| | - Katia Boggian
- Division of Infectious Diseases and Hospital Hygiene, Cantonal Hospital St Gallen, St Gallen, Switzerland
| | - Christian Garzoni
- Clinic of Internal Medicine and Infectious Diseases, Clinica Luganese, Lugano, Switzerland
| | - Dionysios Neofytos
- Transplant Infectious Diseases Unit, University Hospitals of Geneva and Faculty of Medicine, Geneva, Switzerland
| | - Christian van Delden
- Transplant Infectious Diseases Unit, University Hospitals of Geneva and Faculty of Medicine, Geneva, Switzerland
| | - Mirjam Mäusezahl
- Swiss Federal Office of Public Health, Epidemiological Evaluation and Surveillance Section, Bern, Switzerland
| | - Cédric Hirzel
- Department of Infectious Diseases, Bern University Hospital, University of Bern, Bern, Switzerland
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19
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Wang W, Khanna N, Lin J, Liu X. Black carbon emissions and reduction potential in China: 2015-2050. J Environ Manage 2023; 329:117087. [PMID: 36566733 DOI: 10.1016/j.jenvman.2022.117087] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 12/14/2022] [Accepted: 12/17/2022] [Indexed: 06/17/2023]
Abstract
Black carbon is a product of the incomplete combustion of carbonaceous fuels and has significant adverse effects on climate change, air quality, and human health. China has been a major contributor to global anthropogenic black carbon emissions. This study develops a black carbon inventory in China, using 2015 as the base year, and projects annual black carbon emissions in China for the period 2016-2050, under two scenarios: a Reference scenario and an Accelerated Reduction scenario. The study estimates that the total black carbon emissions in China in 2015 were 1100 thousand tons (kt), with residential use being the biggest contributor, accounting for more than half of the total black carbon emissions, followed by coke production, industry, agricultural waste burning, and transportation. This study then projects the total black carbon emissions in China in 2050 to be 278 kt in the Reference scenario and 86 kt in the Accelerated Reduction Scenario. Compared to the Reference scenario, the Accelerated Reduction scenario will achieve much faster and deeper black carbon reductions in all the sectors. The dramatic reductions can be attributed to the fuel switching in the residential sector, faster implementation of high-efficiency emission control measures in the industry, transportation, and coke production sectors, and faster phase-out of agricultural waste open burning. This analysis reveals the high potential of black carbon emission reductions across multiple sectors in China through the next thirty years.
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Affiliation(s)
- Wenjun Wang
- University of California, Berkeley, Berkeley, CA, 94720, USA
| | - Nina Khanna
- Lawrence Berkeley National Laboratory, Berkeley, CA, 94720, USA.
| | - Jiang Lin
- University of California, Berkeley, Berkeley, CA, 94720, USA; Lawrence Berkeley National Laboratory, Berkeley, CA, 94720, USA
| | - Xu Liu
- Lawrence Berkeley National Laboratory, Berkeley, CA, 94720, USA; National School of Development, Peking University, Beijing, 100871, China
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20
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Busca A, Salmanton-García J, Marchesi F, Farina F, Seval GC, Van Doesum J, De Jonge N, Bahr NC, Maertens J, Meletiadis J, Fracchiolla NS, Weinbergerová B, Verga L, Ráčil Z, Jiménez M, Glenthøj A, Blennow O, Tanase AD, Schönlein M, Prezioso L, Khanna N, Duarte RF, Žák P, Nucci M, Machado M, Kulasekararaj A, Espigado I, De Kort E, Ribera-Santa Susana JM, Marchetti M, Magliano G, Falces-Romero I, Ilhan O, Ammatuna E, Zompi S, Tsirigotis P, Antoniadou A, Zambrotta GPM, Nordlander A, Karlsson LK, Hanakova M, Dragonetti G, Cabirta A, Berg Venemyr C, Gräfe S, Van Praet J, Tragiannidis A, Petzer V, López-García A, Itri F, Groh A, Gavriilaki E, Dargenio M, Rahimli L, Cornely OA, Pagano L. Outcome of COVID-19 in allogeneic stem cell transplant recipients: Results from the EPICOVIDEHA registry. Front Immunol 2023; 14:1125030. [PMID: 36911708 PMCID: PMC9999728 DOI: 10.3389/fimmu.2023.1125030] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 02/01/2023] [Indexed: 03/04/2023] Open
Abstract
Background The outcome of COVID-19 in allogeneic hematopoietic stem cell transplantation (HSCT) recipients is almost uniformely considered poor. The aim of present study was to retrospectively analyse the outcome and risk factors for mortality in a large series of patients who developed COVID-19 infection after an allogeneic HSCT. Methods This multicenter retrospective study promoted by the European Hematology Association - Infections in Hematology Study Working Group, included 326 adult HSCT patients who had COVID-19 between January 2020 and March 2022. Results The median time from HSCT to the diagnosis of COVID-19 was 268 days (IQR 86-713; range 0-185 days). COVID-19 severity was mild in 21% of the patients, severe in 39% and critical in 16% of the patients. In multivariable analysis factors associated with a higher risk of mortality were, age above 50 years, presence of 3 or more comorbidities, active hematologic disease at time of COVID-19 infection, development of COVID-19 within 12 months of HSCT, and severe/critical infections. Overall mortality rate was 21% (n=68): COVID-19 was the main or secondary cause of death in 16% of the patients (n=53). Conclusions Mortality in HSCT recipients who develop COVID-19 is high and largely dependent on age, comorbidities, active hematologic disease, timing from transplant and severity of the infection.
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Affiliation(s)
- Alessandro Busca
- Stem Cell Transplant Center, AOU Citta’ della Salute e della Scienza, Turin, Italy
| | - Jon Salmanton-García
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany
| | - Francesco Marchesi
- Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | | | | | | | | | - Nathan C. Bahr
- University of Kansas Medical Center, Kansas, KS, United States
| | - Johan Maertens
- Department of Microbiology, Immunology, and Transplantation, KULeuven, Leuven, Belgium
- Department of Hematology, UZ Leuven, Leuven, Belgium
| | - Joseph Meletiadis
- Clinical Microbiology Laboratory, Medical School, “Attikon” University General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Barbora Weinbergerová
- Department of Internal Medicine - Hematology and Oncology, Masaryk University Hospital Brno, Brno, Czechia
| | - Luisa Verga
- Azienda Ospedaliera San Gerardo - Monza, Monza, Italy
- Università Milano-Bicocca, Milan, Italy
| | - Zdeněk Ráčil
- Institute of Hematology and Blood Transfusion, Prague, Czechia
| | - Moraima Jiménez
- Department of Hematology, Vall d’Hebron Hospital Universitari, Experimental Hematology, Vall d’Hebron Institute of Oncology (VHIO), Vall d’Hebron Barcelona Hospital, Barcelona, Spain
- Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Andreas Glenthøj
- Department of Hematology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Ola Blennow
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Alina Daniela Tanase
- Fundeni Clinical Institute, University of Medicine and Pharmacy Carol Davila, Bucharest, Romania
| | - Martin Schönlein
- Department of Oncology, Hematology and Bone Marrow Transplantation with Section of Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lucia Prezioso
- Hospital University of Parma - Hematology and Bone Marrow Unit, Parma, Italy
| | - Nina Khanna
- Division of Infectious Diseases and Hospital Epidemiology, and Department of Clinical Research, University and University Hospital of Basel, Basel, Switzerland
| | | | - Pavel Žák
- University Hospital Hradec Králové, Hradec Králové, Czechia
| | - Marcio Nucci
- Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marina Machado
- Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Austin Kulasekararaj
- King’s College Hospital, London, United Kingdom
- King’s College London, London, United Kingdom
| | - Ildefonso Espigado
- Department of Hematology, University Hospital Virgen Macarena - University Hospital Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS/CSIC), Universidad de Sevilla (Departamento de Medicina), Seville, Spain
| | | | | | - Monia Marchetti
- Azienda Ospedaliera Nazionale SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | | | | | | | | | - Sofia Zompi
- Stem Cell Transplant Center, AOU Citta’ della Salute e della Scienza, Turin, Italy
| | - Panagiotis Tsirigotis
- Clinical Microbiology Laboratory, Medical School, “Attikon” University General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Anastasia Antoniadou
- Clinical Microbiology Laboratory, Medical School, “Attikon” University General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Anna Nordlander
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | | | | | - Giulia Dragonetti
- Hematology Unit, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Rome, Italy
| | - Alba Cabirta
- Department of Hematology, Vall d’Hebron Hospital Universitari, Experimental Hematology, Vall d’Hebron Institute of Oncology (VHIO), Vall d’Hebron Barcelona Hospital, Barcelona, Spain
| | - Caroline Berg Venemyr
- Department of Hematology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Stefanie Gräfe
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany
| | - Jens Van Praet
- Department of Nephrology and Infectious diseases, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium
| | | | - Verena Petzer
- Department of Hematology and Oncology, Medical University of Innsbruck, Innsbruck, Austria
| | - Alberto López-García
- Fundacion Jimenez Diaz University Hospital, Health Research Institute IIS-FJD, Madrid, Spain
| | - Federico Itri
- San Luigi Gonzaga Hospital - Orbassano, Orbassano, Italy
| | - Ana Groh
- Infektiologie, Universitätsklinikum Frankfurt am Main, Frankfurt am Main, Germany
| | - Eleni Gavriilaki
- General Hospital of Thessaloniki “George Papanikolaou”, Thessaloniki, Greece
| | | | - Laman Rahimli
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany
| | - Oliver A. Cornely
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Clinical Trials Centre Cologne (ZKS Köln), Cologne, Germany
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Center for Molecular Medicine Cologne (CMMC), Cologne, Germany
- German Centre for Infection Research (DZIF) , Cologne, Germany
| | - Livio Pagano
- Hematology Unit, Università Cattolica del Sacro Cuore, Rome, Italy
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21
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Capoferri G, Walti CS, Urwyler P, Ragozzino S, Passweg JR, Halter J, Battegay M, Baettig V, Weisser M, Arnold B, Morin B, Guetlin Y, Torres DA, Barut GT, Thiel V, Egli A, Drexler B, Khanna N. Dynamics of antibody titers to SARS-CoV-2 and clinical outcomes after sotrovimab pre-exposure prophylaxis early after allogeneic hematopoietic stem cell transplantation. Bone Marrow Transplant 2023; 58:597-599. [PMID: 36797421 PMCID: PMC9933011 DOI: 10.1038/s41409-023-01936-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 02/03/2023] [Accepted: 02/08/2023] [Indexed: 02/18/2023]
Affiliation(s)
- Gioele Capoferri
- grid.410567.1Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
| | - Carla Simone Walti
- grid.410567.1Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland ,grid.410567.1Department of Clinical Research, University Hospital of Basel, Basel, Switzerland
| | - Pascal Urwyler
- grid.410567.1Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
| | - Silvio Ragozzino
- grid.410567.1Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
| | - Jakob R. Passweg
- grid.410567.1Department of Hematology, University Hospital Basel, Basel, Switzerland
| | - Jörg Halter
- grid.410567.1Department of Hematology, University Hospital Basel, Basel, Switzerland
| | - Manuel Battegay
- grid.410567.1Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
| | - Veronika Baettig
- grid.410567.1Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
| | - Maja Weisser
- grid.410567.1Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
| | - Brice Arnold
- grid.6612.30000 0004 1937 0642Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Benedict Morin
- grid.6612.30000 0004 1937 0642Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Yukino Guetlin
- grid.6612.30000 0004 1937 0642Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Diana Albertos Torres
- grid.6612.30000 0004 1937 0642Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Güliz Tuba Barut
- grid.438536.fInstitute of Virology and Immunology (IVI), Mittelhäusern and Bern, Bern, Switzerland ,grid.5734.50000 0001 0726 5157Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Volker Thiel
- grid.438536.fInstitute of Virology and Immunology (IVI), Mittelhäusern and Bern, Bern, Switzerland ,grid.5734.50000 0001 0726 5157Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Adrian Egli
- grid.6612.30000 0004 1937 0642Department of Biomedicine, University of Basel, Basel, Switzerland ,grid.410567.1Division of Clinical Microbiology, University Hospital Basel, Basel, Switzerland
| | - Beatrice Drexler
- grid.410567.1Department of Hematology, University Hospital Basel, Basel, Switzerland
| | - Nina Khanna
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland. .,Department of Clinical Research, University Hospital of Basel, Basel, Switzerland. .,Department of Biomedicine, University of Basel, Basel, Switzerland.
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22
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Sava M, Bättig V, Gerull S, Passweg JR, Khanna N, Garzoni C, Gerber B, Mueller NJ, Schanz U, Berger C, Chalandon Y, van Delden C, Neofytos D, Stampf S, Franzeck FC, Weisser M. Bloodstream infections in allogeneic haematopoietic cell recipients from the Swiss Transplant Cohort Study: trends of causative pathogens and resistance rates. Bone Marrow Transplant 2023; 58:115-118. [PMID: 36310245 PMCID: PMC9812769 DOI: 10.1038/s41409-022-01851-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 10/05/2022] [Accepted: 10/11/2022] [Indexed: 01/10/2023]
Affiliation(s)
- Mihaela Sava
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
| | - Veronika Bättig
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
| | - Sabine Gerull
- Division of Oncology, Hematology and Transfusion Medicine, Kantonsspital Aarau, Aarau, Switzerland
| | - Jakob R Passweg
- Department of Hematology, University Hospital Basel, Basel, Switzerland
| | - Nina Khanna
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
| | - Christian Garzoni
- Clinic of Internal Medicine and Infectious Diseases, Clinica Luganese Moncucco, Lugano, Switzerland
| | - Bernhard Gerber
- Clinic of Hematology, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland.,Division of Medical Oncology and Hematology, University Hospital Zurich, Zurich, Switzerland
| | - Nicolas J Mueller
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland
| | - Urs Schanz
- Division of Medical Oncology and Hematology, University Hospital Zurich, Zurich, Switzerland
| | - Christoph Berger
- Division of Infectious Diseases and Hospital Epidemiology, University Children's Hospital Zurich, Zurich, Switzerland
| | - Yves Chalandon
- Division of Hematology and Faculty of Medicine, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Christian van Delden
- Transplant Infectious Diseases Unit, University Hospitals Geneva, Geneva, Switzerland
| | - Dionysios Neofytos
- Transplant Infectious Diseases Unit, University Hospitals Geneva, Geneva, Switzerland
| | - Susanne Stampf
- Clinic for Transplantation Immunology and Nephrology (Swiss Transplant Cohort Study), University Hospital of Basel, Basel, Switzerland
| | - Fabian C Franzeck
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
| | - Maja Weisser
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland.
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23
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Pham TT, Andrey DO, Stampf S, Burkhard SH, Hirzel C, Tschopp J, Ullrich K, Strahm C, Schreiber PW, Boillat-Blanco N, Garzoni C, Khanna N, Manuel O, Mueller NJ, Suva D, van Delden C, Uçkay I, Neofytos D. Epidemiology and outcomes of bone and joint infections in solid organ transplant recipients. Am J Transplant 2022; 22:3031-3046. [PMID: 36031963 PMCID: PMC10087422 DOI: 10.1111/ajt.17184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 08/23/2022] [Accepted: 08/24/2022] [Indexed: 01/25/2023]
Abstract
Bone and joint infection (BJI) epidemiology and outcomes in solid organ transplant recipients (SOTr) remain largely unknown. We aim to describe BJI in a multi-center cohort of SOTr (Swiss Transplant Cohort Study). All consecutive SOTr with BJI (01.05.2008-31.12.2019) were included. A nested case-control study to identify risk factors for BJI was performed. Among 4482 patients, 61 SOTr with 82 BJI were included, at an incidence of 1.4% (95% CI 1.1-1.7), higher in heart and kidney-pancreas SOTr (Gray's test p < .01). Although BJI were predominately late events (median of 18.5 months post-SOT), most infections occurred during the first year post-transplant in thoracic SOTr. Diabetic foot osteomyelitis was the most frequent infection (38/82, 46.3%), followed by non-vertebral osteomyelitis (26/82, 31.7%). Pathogens included Gram-positive cocci (70/131, 53.4%), Gram-negative bacilli (34/131, 26.0%), and fungi (9/131, 6.9%). BJI predictors included male gender (OR 2.94, 95% CI 1.26-6.89) and diabetes (OR 2.97, 95% CI 1.34-6.56). Treatment failure was observed in 25.9% (21/81) patients and 1-year mortality post-BJI diagnosis was 14.8% (9/61). BJI remain a rare event in SOTr, associated with subtle clinical presentations, high morbidity and relapses, requiring additional studies in the future.
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Affiliation(s)
- Truong-Thanh Pham
- Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland.,Division of Orthopaedics and Trauma Surgery, Geneva University Hospitals, Geneva, Switzerland
| | - Diego O Andrey
- Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland
| | - Susanne Stampf
- Clinic for Transplantation Immunology and Nephrology (Swiss Transplant Cohort Study), University Hospital of Basel, Basel, Switzerland
| | - Sara H Burkhard
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Zurich and University of Zurich, Zurich, Switzerland
| | - Cédric Hirzel
- Department of Infectious Diseases, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Johnathan Tschopp
- Infectious Diseases Service, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Kathrin Ullrich
- Division of Infectious Diseases and Hospital Epidemiology, University and University Hospital of Basel, Basel, Switzerland
| | - Carol Strahm
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Peter W Schreiber
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Zurich and University of Zurich, Zurich, Switzerland
| | - Noémie Boillat-Blanco
- Infectious Diseases Service, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Christian Garzoni
- Departments of Internal Medicine and Infectious Disease, Clinica Luganese, Lugano, Switzerland
| | - Nina Khanna
- Division of Infectious Diseases and Hospital Epidemiology, University and University Hospital of Basel, Basel, Switzerland
| | - Oriol Manuel
- Infectious Diseases Service, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.,Transplantation Center, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Nicolas J Mueller
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Zurich and University of Zurich, Zurich, Switzerland
| | - Domizio Suva
- Division of Orthopaedics and Trauma Surgery, Geneva University Hospitals, Geneva, Switzerland
| | - Christian van Delden
- Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland.,Transplant Infectious Diseases Unit, University Hospitals of Geneva and Faculty of Medicine, Geneva, Switzerland
| | - Ilker Uçkay
- Infectious Diseases, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Dionysios Neofytos
- Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland.,Transplant Infectious Diseases Unit, University Hospitals of Geneva and Faculty of Medicine, Geneva, Switzerland
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24
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Castellanos-Rueda R, Di Roberto RB, Bieberich F, Schlatter FS, Palianina D, Nguyen OTP, Kapetanovic E, Läubli H, Hierlemann A, Khanna N, Reddy ST. speedingCARs: accelerating the engineering of CAR T cells by signaling domain shuffling and single-cell sequencing. Nat Commun 2022; 13:6555. [PMID: 36323661 PMCID: PMC9630321 DOI: 10.1038/s41467-022-34141-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 10/14/2022] [Indexed: 11/05/2022] Open
Abstract
Chimeric antigen receptors (CARs) consist of an antigen-binding region fused to intracellular signaling domains, enabling customized T cell responses against targets. Despite their major role in T cell activation, effector function and persistence, only a small set of immune signaling domains have been explored. Here we present speedingCARs, an integrated method for engineering CAR T cells via signaling domain shuffling and pooled functional screening. Leveraging the inherent modularity of natural signaling domains, we generate a library of 180 unique CAR variants genomically integrated into primary human T cells by CRISPR-Cas9. In vitro tumor cell co-culture, followed by single-cell RNA sequencing (scRNA-seq) and single-cell CAR sequencing (scCAR-seq), enables high-throughput screening for identifying several variants with tumor killing properties and T cell phenotypes markedly different from standard CARs. Mapping of the CAR scRNA-seq data onto that of tumor infiltrating lymphocytes further helps guide the selection of variants. These results thus help expand the CAR signaling domain combination space, and supports speedingCARs as a tool for the engineering of CARs for potential therapeutic development.
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Affiliation(s)
- Rocío Castellanos-Rueda
- grid.5801.c0000 0001 2156 2780Department of Biosystems Science and Engineering, ETH Zürich, 4058 Basel, Switzerland ,grid.7400.30000 0004 1937 0650Life Science Zurich Graduate School, ETH Zürich, University of Zurich, 8057 Zürich, Switzerland
| | - Raphaël B. Di Roberto
- grid.5801.c0000 0001 2156 2780Department of Biosystems Science and Engineering, ETH Zürich, 4058 Basel, Switzerland
| | - Florian Bieberich
- grid.5801.c0000 0001 2156 2780Department of Biosystems Science and Engineering, ETH Zürich, 4058 Basel, Switzerland ,grid.7400.30000 0004 1937 0650Life Science Zurich Graduate School, ETH Zürich, University of Zurich, 8057 Zürich, Switzerland
| | - Fabrice S. Schlatter
- grid.5801.c0000 0001 2156 2780Department of Biosystems Science and Engineering, ETH Zürich, 4058 Basel, Switzerland
| | - Darya Palianina
- grid.6612.30000 0004 1937 0642Department of Biomedicine, University of Basel, 4031 Basel, Switzerland
| | - Oanh T. P. Nguyen
- grid.5801.c0000 0001 2156 2780Department of Biosystems Science and Engineering, ETH Zürich, 4058 Basel, Switzerland
| | - Edo Kapetanovic
- grid.5801.c0000 0001 2156 2780Department of Biosystems Science and Engineering, ETH Zürich, 4058 Basel, Switzerland
| | - Heinz Läubli
- grid.6612.30000 0004 1937 0642Department of Biomedicine, University of Basel, 4031 Basel, Switzerland
| | - Andreas Hierlemann
- grid.5801.c0000 0001 2156 2780Department of Biosystems Science and Engineering, ETH Zürich, 4058 Basel, Switzerland
| | - Nina Khanna
- grid.6612.30000 0004 1937 0642Department of Biomedicine, University of Basel, 4031 Basel, Switzerland
| | - Sai T. Reddy
- grid.5801.c0000 0001 2156 2780Department of Biosystems Science and Engineering, ETH Zürich, 4058 Basel, Switzerland
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25
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Bajpai J, Simha V, Anne S, Bhargava P, Srinivas S, Khanna N, Rekhi B, Noronha V, Patil V, Laskar S, Prabhash K, Gupta S, Banavali S. 431P Alveolar soft part sarcomas: A tertiary care Indian centre experience. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
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26
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Gulia A, Puri A, Kamath N, Thakur R, Laskar S, Bajpai J, Khanna N, Chinnaswamy G, Rekhi B. 436P Oncologic outcomes in patients with extraskeletal Ewing’s sarcoma (EES): A tertiary care centre experience. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
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27
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Bagal B, Goda Shastri J, Nayak L, Chatterjee A, Dasgupta A, Jain H, Thorat J, Sahay A, Epari S, Khanna N, Laskar S, Gupta T, Sengar M. 216P Lenalidomide maintenance after whole brain radiotherapy in relapsed/refractory primary CNS lymphoma. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2022] Open
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28
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Lin J, Khanna N, Liu X, Wang W, Gordon J, Dai F. Opportunities to tackle short-lived climate pollutants and other greenhouse gases for China. Sci Total Environ 2022; 842:156842. [PMID: 35738378 DOI: 10.1016/j.scitotenv.2022.156842] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 06/13/2022] [Accepted: 06/16/2022] [Indexed: 06/15/2023]
Abstract
To limit the global temperature increase to below 1.5 °C, it is critical to reduce not only carbon dioxide (CO2), but also specific non-CO2 greenhouse gases (GHGs) and precursors, including some short-lived climate pollutants (SLCPs). These include emissions of black carbon, methane (CH4), tropospheric ozone, and fluorinated gases such as hydrofluorocarbons (HFCs). As the largest CH4 emitter and second-largest HFCs emitter, China plays a critical role in global efforts to reduce SLCPs and has acknowledged the need to reduce non-CO2 GHGs in its 2060 carbon neutrality goal. This study reviewed leading international experiences with SLCP reduction to identify global best practices to inform target development and policy actions in China and elsewhere. We used bottom-up modeling and scenario analysis to evaluate pathways of non-CO2 emission mitigation in China to 2050, drawing on mitigation measures developed through updated 2030 and 2050 cost curves. We identified a cost-effective reduction potential of 35 % for methane, 30 % for fluorinated gases, and 40 % for nitrous oxides-another potent GHG-in 2030 relative to 2015 levels for China under a Deep Non-CO2 Mitigation scenario. Annual total reduction potential of 1080 million metric tons of CO2 equivalent is also possible by 2030. For long-term targets, progress made on reducing SLCPs could help China reach its carbon neutrality target by 2060. While some uncertainties regarding the long-term mitigation potential of SLCPs remain, our analyses suggest that the fast adoption of available cost-effective technologies could allow China to reduce its non-CO2 GHGs by 56 % by 2050.
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Affiliation(s)
- Jiang Lin
- Lawrence Berkeley National Laboratory, Berkeley, CA 94720, United States; University of California, Berkeley, Berkeley, CA 94720, United States.
| | - Nina Khanna
- Lawrence Berkeley National Laboratory, Berkeley, CA 94720, United States
| | - Xu Liu
- Lawrence Berkeley National Laboratory, Berkeley, CA 94720, United States; National School of Development, Peking University, Beijing 100871, China
| | - Wenjun Wang
- University of California, Berkeley, Berkeley, CA 94720, United States
| | - Jessica Gordon
- California-China Climate Institute, University of California, Berkeley, Berkeley, CA 94720, United States
| | - Fan Dai
- California-China Climate Institute, University of California, Berkeley, Berkeley, CA 94720, United States
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29
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Blaskovich MAT, Hansford KA, Butler MS, Ramu S, Kavanagh AM, Jarrad AM, Prasetyoputri A, Pitt ME, Huang JX, Lindahl F, Ziora ZM, Bradford T, Muldoon C, Rajaratnam P, Pelingon R, Edwards DJ, Zhang B, Amado M, Elliott AG, Zuegg J, Coin L, Woischnig AK, Khanna N, Breidenstein E, Stincone A, Mason C, Khan N, Cho HK, Karau MJ, Greenwood-Quaintance KE, Patel R, Wootton M, James ML, Hutton ML, Lyras D, Ogunniyi AD, Mahdi LK, Trott DJ, Wu X, Niles S, Lewis K, Smith JR, Barber KE, Yim J, Rice SA, Rybak MJ, Ishmael CR, Hori KR, Bernthal NM, Francis KP, Roberts JA, Paterson DL, Cooper MA. A lipoglycopeptide antibiotic for Gram-positive biofilm-related infections. Sci Transl Med 2022; 14:eabj2381. [DOI: 10.1126/scitranslmed.abj2381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Drug-resistant Gram-positive bacterial infections are still a substantial burden on the public health system, with two bacteria (
Staphylococcus aureus
and
Streptococcus pneumoniae
) accounting for over 1.5 million drug-resistant infections in the United States alone in 2017. In 2019, 250,000 deaths were attributed to these pathogens globally. We have developed a preclinical glycopeptide antibiotic, MCC5145, that has excellent potency (MIC
90
≤ 0.06 μg/ml) against hundreds of isolates of methicillin-resistant
S. aureus
(MRSA) and other Gram-positive bacteria, with a greater than 1000-fold margin over mammalian cell cytotoxicity values. The antibiotic has therapeutic in vivo efficacy when dosed subcutaneously in multiple murine models of established bacterial infections, including thigh infection with MRSA and blood septicemia with
S. pneumoniae
, as well as when dosed orally in an antibiotic-induced
Clostridioides difficile
infection model. MCC5145 exhibited reduced nephrotoxicity at microbiologically active doses in mice compared to vancomycin. MCC5145 also showed improved activity against biofilms compared to vancomycin, both in vitro and in vivo, and a low propensity to select for drug resistance. Characterization of drug action using a transposon library bioinformatic platform showed a mechanistic distinction from other glycopeptide antibiotics.
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Affiliation(s)
- Mark A. T. Blaskovich
- Centre for Superbug Solutions, Institute for Molecular Bioscience, The University of Queensland, St. Lucia, Queensland 4072, Australia
| | - Karl A. Hansford
- Centre for Superbug Solutions, Institute for Molecular Bioscience, The University of Queensland, St. Lucia, Queensland 4072, Australia
| | - Mark S. Butler
- Centre for Superbug Solutions, Institute for Molecular Bioscience, The University of Queensland, St. Lucia, Queensland 4072, Australia
| | - Soumya Ramu
- Centre for Superbug Solutions, Institute for Molecular Bioscience, The University of Queensland, St. Lucia, Queensland 4072, Australia
| | - Angela M. Kavanagh
- Centre for Superbug Solutions, Institute for Molecular Bioscience, The University of Queensland, St. Lucia, Queensland 4072, Australia
| | - Angie M. Jarrad
- Centre for Superbug Solutions, Institute for Molecular Bioscience, The University of Queensland, St. Lucia, Queensland 4072, Australia
| | - Anggia Prasetyoputri
- Centre for Superbug Solutions, Institute for Molecular Bioscience, The University of Queensland, St. Lucia, Queensland 4072, Australia
| | - Miranda E. Pitt
- Centre for Superbug Solutions, Institute for Molecular Bioscience, The University of Queensland, St. Lucia, Queensland 4072, Australia
| | - Johnny X. Huang
- Centre for Superbug Solutions, Institute for Molecular Bioscience, The University of Queensland, St. Lucia, Queensland 4072, Australia
| | - Fredrik Lindahl
- Centre for Superbug Solutions, Institute for Molecular Bioscience, The University of Queensland, St. Lucia, Queensland 4072, Australia
| | - Zyta M. Ziora
- Centre for Superbug Solutions, Institute for Molecular Bioscience, The University of Queensland, St. Lucia, Queensland 4072, Australia
| | - Tanya Bradford
- Centre for Superbug Solutions, Institute for Molecular Bioscience, The University of Queensland, St. Lucia, Queensland 4072, Australia
| | - Craig Muldoon
- Centre for Superbug Solutions, Institute for Molecular Bioscience, The University of Queensland, St. Lucia, Queensland 4072, Australia
| | - Premraj Rajaratnam
- Centre for Superbug Solutions, Institute for Molecular Bioscience, The University of Queensland, St. Lucia, Queensland 4072, Australia
| | - Ruby Pelingon
- Centre for Superbug Solutions, Institute for Molecular Bioscience, The University of Queensland, St. Lucia, Queensland 4072, Australia
| | - David J. Edwards
- Centre for Superbug Solutions, Institute for Molecular Bioscience, The University of Queensland, St. Lucia, Queensland 4072, Australia
| | - Bing Zhang
- Centre for Superbug Solutions, Institute for Molecular Bioscience, The University of Queensland, St. Lucia, Queensland 4072, Australia
| | - Maite Amado
- Centre for Superbug Solutions, Institute for Molecular Bioscience, The University of Queensland, St. Lucia, Queensland 4072, Australia
| | - Alysha G. Elliott
- Centre for Superbug Solutions, Institute for Molecular Bioscience, The University of Queensland, St. Lucia, Queensland 4072, Australia
| | - Johannes Zuegg
- Centre for Superbug Solutions, Institute for Molecular Bioscience, The University of Queensland, St. Lucia, Queensland 4072, Australia
| | - Lachlan Coin
- Centre for Superbug Solutions, Institute for Molecular Bioscience, The University of Queensland, St. Lucia, Queensland 4072, Australia
| | - Anne-Kathrin Woischnig
- University and University Hospital of Basel, Division of Infectious Diseases and Infection Biology Laboratory Department of Biomedicine, Hebelstrasse 20, CH-4031 Basel, Switzerland
| | - Nina Khanna
- University and University Hospital of Basel, Division of Infectious Diseases and Infection Biology Laboratory Department of Biomedicine, Hebelstrasse 20, CH-4031 Basel, Switzerland
| | - Elena Breidenstein
- Summit Therapeutics, The Works, Unity Campus, Cambridgeshire, CB22 3FT, UK
| | - Anna Stincone
- Summit Therapeutics, The Works, Unity Campus, Cambridgeshire, CB22 3FT, UK
| | - Clive Mason
- Summit Therapeutics, The Works, Unity Campus, Cambridgeshire, CB22 3FT, UK
| | - Nawaz Khan
- Summit Therapeutics, The Works, Unity Campus, Cambridgeshire, CB22 3FT, UK
| | - Hye-Kyung Cho
- Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA
| | - Melissa J. Karau
- Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA
| | - Kerryl E. Greenwood-Quaintance
- Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA
| | - Robin Patel
- Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA
- Division of Public Health, Infectious Diseases and Occupational Medicine, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Mandy Wootton
- Specialist Antimicrobial Chemotherapy Unit Public Health Wales, University Hospital of Wales, Heath Park, Cardiff CF14 4XW, Wales
| | - Meagan L. James
- Infection and Immunity Program, Monash Biomedicine Discovery Institute and Department of Microbiology, Monash University, Clayton, Victoria 3800, Australia
| | - Melanie L. Hutton
- Infection and Immunity Program, Monash Biomedicine Discovery Institute and Department of Microbiology, Monash University, Clayton, Victoria 3800, Australia
| | - Dena Lyras
- Infection and Immunity Program, Monash Biomedicine Discovery Institute and Department of Microbiology, Monash University, Clayton, Victoria 3800, Australia
| | - Abiodun D. Ogunniyi
- Australian Centre for Antimicrobial Resistance Ecology, School of Animal and Veterinary Sciences, The University of Adelaide, Roseworthy, South Australia 5371, Australia
| | - Layla K. Mahdi
- Australian Centre for Antimicrobial Resistance Ecology, School of Animal and Veterinary Sciences, The University of Adelaide, Roseworthy, South Australia 5371, Australia
| | - Darren J. Trott
- Australian Centre for Antimicrobial Resistance Ecology, School of Animal and Veterinary Sciences, The University of Adelaide, Roseworthy, South Australia 5371, Australia
| | - Xiaoqian Wu
- Antimicrobial Discovery Center, Department of Biology, Northeastern University, 360 Huntington Avenue, Boston, MA 02115, USA
| | - Samantha Niles
- Antimicrobial Discovery Center, Department of Biology, Northeastern University, 360 Huntington Avenue, Boston, MA 02115, USA
| | - Kim Lewis
- Antimicrobial Discovery Center, Department of Biology, Northeastern University, 360 Huntington Avenue, Boston, MA 02115, USA
| | - Jordan R. Smith
- Anti-Infective Research Laboratory, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI 48201, USA
| | - Katie E. Barber
- Anti-Infective Research Laboratory, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI 48201, USA
| | - Juwon Yim
- Anti-Infective Research Laboratory, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI 48201, USA
| | - Seth Alan Rice
- Anti-Infective Research Laboratory, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI 48201, USA
| | - Michael J. Rybak
- Anti-Infective Research Laboratory, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI 48201, USA
- School of Medicine, Wayne State University, Detroit, MI 48201, USA
| | - Chad R. Ishmael
- Department of Orthopaedic Surgery, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA
| | - Kellyn R. Hori
- Department of Orthopaedic Surgery, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA
| | - Nicholas M. Bernthal
- Department of Orthopaedic Surgery, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA
| | - Kevin P. Francis
- Department of Orthopaedic Surgery, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA
- PerkinElmer, 68 Elm Street, Hopkinton, MA 01748, USA
| | - Jason A. Roberts
- University of Queensland Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Queensland 4029, Australia
- Departments of Pharmacy and Intensive Care Medicine, Royal Brisbane and Women’s Hospital, Brisbane, Queensland 4029, Australia
- Division of Anaesthesiology Critical Care Emergency and Pain Medicine, Nîmes University Hospital, University of Montpellier, 30029 Nîmes, France
| | - David L. Paterson
- University of Queensland Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Queensland 4029, Australia
| | - Matthew A. Cooper
- Centre for Superbug Solutions, Institute for Molecular Bioscience, The University of Queensland, St. Lucia, Queensland 4072, Australia
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30
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Abhyankar N, Lin J, Kahrl F, Yin S, Paliwal U, Liu X, Khanna N, Luo Q, Wooley D, O’Boyle M, Ashmoore O, Orvis R, Solomon M, Phadke A. Achieving an 80% Carbon Free Electricity System in China by 2035. iScience 2022; 25:105180. [PMID: 36217546 PMCID: PMC9547298 DOI: 10.1016/j.isci.2022.105180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 08/08/2022] [Accepted: 09/19/2022] [Indexed: 11/23/2022] Open
Abstract
Dramatic reductions in solar, wind, and battery storage costs create new opportunities to reduce emissions and costs in China’s electricity sector, beyond current policy goals. This study examines the cost, reliability, emissions, public health, and employment implications of increasing the share of non-fossil fuel (“carbon free”) electricity generation in China to 80% by 2035. The analysis uses state-of-the-art modeling with high resolution load, wind, and solar inputs. The study finds that achieving an 80% carbon-free electricity system in China by 2035 could reduce wholesale electricity costs, relative to a current policy baseline, while maintaining high levels of reliability, reducing deaths from air pollution, and increasing employment. In our 80% scenario, wind and solar generation capacity reach 3 TW and battery storage capacity reaches 0.4 TW by 2035, implying a rapid scale up in these resources that will require changes in policy targets, markets and regulation, and land use policies. China could reach 80% carbon-free electricity by 2035 at 6% lower cost China’s power grids can be reliably operated with a high level of non-fossil generation Exceeding existing non-fossil goals can reduce additional emission and health impacts Job gains in clean energy more than offset those lost in coal-related industries
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Affiliation(s)
- Nikit Abhyankar
- Electricity Market and Policy Department, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
| | - Jiang Lin
- Electricity Market and Policy Department, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
- Corresponding author
| | - Fritz Kahrl
- Electricity Market and Policy Department, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
| | - Shengfei Yin
- Electricity Market and Policy Department, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
| | - Umed Paliwal
- Electricity Market and Policy Department, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
| | - Xu Liu
- Electricity Market and Policy Department, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
- National School of Development, Peking University, Beijing 100871, China
| | - Nina Khanna
- Electricity Market and Policy Department, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
| | - Qian Luo
- Electricity Market and Policy Department, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
| | - David Wooley
- UC Berkeley, Goldman School of Public Policy, Center for Environmental Public Policy, Berkeley, CA 94720, USA
| | - Mike O’Boyle
- Energy Innovation Energy Innovation: Policy and Technology LLC, San Francisco, CA 94111, USA
| | - Olivia Ashmoore
- Energy Innovation Energy Innovation: Policy and Technology LLC, San Francisco, CA 94111, USA
| | - Robbie Orvis
- Energy Innovation Energy Innovation: Policy and Technology LLC, San Francisco, CA 94111, USA
| | - Michelle Solomon
- Energy Innovation Energy Innovation: Policy and Technology LLC, San Francisco, CA 94111, USA
| | - Amol Phadke
- Electricity Market and Policy Department, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
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31
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Darie AM, Khanna N, Jahn K, Osthoff M, Bassetti S, Osthoff M, Schumann DM, Albrich WC, Hirsch H, Brutsche M, Grize L, Tamm M, Stolz D. Fast multiplex bacterial PCR of bronchoalveolar lavage for antibiotic stewardship in hospitalised patients with pneumonia at risk of Gram-negative bacterial infection (Flagship II): a multicentre, randomised controlled trial. The Lancet Respiratory Medicine 2022; 10:877-887. [DOI: 10.1016/s2213-2600(22)00086-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 02/21/2022] [Accepted: 02/22/2022] [Indexed: 10/18/2022]
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Weisser M, Khanna N, Hedstueck A, Tschudin Sutter S, Roesch S, Stehle G, Sava M, Deigendesch N, Battegay M, Infanti L, Holbro A, Bassetti S, Pargger H, Hirsch HH, Leuzinger K, Kaiser L, Vu D, Baur K, Massaro N, Busch MP, Simmons G, Stone M, Felgner PL, de Assis RR, Khan S, Tsai C, Robinson PV, Seftel D, Irsch J, Bagri A, Buser AS, Corash L. Characterization of Pathogen Inactivated
COVID
‐19 Convalescent Plasma and Responses in Transfused Patients. Transfusion 2022; 62:1997-2011. [PMID: 36054476 PMCID: PMC9538076 DOI: 10.1111/trf.17083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 07/31/2022] [Accepted: 07/31/2022] [Indexed: 12/15/2022]
Abstract
Background Efficacy of donated COVID‐19 convalescent plasma (dCCP) is uncertain and may depend on antibody titers, neutralizing capacity, timing of administration, and patient characteristics. Study Design and Methods In a single‐center hypothesis‐generating prospective case–control study with 1:2 matched dCCP recipients to controls according to disease severity at day 1, hospitalized adults with COVID‐19 pneumonia received 2 × 200 ml pathogen‐reduced treated dCCP from 2 different donors. We evaluated severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) antibodies in COVID‐19 convalescent plasma donors and recipients using multiple antibody assays including a Coronavirus antigen microarray (COVAM), and binding and neutralizing antibody assays. Outcomes were dCCP characteristics, antibody responses, 28‐day mortality, and dCCP ‐related adverse events in recipients. Results Eleven of 13 dCCPs (85%) contained neutralizing antibodies (nAb). PRT did not affect dCCP antibody activity. Fifteen CCP recipients and 30 controls (median age 64 and 65 years, respectively) were enrolled. dCCP recipients received 2 dCCPs from 2 different donors after a median of one hospital day and 11 days after symptom onset. One dCCP recipient (6.7%) and 6 controls (20%) died (p = 0.233). We observed no dCCP‐related adverse events. Transfusion of unselected dCCP led to heterogeneous SARS CoV‐2 antibody responses. COVAM clustered dCCPs in 4 distinct groups and showed endogenous immune responses to SARS‐CoV‐2 antigens over 14–21 days post dCCP in all except 4 immunosuppressed recipients. Discussion PRT did not impact dCCP anti‐virus neutralizing activity. Transfusion of unselected dCCP did not impact survival and had no adverse effects. Variable dCCP antibodies and post‐transfusion antibody responses indicate the need for controlled trials using well‐characterized dCCP with informative assays.
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Affiliation(s)
- Maja Weisser
- Division of Infectious Diseases & Hospital Epidemiology University and University Hospital of Basel Basel Switzerland
- Department of Clinical Research University Hospital Basel Basel Switzerland
| | - Nina Khanna
- Division of Infectious Diseases & Hospital Epidemiology University and University Hospital of Basel Basel Switzerland
- Department of Clinical Research University Hospital Basel Basel Switzerland
| | - Anemone Hedstueck
- Division of Infectious Diseases & Hospital Epidemiology University and University Hospital of Basel Basel Switzerland
| | - Sarah Tschudin Sutter
- Division of Infectious Diseases & Hospital Epidemiology University and University Hospital of Basel Basel Switzerland
- Department of Clinical Research University Hospital Basel Basel Switzerland
| | - Sandra Roesch
- Division of Infectious Diseases & Hospital Epidemiology University and University Hospital of Basel Basel Switzerland
| | - Gregor Stehle
- Regional Blood Transfusion Service, Swiss Red Cross, Basel Basel Switzerland
| | - Mihaela Sava
- Division of Infectious Diseases & Hospital Epidemiology University and University Hospital of Basel Basel Switzerland
| | | | - Manuel Battegay
- Division of Infectious Diseases & Hospital Epidemiology University and University Hospital of Basel Basel Switzerland
- Department of Clinical Research University Hospital Basel Basel Switzerland
| | - Laura Infanti
- Regional Blood Transfusion Service, Swiss Red Cross, Basel Basel Switzerland
| | - Andreas Holbro
- Regional Blood Transfusion Service, Swiss Red Cross, Basel Basel Switzerland
| | - Stefano Bassetti
- Department of Clinical Research University Hospital Basel Basel Switzerland
- Department of Internal Medicine University Hospital Basel Basel Switzerland
| | - Hans Pargger
- Department of Clinical Research University Hospital Basel Basel Switzerland
- Department of Intensive Care University Hospital Basel Basel Switzerland
| | - Hans H. Hirsch
- Division of Infectious Diseases & Hospital Epidemiology University and University Hospital of Basel Basel Switzerland
- Department of Clinical Research University Hospital Basel Basel Switzerland
- Transplantation & Clinical Virology, Department of Biomedicine University of Basel Basel Switzerland
| | - Karoline Leuzinger
- Transplantation & Clinical Virology, Department of Biomedicine University of Basel Basel Switzerland
| | - Laurent Kaiser
- Geneva Centre for Emerging Viral Diseases, Geneva University Hospitals, 1205 Geneva, Switzerland; Laboratory of Virology, Division of Laboratory Medicine, Geneva University Hospitals & Faculty of Medicine University of Geneva Geneva Switzerland
| | - Diem‐Lan Vu
- Division of Infectious Diseases Geneva University Hospitals Geneva Switzerland
| | - Katharina Baur
- Regional Blood Transfusion Service, Swiss Red Cross, Basel Basel Switzerland
| | - Nadine Massaro
- Regional Blood Transfusion Service, Swiss Red Cross, Basel Basel Switzerland
| | - Michael Paul Busch
- Department of Laboratory Medicine University of California, San Francisco San Francisco CA USA
- Vitalant Research Institute San Francisco CA
| | - Graham Simmons
- Department of Laboratory Medicine University of California, San Francisco San Francisco CA USA
- Vitalant Research Institute San Francisco CA
| | - Mars Stone
- Department of Laboratory Medicine University of California, San Francisco San Francisco CA USA
- Vitalant Research Institute San Francisco CA
| | - Philip L. Felgner
- Department of Physiology and Biophysics, Vaccine Research and Development Laboratory University of California, Irvine Irvine CA USA
| | - Rafael R. de Assis
- Department of Physiology and Biophysics, Vaccine Research and Development Laboratory University of California, Irvine Irvine CA USA
| | - Saahir Khan
- Division of Infectious Diseases, Department of Medicine, Keck School of Medicine University of Southern California Los Angeles CA USA
| | | | | | | | | | | | - Andreas S. Buser
- Department of Clinical Research University Hospital Basel Basel Switzerland
- Regional Blood Transfusion Service, Swiss Red Cross, Basel Basel Switzerland
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Criscuolo M, Salmanton-García J, Fracchiolla N, Dragonetti G, Khanna N, Weinbergerová B, Schönlein M, Machado M, Labrador J, Kolditz M, Itri F, Gomes da Silva M, Bonuomo V, Sciumè M, Nunes Rodrigues R, Gräfe S, Marchesi F, Cornely OA, Pagano L. SARS-CoV-2 Infection among Patients with Mastocytosis: An EPICOVIDEHA Report. J Investig Allergol Clin Immunol 2022:0. [PMID: 35894666 DOI: 10.18176/jiaci.0845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- M Criscuolo
- Hematology Unit, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Rome, Italy
| | - J Salmanton-García
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Cologne, Germany University of Cologne, Faculty of Medicine and University Hospital Cologne, Colo
| | - N Fracchiolla
- Hematology Unit, Fondazione IRCCS Ca´ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - G Dragonetti
- Hematology Unit, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Rome, Italy
| | - N Khanna
- Division of Infectious Diseases and Hospital Epidemiology, and Department of Clinical Research, University and University Hospital of Basel, Basel, Switzerland
| | - B Weinbergerová
- University Hospital Brno - Department of Internal Medicine, Hematology and Oncology, Brno, Czech Republic
| | - M Schönlein
- Department of Oncology, Hematology and Bone Marrow Transplantation with Section of Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - M Machado
- Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - J Labrador
- Department of Hematology, Hospital Universitario de Burgos, Burgos, Spain
| | - M Kolditz
- University Hospital Dresden, Dresden, Germany
| | - F Itri
- San Luigi Gonzaga Hospital - Orbassano, Orbassano, Italy
| | | | - V Bonuomo
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | - M Sciumè
- Hematology Unit, Fondazione IRCCS Ca´ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - S Gräfe
- Universitätsklinikum Hamburg Eppendorf, Hamburg, Germany University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Cologne, Germany; University of Cologne
| | - F Marchesi
- Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - O A Cornely
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Cologne, Germany; University of Cologne, Faculty of Medicine and University Hospital Cologne, Cha
| | - L Pagano
- Hematology Unit, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Rome, Italy; Hematology Unit, Università Cattolica del Sacro Cuore, Rome, Italy
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Callegari I, Schneider M, Berloffa G, Mühlethaler T, Holdermann S, Galli E, Roloff T, Boss R, Infanti L, Khanna N, Egli A, Buser A, Zimmer G, Derfuss T, Sanderson NSR. Potent neutralization by monoclonal human IgM against SARS-CoV-2 is impaired by class switch. EMBO Rep 2022; 23:e53956. [PMID: 35548920 PMCID: PMC9253785 DOI: 10.15252/embr.202153956] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 04/13/2022] [Accepted: 04/27/2022] [Indexed: 01/11/2023] Open
Abstract
To investigate the class‐dependent properties of anti‐viral IgM antibodies, we use membrane antigen capture activated cell sorting to isolate spike‐protein‐specific B cells from donors recently infected with SARS‐CoV‐2, allowing production of recombinant antibodies. We isolate 20, spike‐protein‐specific antibodies of classes IgM, IgG, and IgA, none of which shows any antigen‐independent binding to human cells. Two antibodies of class IgM mediate virus neutralization at picomolar concentrations, but this potency is lost following artificial switch to IgG. Although, as expected, the IgG versions of the antibodies appear to have lower avidity than their IgM parents, this is not sufficient to explain the loss of potency.
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Affiliation(s)
- Ilaria Callegari
- Department of Biomedicine, University of Basel and University Hospital Basel, Basel, Switzerland.,MS Center, Neurologic Clinic and Policlinic, Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel, University of Basel, Basel, Switzerland
| | - Mika Schneider
- Department of Biomedicine, University of Basel and University Hospital Basel, Basel, Switzerland
| | - Giuliano Berloffa
- Department of Biomedicine, University of Basel and University Hospital Basel, Basel, Switzerland
| | - Tobias Mühlethaler
- Biophysics Facility, Biozentrum, University of Basel, Basel, Switzerland
| | - Sebastian Holdermann
- Department of Biomedicine, University of Basel and University Hospital Basel, Basel, Switzerland.,MS Center, Neurologic Clinic and Policlinic, Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel, University of Basel, Basel, Switzerland
| | - Edoardo Galli
- Department of Biomedicine, University of Basel and University Hospital Basel, Basel, Switzerland.,MS Center, Neurologic Clinic and Policlinic, Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel, University of Basel, Basel, Switzerland
| | - Tim Roloff
- Applied Microbiology Research, Department of Biomedicine, University of Basel, Basel, Switzerland.,Clinical Bacteriology and Mycology, University Hospital Basel, Basel, Switzerland
| | - Renate Boss
- Federal Food Safety and Veterinary Office, Bern, Switzerland
| | - Laura Infanti
- Regional Blood Transfusion Service, Swiss Red Cross, Basel, Switzerland
| | - Nina Khanna
- Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
| | - Adrian Egli
- Applied Microbiology Research, Department of Biomedicine, University of Basel, Basel, Switzerland.,Clinical Bacteriology and Mycology, University Hospital Basel, Basel, Switzerland
| | - Andreas Buser
- Regional Blood Transfusion Service, Swiss Red Cross, Basel, Switzerland
| | - Gert Zimmer
- Institute of Virology and Immunology, Bern & Mittelhäusern, Switzerland.,Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Tobias Derfuss
- Department of Biomedicine, University of Basel and University Hospital Basel, Basel, Switzerland.,MS Center, Neurologic Clinic and Policlinic, Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel, University of Basel, Basel, Switzerland
| | - Nicholas S R Sanderson
- Department of Biomedicine, University of Basel and University Hospital Basel, Basel, Switzerland.,MS Center, Neurologic Clinic and Policlinic, Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel, University of Basel, Basel, Switzerland
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35
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Brune JE, Dickenmann M, Wehmeier C, Sidler D, Walti L, Golshayan D, Manuel O, Hadaya K, Neofytos D, Schnyder A, Boggian K, Müller T, Schachtner T, Khanna N, Schaub S. Impact of different urinary tract infection phenotypes within the first year post-transplant on renal allograft outcomes. Am J Transplant 2022; 22:1823-1833. [PMID: 35286781 PMCID: PMC9542091 DOI: 10.1111/ajt.17026] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 02/22/2022] [Accepted: 03/03/2022] [Indexed: 01/25/2023]
Abstract
In this study, we investigated the clinical impact of different urinary tract infection (UTI) phenotypes occurring within the first year after renal transplantation. The population included 2368 transplantations having 2363 UTI events. Patients were categorized into four groups based on their compiled UTI events observed within the first year after transplantation: (i) no colonization or UTI (n = 1404; 59%), (ii) colonization only (n = 353; 15%), (iii) occasional UTI with 1-2 episodes (n = 456; 19%), and (iv) recurrent UTI with ≥3 episodes (n = 155; 7%). One-year mortality and graft loss rate were not different among the four groups, but patients with recurrent UTI had a 7-10 ml/min lower eGFR at year one (44 ml/min vs. 54, 53, and 51 ml/min; p < .001). UTI phenotypes had no impact on long-term patient survival (p = .33). However, patients with recurrent UTI demonstrated a 10% lower long-term death-censored allograft survival (p < .001). Furthermore, recurrent UTI was a strong and independent risk factor for reduced death-censored allograft survival in a multivariable analysis (HR 4.41, 95% CI 2.53-7.68, p < .001). We conclude that colonization and occasional UTI have no impact on pertinent outcomes, but recurrent UTI are associated with lower one-year eGFR and lower long-term death-censored allograft survival. Better strategies to prevent and treat recurrent UTI are needed.
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Affiliation(s)
- Jakob E. Brune
- Clinic for Transplantation Immunology and NephrologyUniversity Hospital BaselBaselSwitzerland
| | - Michael Dickenmann
- Clinic for Transplantation Immunology and NephrologyUniversity Hospital BaselBaselSwitzerland
| | - Caroline Wehmeier
- Clinic for Transplantation Immunology and NephrologyUniversity Hospital BaselBaselSwitzerland
| | - Daniel Sidler
- Clinic for Nephrology, InselspitalUniversity Hospital BernBernSwitzerland
| | - Laura Walti
- Department of Infectious DiseasesInselspital, University Hospital BernBernSwitzerland
| | - Dela Golshayan
- Transplantation CenterLausanne University HospitalLausanneSwitzerland
| | - Oriol Manuel
- Infectious Diseases Service and Transplantation CenterLausanne University HospitalLausanneSwitzerland
| | - Karine Hadaya
- Clinic for NephrologyUniversity Hospital GenevaGenevaSwitzerland
| | - Dionysios Neofytos
- Clinic for Infectious DiseasesUniversity Hospital GenevaGenevaSwitzerland
| | - Aurelia Schnyder
- Clinic for NephrologyKantonsspital St.GallenSt.GallenSwitzerland
| | - Katia Boggian
- Division of Infectious Diseases and Hospital EpidemiologyKantonsspital St.GallenSt.GallenSwitzerland
| | - Thomas Müller
- Clinic for NephrologyUniversity Hospital ZürichZürichSwitzerland
| | | | - Nina Khanna
- Clinic for Infectious DiseasesUniversity Hospital BaselBaselSwitzerland
| | - Stefan Schaub
- Clinic for Transplantation Immunology and NephrologyUniversity Hospital BaselBaselSwitzerland,Transplantation ImmunologyDepartment of BiomedicineUniversity of BaselBaselSwitzerland
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36
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van den Bogaart L, Lang BM, Rossi S, Neofytos D, Walti LN, Khanna N, Mueller NJ, Boggian K, Garzoni C, Mombelli M, Manuel O. Central Nervous System Infections in Solid Organ Transplant Recipients: Results from the Swiss Transplant Cohort Study. J Infect 2022; 85:1-7. [PMID: 35605804 DOI: 10.1016/j.jinf.2022.05.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 01/25/2022] [Accepted: 05/17/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To describe the epidemiology and clinical presentation of central nervous system (CNS) infections in solid organ transplant (SOT) recipients in the current era of transplantation. METHODS Patients from the Swiss Transplant Cohort Study (STCS) transplanted between 2008 and 2018 were included with a median follow-up of 3.8 years. Epidemiological, microbiological, and clinical data were extracted from the STCS database and patients' medical records. We calculated incidence rates and 90-day survival of transplant recipients with CNS infection. RESULTS Among 4762 patients, 42 episodes of CNS infection in 41 (0.8%) SOT recipients were identified, with an overall incidence rate of 2.06 per 1000 patient-years. Incidence of CNS infections was similar across all types of transplantations. Time to CNS infection onset ranged from 0.6 to 97 months after transplant. There were 22/42 (52.4%) cases of viral infections, 11/42 (26.2%) of fungal infections, 5/42 (11.9%) of bacterial infections and 4/42 (9.5%) of probable viral/bacterial etiology. Clinical presentation was meningitis/encephalitis in 25 cases (59.5%) and brain-space occupying lesions in 17 cases (40.5%). Twenty-three cases (60.5%) were considered opportunistic infections. Diagnosis were achieved mainly by brain biopsy/necropsy (15/42, 36%) or by cerebrospinal fluid analysis (20/42, 48%). Up to 40% of cases (17/42) had concurrent extra-neurological disease localizations. Overall, 90-day mortality rate was 29.0% (73.0% for fungal, 14.0% for viral and 11.0% for bacterial and probable infections, p<0.0001). CONCLUSIONS CNS infections were rare in the STCS, with viral meningoencephalitis being the most common disease. Fungal infections were associated with a high mortality.
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Affiliation(s)
- Lorena van den Bogaart
- Service of Infectious Diseases and Transplantation Center, Lausanne University Hospital, Lausanne, Switzerland.
| | - Brian M Lang
- Transplantationsimmunologie and Nephrologie Data Center of Swiss Transplant Cohort Study, Basel University Hospital, Basel, Switzerland
| | - Simona Rossi
- Transplantationsimmunologie and Nephrologie Data Center of Swiss Transplant Cohort Study, Basel University Hospital, Basel, Switzerland
| | - Dionysios Neofytos
- Transplant Infectious Diseases Unit, Geneva University Hospital, Geneva, Switzerland
| | - Laura N Walti
- Department of Infectious Diseases, Inselspital Bern University Hospital, Bern, Switzerland
| | - Nina Khanna
- Division of Infectious Diseases and Hospital Epidemiology, Basel University Hospital, Basel, Switzerland
| | - Nicolas J Mueller
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital and University of Zurich, Zurich, Switzerland
| | - Katia Boggian
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St Gallen, St Gallen, Switzerland
| | - Christian Garzoni
- Clinic of Internal Medicine and Infectious Diseases, Clinica Luganese Moncucco, Lugano, Switzerland
| | - Matteo Mombelli
- Service of Infectious Diseases and Transplantation Center, Lausanne University Hospital, Lausanne, Switzerland
| | - Oriol Manuel
- Service of Infectious Diseases and Transplantation Center, Lausanne University Hospital, Lausanne, Switzerland
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Marchesi F, Salmanton-García J, Emarah Z, Piukovics K, Nucci M, López-García A, Rácil Z, Farina F, Popova M, Zompi S, Audisio E, Ledoux MP, Verga L, Weinbergerová B, Szotkovski T, Da Silva MG, Fracchiolla N, De Jonge N, Collins G, Marchetti M, Magliano G, García-Vidal C, Biernat MM, Van Doesum J, Machado M, Demirkan F, Al-Khabori M, Žák P, Víšek B, Stoma I, Méndez GA, Maertens J, Khanna N, Espigado I, Dragonetti G, Fianchi L, Del Principe MI, Cabirta A, Ormazabal-Vélez I, Jaksic O, Buquicchio C, Bonuomo V, Batinié J, Omrani AS, Lamure S, Finizio O, Fernández N, Falces-Romero I, Blennow O, Bergantim R, Ali N, Win S, Van Praet J, Tisi MC, Shirinova A, Schönlein M, Prattes J, Piedimonte M, Petzer V, Navrátil M, Kulasekararaj A, Jindra P, Sramek J, Glenthøj A, Fazzi R, De Ramón-Sánchez C, Cattaneo C, Calbacho M, Bahr NC, El-Ashwah S, Cordoba R, Hanakova M, Zambrotta GPM, Zambrotta G, Sciumè M, Booth S, Rodrigues RN, Sacchi MV, García-Poutón N, Martín-González JA, Khostelidi S, Gräfe S, Rahimli L, Ammatuna E, Busca A, Corradini P, Hoenigl M, Klimko N, Koehler P, Pagliuca A, Passamonti F, Cornely OA, Pagano L. COVID-19 in adult acute myeloid leukemia patients: a long-term follow-up study from the European Hematology Association survey (EPICOVIDEHA). Haematologica 2022; 108:22-33. [PMID: 35545919 PMCID: PMC9827164 DOI: 10.3324/haematol.2022.280847] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Indexed: 02/04/2023] Open
Abstract
Patients with acute myeloid leukemia (AML) are at high risk of dying from coronavirus disease 2019 (COVID-19). The optimal management of AML patients with COVID-19 has not been established. Our multicenter study included 388 adult AML patients diagnosed with COVID-19 between February 2020 and October 2021. The vast majority were receiving or had received AML treatment in the preceding 3 months. COVID-19 was severe in 41.2% and critical in 21.1% of cases. The chemotherapeutic schedule was modified in 174 patients (44.8%), delayed in 68 and permanently discontinued in 106. After a median follow-up of 325 days, 180 patients (46.4%) had died; death was attributed to COVID-19 (43.3%), AML (26.1%) or to a combination of both (26.7%), whereas in 3.9% of cases the reason was unknown. Active disease, older age, and treatment discontinuation were associated with death, whereas AML treatment delay was protective. Seventy-nine patients had a simultaneous AML and COVID-19 diagnosis, with better survival when AML treatment could be delayed (80%; P<0.001). Overall survival in patients with a diagnosis of COVID-19 between January 2020 and August 2020 was significantly lower than that in patients diagnosed between September 2020 and February 2021 and between March 2021 and September 2021 (39.8% vs. 60% vs. 61.9%, respectively; P=0.006). COVID-19 in AML patients was associated with a high mortality rate and modifications of therapeutic algorithms. The best approach to improve survival was to delay AML treatment, whenever possible.
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Affiliation(s)
- Francesco Marchesi
- Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy,FM and JSG contributed equally as co-first authors
| | - Jon Salmanton-García
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany,University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Cologne, Germany,FM and JSG contributed equally as co-first authors
| | - Ziad Emarah
- Oncology Center, Mansoura University, Mansoura, Egypt
| | - Klára Piukovics
- Department of Internal Medicine, South Division Faculty of Medicine University of Szeged, Szeged, Hungary
| | - Marcio Nucci
- Department of Internal Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Alberto López-García
- Fundacion Jimenez Diaz University Hospital, Health Research Institute IIS-FJD, Madrid, Spain
| | - Zdenék Rácil
- Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | | | - Marina Popova
- RM Gorbacheva Research Institute, Pavlov University, St. Petersburg, Russia
| | - Sofia Zompi
- Stem Cell Transplant Center, AOU Citta' della Salute e della Scienza, Turin, Italy
| | - Ernesta Audisio
- Stem Cell Transplant Center, AOU Citta' della Salute e della Scienza, Turin, Italy
| | | | - Luisa Verga
- Azienda Ospedaliera San Gerardo - Monza, Monza, Italy,Università Milano-Bicocca, Milan, Italy
| | - Barbora Weinbergerová
- Department of Internal Medicine, Hematology and Oncology, University Hospital Brno, Brno, Czech Republic
| | | | | | - Nicola Fracchiolla
- Hematology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Nick De Jonge
- Amsterdam UMC, location VUmc, Amsterdam, the Netherlands
| | | | - Monia Marchetti
- Azienda Ospedaliera Nazionale “SS. Antonio e Biagio e Cesare Arrigo”, Alessandria, Italy
| | | | - Carolina García-Vidal
- Department of Infectious Diseases, Hospital Clinic de Barcelona, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Monika M. Biernat
- Department of Haematology, Blood Neoplasms, and Bone Marrow Transplantation, Wroclaw Medical University, Wroclaw, Poland
| | - Jaap Van Doesum
- University Medical Center Groningen, Groningen, the Netherlands
| | - Marina Machado
- Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Fatih Demirkan
- Division of Hematology, Dokuz Eylul University, Izmir, Turkey
| | | | - Pavel Žák
- University Hospital Hradec Králové, Hradec Králové, Czech Republic
| | - Benjamín Víšek
- University Hospital Hradec Králové, Hradec Králové, Czech Republic
| | - Igor Stoma
- Gomel State Medical University, Gomel, Belarus
| | | | - Johan Maertens
- Department of Microbiology, Immunology, and Transplantation, KULeuven and Department of Hematology, UZ Leuven, Leuven, Belgium
| | - Nina Khanna
- Division of Infectious Diseases and Hospital Epidemiology, and Department of Clinical Research, University and University Hospital of Basel, Basel, Switzerland
| | - Ildefonso Espigado
- Department of Hematology, University Hospital Virgen Macarena - University Hospital Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS/CSIC), Universidad de Sevilla, Seville, Spain
| | - Giulia Dragonetti
- Hematology Unit, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Rome, Italy
| | - Luana Fianchi
- Hematology Unit, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Rome, Italy
| | | | - Alba Cabirta
- Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain,Department of Hematology, Vall d’Hebron Hospital Universitari, Experimental Hematology, Vall d’Hebron Institute of Oncology (VHIO), Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain
| | | | | | | | - Valentina Bonuomo
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | - Josip Batinié
- Croatian Cooperative Group for Hematological Diseases (CROHEM), Zagreb, Croatia,Faculty of Medicine University of Zagreb, Zagreb, Croatia,University Hospital Centre Zagreb, Zagreb, Croatia
| | - Ali S. Omrani
- Hamad Medical Corporation, Division of Infectious Diseases, Doha, Qatar
| | - Sylvain Lamure
- Département d’Hématologie Clinique, CHU de Montpellier, UMR-CNRS 5535, Universite de Montpellier, Montpellier, France
| | | | - Noemí Fernández
- Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | | | - Ola Blennow
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Rui Bergantim
- Centro Hospitalar e Universitário São João, Porto, Portugal
| | - Natasha Ali
- Aga Khan University Hospital, Karachi, Pakistan
| | - Sein Win
- Department of Clinical Hematology, Yangon General Hospital, University of Medicine, Yangon, Myanmar
| | - Jens Van Praet
- Department of Nephrology and Infectious Diseases, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium
| | | | - Ayten Shirinova
- Azerbaijan Scientific Research Hematology and Transfusiology Institute, Baku, Azerbaijan
| | - Martin Schönlein
- Department of Oncology, Hematology and Bone Marrow Transplantation with Section of Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Juergen Prattes
- Medical University of Graz, Department for Infectious Diseases, Graz, Austria
| | | | - Verena Petzer
- Department of Hematology and Oncology, Medical University of Innsbruck, Innsbruck, Austria
| | - Milan Navrátil
- Head of the ICU and Transplant Unit, Department of Hematooncology, University Hospital of Ostrava, Ostrava-Poruba, Czech Republic
| | | | - Pavel Jindra
- University Hospital Pilsen, Pilsen, Czech Republic
| | - Jirí Sramek
- Department of Hematology and Oncology, University Hospital Pilsen, Pilsen, Czech Republic,Department of Histology and Embryology, Faculty of Medicine, Pilsen, Czech Republic
| | - Andreas Glenthøj
- Department of Hematology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Rita Fazzi
- AOUP - Azienda Ospedaliera Università Pisana - Cisanello, Pisa, Italy
| | - Cristina De Ramón-Sánchez
- Hematology Department, Hospital Universitario de Salamanca, Salamanca, Spain,IBSAL, Centro de Investigación del Cáncer-IBMCC (USAL-CSIC), Salamanca, Spain
| | | | | | | | | | - Raul Cordoba
- Fundacion Jimenez Diaz University Hospital, Health Research Institute IIS-FJD, Madrid, Spain
| | - Michaela Hanakova
- Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | | | | | - Mariarita Sciumè
- Hematology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | | | - Maria Vittoria Sacchi
- Azienda Ospedaliera Nazionale “SS. Antonio e Biagio e Cesare Arrigo”, Alessandria, Italy
| | - Nicole García-Poutón
- Department of Infectious Diseases, Hospital Clinic de Barcelona, University of Barcelona, IDIBAPS, Barcelona, Spain
| | | | - Sofya Khostelidi
- North-Western State Medical University named after Iliá Ilich Méchnikov, Saint-Petersburg, Russia
| | - Stefanie Gräfe
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany,University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Cologne, Germany,Universitätsklinikum Hamburg Eppendorf, Hamburg, Germany
| | - Laman Rahimli
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany,University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Cologne, Germany
| | | | - Alessandro Busca
- Stem Cell Transplant Center, AOU Citta' della Salute e della Scienza, Turin, Italy
| | - Paolo Corradini
- University of Milan and Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Martin Hoenigl
- Clinical and Translational Fungal-Working Group, University of California San Diego, La Jolla, CA, USA,Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, San Diego, CA, USA,Division of Infectious Diseases, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Nikolai Klimko
- North-Western State Medical University named after Iliá Ilich Méchnikov, Saint-Petersburg, Russia
| | - Philipp Koehler
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany,University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Cologne, Germany
| | - Antonio Pagliuca
- Department of Haematological Medicine, Kings College Hospital NHS Foundation Trust, London, UK
| | - Francesco Passamonti
- Department of Medicine and Surgery, University of Insubria and ASST Sette Laghi, Ospedale di Circolo of Varese, Varese, Italy
| | - Oliver A. Cornely
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany,University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Cologne, Germany,German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany,University of Cologne, Faculty of Medicine and University Hospital Cologne, Clinical Trials Centre Cologne (ZKS Köln), Cologne, Germany,OAC and LP contributed equally as co-senior authors
| | - Livio Pagano
- Hematology Unit, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Rome, Italy,Hematology Unit, Università Cattolica del Sacro Cuore, Rome, Italy,OAC and LP contributed equally as co-senior authors
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Salina A, Schumann DM, Franchetti L, Jahn K, Purkabiri K, Müller R, Strobel W, Khanna N, Tamm M, Stolz D. Multiplex bacterial PCR in the bronchoalveolar lavage fluid of non-intubated patients with suspected pulmonary infection: a quasi-experimental study. ERJ Open Res 2022; 8:00595-2021. [PMID: 35479296 PMCID: PMC9035597 DOI: 10.1183/23120541.00595-2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 01/23/2022] [Indexed: 11/05/2022] Open
Abstract
Background Early pathogen identification in pulmonary infection is crucial to guide antibacterial therapy and decrease length of hospital stay. We hypothesise that compared to conventional diagnostic methods, a multiplex bacterial polymerase chain reaction assay has a higher diagnostic yield in bronchoalveolar lavage (BAL) fluid and improved clinical outcomes in patients with suspicion of pulmonary infection. Methods A prospective, monocentric, quasi-experimental, observational study was carried out. Unselected patients with suspected pulmonary infection who underwent bronchoscopy with BAL were included in the study over a period of 1 year. In addition to conventional diagnostic methods, a multiplex PCR bacterial assay was performed in BAL on a 2 week on: 1 week off pre-determined schedule. No therapeutic recommendations were provided to the treating physician. Results 605 cases were included, 54% of whom were immunosuppressed. Conventional diagnostic methods detected 56% of the bacteria evidenced by PCR. PCR failed to detect bacteria in 4% of the cases with a positive conventional diagnostic result. After bronchoscopy, 42% of the patients received antibacterial therapy for pulmonary infection for a median of 12 antibiotic days. There was no statistically significant difference in length of hospital stay (median 8 versus 8; p=0.839), antibiotic exposure (median 11 versus 14; p=0.362) or number of antibiotics prescribed (median 2 versus 2; p=0.595) between the two groups. Conclusions A multiplex bacterial PCR detected more bacteria in BAL fluid than conventional diagnostic methods. However, without a specific antibiotic stewardship approach and a clear understanding of the clinical implications of a positive or negative PCR result, the PCR results did not influence clinical outcomes.
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Affiliation(s)
- Anna Salina
- Clinic of Respiratory Medicine and Pulmonary Cell Research, University Hospital Basel, Basel, Switzerland
| | - Desiree M Schumann
- Clinic of Respiratory Medicine and Pulmonary Cell Research, University Hospital Basel, Basel, Switzerland
| | - Léo Franchetti
- Clinic of Respiratory Medicine and Pulmonary Cell Research, University Hospital Basel, Basel, Switzerland
| | - Kathleen Jahn
- Clinic of Respiratory Medicine and Pulmonary Cell Research, University Hospital Basel, Basel, Switzerland
| | - Kurosch Purkabiri
- Clinic of Respiratory Medicine and Pulmonary Cell Research, University Hospital Basel, Basel, Switzerland
| | - Raphael Müller
- Clinic of Respiratory Medicine and Pulmonary Cell Research, University Hospital Basel, Basel, Switzerland
| | - Werner Strobel
- Clinic of Respiratory Medicine and Pulmonary Cell Research, University Hospital Basel, Basel, Switzerland
| | - Nina Khanna
- Clinic of Infectiology and Hospital Hygiene, University Hospital Basel, Basel, Switzerland
| | - Michael Tamm
- Clinic of Respiratory Medicine and Pulmonary Cell Research, University Hospital Basel, Basel, Switzerland
| | - Daiana Stolz
- Clinic of Respiratory Medicine and Pulmonary Cell Research, University Hospital Basel, Basel, Switzerland.,Faculty of Medicine, Clinic of Respiratory Medicine, Medical Center, University of Freiburg, Freiburg, Germany
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Cardoso E, Herrmann MJ, Grize L, Hostettler KE, Bassetti S, Siegemund M, Khanna N, Sava M, Sommer G, Tamm M, Stolz D. Is sleep-disordered breathing a risk factor for COVID-19 or vice versa? ERJ Open Res 2022; 8:00034-2022. [PMID: 35475113 PMCID: PMC8883039 DOI: 10.1183/23120541.00034-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 02/08/2022] [Indexed: 12/04/2022] Open
Abstract
Sleep is a physiologically invigorating, mostly nocturnal state, that plays an important role in the empowerment of the immune system [1]. Obstructive sleep apnoea (OSA) is the most frequent form of sleep disordered breathing (SDB) [2], which may represent a relevant risk factor for the clinical course and prognosis of coronavirus disease 2019 (COVID-19) [3, 4]. Common characteristics and comorbidities of OSA and COVID-19 (male gender, age >60 years, metabolic syndrome, cardiovascular and chronic pulmonary disease) were recently described as prognostic factors in COVID-19 [5]. However, the prevalence of SDB after COVID-19 remains insufficiently explored. Sleep disordered breathing may be a risk factor or a sequela of COVID-19.https://bit.ly/37v5Gyz
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40
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Shivakumar J, Parambil B, Prasad M, Gollamudi V, Ramadwar M, Qureshi S, Laskar S, Khanna N, Baheti A, Patil V, Shah S, Chinnasamy G. Clinical profile and outcome of adrenocortical in children: A single center retrospective study from India. Pediatric Hematology Oncology Journal 2022. [DOI: 10.1016/j.phoj.2022.10.121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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41
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Ragozzino S, Goldenberger D, Wright PR, Zimmerli S, Mühlethaler K, Neofytos D, Riat A, Boggian K, Nolte O, Conen A, Fankhauser H, Schreiber PW, Zbinden R, Lamoth F, Khanna N. Distribution of Aspergillus Species and Prevalence of Azole Resistance in Respiratory Samples From Swiss Tertiary Care Hospitals. Open Forum Infect Dis 2021; 9:ofab638. [PMID: 35111868 PMCID: PMC8802793 DOI: 10.1093/ofid/ofab638] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 12/17/2021] [Indexed: 11/14/2022] Open
Abstract
Among 400 Aspergillus species from respiratory samples in Switzerland, Aspergillus fumigatus was the most frequent species. Non-fumigatus Aspergillus spp were more prevalent among solid organ transplant recipients and after azole exposure. Azole resistance was detected in 4 A fumigatus isolates, 3 of them with the “environmental” mutation TR34/L98H in the cyp51A gene.
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Affiliation(s)
- Silvio Ragozzino
- Division of Infectious Diseases and Hospital Epidemiology, University of Basel and University Hospital Basel, Basel, Switzerland
| | - Daniel Goldenberger
- Clinical Bacteriology and Mycology, University of Basel and University Hospital Basel, Basel, Switzerland
| | - Patrick R Wright
- Clinical Trial Unit, University Hospital Basel, Basel, Switzerland
| | - Stefan Zimmerli
- Department of Infectious Diseases, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Konrad Mühlethaler
- Clinical Microbiology, Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Dionysios Neofytos
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Geneva, Geneva, Switzerland
| | - Arnaud Riat
- Division of Laboratory Medicine, Laboratory of Bacteriology, University Hospital Geneva and University of Geneva, Geneva, Switzerland
| | - Katia Boggian
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St Gallen, St Gallen, Switzerland
| | - Oliver Nolte
- Center for Laboratory Medicine, St Gallen, Switzerland
| | - Anna Conen
- Clinic of Infectious Diseases and Hospital Hygiene, Cantonal Hospital Aarau, Aarau, Switzerland
| | - Hans Fankhauser
- Clinical Microbiology, Cantonal Hospital Aarau, Aarau, Switzerland
| | - Peter W Schreiber
- Division of Infectious Diseases and Hospital Epidemiology, University of Zurich and University Hospital Zurich, Zurich, Switzerland
| | - Reinhard Zbinden
- Clinical Microbiology, University Hospital Zurich, Zurich, Switzerland
| | - Frederic Lamoth
- Infectious Diseases Service and Institute of Microbiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Nina Khanna
- Division of Infectious Diseases and Hospital Epidemiology, University of Basel and University Hospital Basel, Basel, Switzerland
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42
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Agnetti J, Büchler AC, Osthoff M, Helfenstein F, Hinic V, Tschudin-Sutter S, Bättig V, Khanna N, Egli A. 653. Direct Identification of Microorganisms in Positive Blood Cultures by the BioFire® FilmArray® Blood Culture Identification Panel Leads to Faster Optimal Antibiotic Therapy: A Before–After Study. Open Forum Infect Dis 2021. [PMCID: PMC8643973 DOI: 10.1093/ofid/ofab466.850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background Rapid pathogen identification from positive blood cultures may help optimize empiric antibiotic therapy quickly by reducing unnecessary broad spectrum antibiotic use and may improve patient outcomes. The BioFire® FilmArray® Blood Culture Identification Panel 1 (BF-FA-BCIP) identifies 24 pathogens directly from positive blood cultures without subculture. 3 resistance genes are included. We aimed to compare the time to optimal antibiotic therapy between BF-FA-BCIP and conventional identification. Methods We performed a single-center retrospective case-control before-after study of 386 cases (November 2018 to October 2019) with BF-FA-BCIP compared to 414 controls (August 2017 to July 2018) with conventional identification. The primary study endpoint was the time from blood sampling to implementation of optimal antimicrobial therapy. Secondary endpoints were time to effective therapy, length of hospital stay, and in-hospital and 30-day mortality. Outcomes were assessed using cause-specific Cox Proportional Hazard models and logistic regressions. Results We included 800 patients with comparable baseline characteristics. Main sources of blood stream infection (BSI) were urinary tract infection and intra-abdominal infection (19.2% vs. 22.0% and 16.8% vs. 15.7% for case and control groups, respectively). Overall, 212 positive blood cultures were considered as contaminations. Identification results were available after a median of 21.9 hours by the BF-FA-BCIP and 44.3 hours by the conventional method. Patients with BF-FA-BCIP received the optimal therapy after a median of 25.5 hours (95%CI 21.0 - 31.2) as compared to 45.7 hours (95%CI 37.7 - 51.2) in the control group (Figure 1). We found no effect of the identification method on secondary outcomes. Kaplan-Meier curve representing the probability of implementing the optimal therapy at any given time according to the identification method (Standard vs. BF-FA-BCIP). ![]()
Shaded ribbons represent the 95 % confidence interval (CI). The vertical dashes represent censored data. The vertical dotted lines represent the median time, i.e. the time at which 50 % of the patients obtained the optimal therapy, for the two methods. Median (95 % CI) time to optimal therapy is 45.7 (37.7 - 51.4) hours with the Standard method and 25.5 (21.0- 31.2) hours with Biofire. The tables below the curves present the numbers expecting optimal therapy according to the bacteria identification method, as well as the number of censored data in parenthesis. Panel A shows data from 0 to 900 hours. Panel B shows the data from 0 to 90 hours to better visualize how the probability to implement optimal therapy varies in the first 72 hours. Conclusion In conclusion, rapid pathogen identification by BF-FA-BCIP was associated with an almost 24h earlier initiation of the optimal antibiotic therapy in BSI. However, the overall benefit for individual patients seems to be limited. Future studies should assess the cost-effectiveness and impact on the prevention of antibiotic resistance using this diagnostic approach. Disclosures All Authors: No reported disclosures
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Affiliation(s)
| | - Andrea C Büchler
- Erasmus University Medical Center, Rotterdam, Zuid-Holland, Netherlands
| | | | | | | | | | | | - Nina Khanna
- University Hospital Basel, Basel-Stadt, Switzerland
| | - Adrian Egli
- University Hospital Basel, Basel-Stadt, Switzerland
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Axfors C, Janiaud P, Schmitt AM, Van't Hooft J, Smith ER, Haber NA, Abayomi A, Abduljalil M, Abdulrahman A, Acosta-Ampudia Y, Aguilar-Guisado M, Al-Beidh F, Alejandria MM, Alfonso RN, Ali M, AlQahtani M, AlZamrooni A, Anaya JM, Ang MAC, Aomar IF, Argumanis LE, Averyanov A, Baklaushev VP, Balionis O, Benfield T, Berry S, Birocco N, Bonifacio LB, Bowen AC, Bown A, Cabello-Gutierrez C, Camacho B, Camacho-Ortiz A, Campbell-Lee S, Cao DH, Cardesa A, Carnate JM, Castillo GJJ, Cavallo R, Chowdhury FR, Chowdhury FUH, Ciccone G, Cingolani A, Climacosa FMM, Compernolle V, Cortez CFN, Costa Neto A, D'Antico S, Daly J, Danielle F, Davis JS, De Rosa FG, Denholm JT, Denkinger CM, Desmecht D, Díaz-Coronado JC, Díaz Ponce-Medrano JA, Donneau AF, Dumagay TE, Dunachie S, Dungog CC, Erinoso O, Escasa IMS, Estcourt LJ, Evans A, Evasan ALM, Fareli CJ, Fernandez-Sanchez V, Galassi C, Gallo JE, Garcia PJ, Garcia PL, Garcia JA, Garigliany M, Garza-Gonzalez E, Gauiran DTV, Gaviria García PA, Giron-Gonzalez JA, Gómez-Almaguer D, Gordon AC, Gothot A, Grass Guaqueta JS, Green C, Grimaldi D, Hammond NE, Harvala H, Heralde FM, Herrick J, Higgins AM, Hills TE, Hines J, Holm K, Hoque A, Hoste E, Ignacio JM, Ivanov AV, Janssen M, Jennings JH, Jha V, King RAN, Kjeldsen-Kragh J, Klenerman P, Kotecha A, Krapp F, Labanca L, Laing E, Landin-Olsson M, Laterre PF, Lim LL, Lim J, Ljungquist O, Llaca-Díaz JM, López-Robles C, López-Cárdenas S, Lopez-Plaza I, Lucero JAC, Lundgren M, Macías J, Maganito SC, Malundo AFG, Manrique RD, Manzini PM, Marcos M, Marquez I, Martínez-Marcos FJ, Mata AM, McArthur CJ, McQuilten ZK, McVerry BJ, Menon DK, Meyfroidt G, Mirasol MAL, Misset B, Molton JS, Mondragon AV, Monsalve DM, Moradi Choghakabodi P, Morpeth SC, Mouncey PR, Moutschen M, Müller-Tidow C, Murphy E, Najdovski T, Nichol AD, Nielsen H, Novak RM, O'Sullivan MVN, Olalla J, Osibogun A, Osikomaiya B, Oyonarte S, Pardo-Oviedo JM, Patel MC, Paterson DL, Peña-Perez CA, Perez-Calatayud AA, Pérez-Alba E, Perkina A, Perry N, Pouladzadeh M, Poyato I, Price DJ, Quero AKH, Rahman MM, Rahman MS, Ramesh M, Ramírez-Santana C, Rasmussen M, Rees MA, Rego E, Roberts JA, Roberts DJ, Rodríguez Y, Rodríguez-Baño J, Rogers BA, Rojas M, Romero A, Rowan KM, Saccona F, Safdarian M, Santos MCM, Sasadeusz J, Scozzari G, Shankar-Hari M, Sharma G, Snelling T, Soto A, Tagayuna PY, Tang A, Tatem G, Teofili L, Tong SYC, Turgeon AF, Veloso JD, Venkatesh B, Ventura-Enriquez Y, Webb SA, Wiese L, Wikén C, Wood EM, Yusubalieva GM, Zacharowski K, Zarychanski R, Khanna N, Moher D, Goodman SN, Ioannidis JPA, Hemkens LG. Association between convalescent plasma treatment and mortality in COVID-19: a collaborative systematic review and meta-analysis of randomized clinical trials. BMC Infect Dis 2021; 21:1170. [PMID: 34800996 PMCID: PMC8605464 DOI: 10.1186/s12879-021-06829-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 10/28/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Convalescent plasma has been widely used to treat COVID-19 and is under investigation in numerous randomized clinical trials, but results are publicly available only for a small number of trials. The objective of this study was to assess the benefits of convalescent plasma treatment compared to placebo or no treatment and all-cause mortality in patients with COVID-19, using data from all available randomized clinical trials, including unpublished and ongoing trials (Open Science Framework, https://doi.org/10.17605/OSF.IO/GEHFX ). METHODS In this collaborative systematic review and meta-analysis, clinical trial registries (ClinicalTrials.gov, WHO International Clinical Trials Registry Platform), the Cochrane COVID-19 register, the LOVE database, and PubMed were searched until April 8, 2021. Investigators of trials registered by March 1, 2021, without published results were contacted via email. Eligible were ongoing, discontinued and completed randomized clinical trials that compared convalescent plasma with placebo or no treatment in COVID-19 patients, regardless of setting or treatment schedule. Aggregated mortality data were extracted from publications or provided by investigators of unpublished trials and combined using the Hartung-Knapp-Sidik-Jonkman random effects model. We investigated the contribution of unpublished trials to the overall evidence. RESULTS A total of 16,477 patients were included in 33 trials (20 unpublished with 3190 patients, 13 published with 13,287 patients). 32 trials enrolled only hospitalized patients (including 3 with only intensive care unit patients). Risk of bias was low for 29/33 trials. Of 8495 patients who received convalescent plasma, 1997 died (23%), and of 7982 control patients, 1952 died (24%). The combined risk ratio for all-cause mortality was 0.97 (95% confidence interval: 0.92; 1.02) with between-study heterogeneity not beyond chance (I2 = 0%). The RECOVERY trial had 69.8% and the unpublished evidence 25.3% of the weight in the meta-analysis. CONCLUSIONS Convalescent plasma treatment of patients with COVID-19 did not reduce all-cause mortality. These results provide strong evidence that convalescent plasma treatment for patients with COVID-19 should not be used outside of randomized trials. Evidence synthesis from collaborations among trial investigators can inform both evidence generation and evidence application in patient care.
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Affiliation(s)
- Cathrine Axfors
- Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, USA
- Department for Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Perrine Janiaud
- Department of Clinical Research, University Hospital Basel, University of Basel, Spitalstrasse 12, 4031, Basel, Switzerland
| | - Andreas M Schmitt
- Department of Clinical Research, University Hospital Basel, University of Basel, Spitalstrasse 12, 4031, Basel, Switzerland
- Department of Medical Oncology, University of Basel, Basel, Switzerland
| | - Janneke Van't Hooft
- Amsterdam University Medical Center, Amsterdam University, Amsterdam, The Netherlands
| | - Emily R Smith
- Department of Global Health, Milken Institute School of Public Health, The George Washington University, Washington, USA
| | - Noah A Haber
- Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, USA
| | | | - Manal Abduljalil
- Internal Medicine, Bahrain Defence Force Hospital, Riffa, Bahrain
| | - Abdulkarim Abdulrahman
- Medical Team, National Task Force for Combating the Coronavirus (COVID19), Riffa, Bahrain
- Mohammed Bin Khalifa Cardiac Centre, Awali, Bahrain
| | - Yeny Acosta-Ampudia
- Center for Autoimmune Diseases Research (CREA), Universidad del Rosario, Bogotá, Colombia
| | - Manuela Aguilar-Guisado
- Infectious Diseases, Microbiology and Preventive Medicine Unit, Hospital Universitario Virgen del Rocío, Seville, Spain
| | - Farah Al-Beidh
- Surgery and Cancer, Anaesthetics, Pain Medicine and Intensive Care, Imperial College London, London, UK
| | - Marissa M Alejandria
- Department of Medicine, Division of Infectious Diseases, University of the Philippines-Philippine General Hospital, Manila, Philippines
| | - Rachelle N Alfonso
- Department of Medicine, Division of Hematology, University of the Philippines-Philippine General Hospital, Manila, Philippines
| | - Mohammad Ali
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Manaf AlQahtani
- Medical Team, National Task Force for Combating the Coronavirus (COVID19), Riffa, Bahrain
- Microbiology, Infectious Diseases, Bahrain Defence Force Hospital, Riffa, Bahrain
- Microbiology, Royal College of Surgeons in Ireland-Medical University in Bahrain, Riffa, Bahrain
| | - Alaa AlZamrooni
- Internal Medicine, Salmaniya Medical Complex, Manama, Bahrain
| | - Juan-Manuel Anaya
- Center for Autoimmune Diseases Research (CREA), Universidad del Rosario, Bogotá, Colombia
| | - Mark Angelo C Ang
- Department of Laboratories, Division of Blood Bank, University of the Philippines-Philippine General Hospital, Manila, Philippines
| | - Ismael F Aomar
- Department of Internal Medicine, Hospital Universitario San Cecilio, Granada, Spain
| | - Luis E Argumanis
- Banco de Sangre, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Alexander Averyanov
- Pulmonary Division, Federal Scientific and Clinical Center of Specialized Medical Care and Medical Technologies of the Federal Medical and Biological Agency, Moscow, Russian Federation
- Fundamental Medicine Department, Pulmonology Scientific and Research Institute under Federal Medical and Biological Agency, Moscow, Russian Federation
| | - Vladimir P Baklaushev
- Fundamental Medicine Department, Pulmonology Scientific and Research Institute under Federal Medical and Biological Agency, Moscow, Russian Federation
- Cell Culture Laboratory, Biomedical Research, Federal Scientific and Clinical Center of Specialized Medical Care and Medical Technologies of the Federal Medical and Biological Agency, Moscow, Russian Federation
| | - Olga Balionis
- Pulmonary Division, Federal Scientific and Clinical Center of Specialized Medical Care and Medical Technologies of the Federal Medical and Biological Agency, Moscow, Russian Federation
- Laboratory of Personalized Medicine, Pulmonology Scientific and Research Institute under Federal Medical and Biological Agency, Moscow, Russian Federation
| | - Thomas Benfield
- Center for Research and Disruption of Infectious Diseases, Department of Infectious Diseases, Copenhagen University Hospital-Amager and Hvidovre, Hvidovre, Denmark
| | | | - Nadia Birocco
- Department of Oncology, University Hospital Città della Salute e della Scienza di Torino, Turin, Italy
| | - Lynn B Bonifacio
- Department of Medicine, Division of Hematology, University of the Philippines-Philippine General Hospital, Manila, Philippines
| | - Asha C Bowen
- Menzies School of Health Research, Casuarina, Australia
- Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Nedlands, Australia
- Department of Infectious Diseases, Perth Children's Hospital, Nedlands, Australia
| | - Abbie Bown
- Rare and Imported Pathogens Laboratory, Public Health England, Porton Down, UK
| | - Carlos Cabello-Gutierrez
- Department Research in Virology and Mycology, Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico
| | - Bernardo Camacho
- Instituto Distrital de Ciencia Biotecnología e Investigación en Salud (IDCBIS), Bogotá, Colombia
| | - Adrian Camacho-Ortiz
- Department of Infectious Diseases, Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | | | - Damon H Cao
- Department of Medicine, Division of Nephrology, Henry Ford Hospital, Detroit, USA
| | - Ana Cardesa
- Clinical Department, Red Andaluza de Diseño y Traslacion de Terapias Avanzadas, Sevilla, Spain
| | - Jose M Carnate
- Department of Laboratories, University of the Philippines-Philippine General Hospital, Manila, Philippines
| | - German Jr J Castillo
- Department of Medicine, Division of Hematology, University of the Philippines-Philippine General Hospital, Manila, Philippines
| | - Rossana Cavallo
- Department of Laboratory Medicine, Unit of Microbiology and Virology, University Hospital Città della Salute e della Scienza di Torino, Turin, Italy
| | - Fazle R Chowdhury
- Internal Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | | | - Giovannino Ciccone
- Department of Quality and Safety in Health Care, Unit of Clinical Epidemiology, University Hospital Città della Salute e della Scienza di Torino, Turin, Italy
| | - Antonella Cingolani
- Infectious Disease, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | | | - Veerle Compernolle
- Blood Services, Belgian Red Cross-Flanders, Mechelen, Belgium
- Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Carlo Francisco N Cortez
- Department of Medicine, Division of Hematology, University of the Philippines-Philippine General Hospital, Manila, Philippines
| | - Abel Costa Neto
- Instituto D'Or de Pesquisa e Ensino (IDOR), São Paulo, Brazil
| | - Sergio D'Antico
- Department of Laboratory Medicine, Unit of Transfusion Medicine, University Hospital Città della Salute e della Scienza di Torino, Turin, Italy
| | - James Daly
- Australian Red Cross Lifeblood, Melbourne, Australia
| | - Franca Danielle
- Department of Laboratory Medicine, Blood Bank, University Hospital Città della Salute e della Scienza di Torino, Turin, Italy
| | | | - Francesco Giuseppe De Rosa
- Department of Medical Sciences, Unit of Infective Diseases, University Hospital Città della Salute e della Scienza di Torino, Turin, Italy
| | - Justin T Denholm
- Victorian Infectious Diseases Service, The Royal Melbourne Hospital, Melbourne, Australia
- Doherty Department, University of Melbourne, The Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
| | - Claudia M Denkinger
- Center of Infectious Diseases, Division of Tropical Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | | | | | | | | | - Teresita E Dumagay
- Department of Medicine, Division of Hematology, University of the Philippines-Philippine General Hospital, Manila, Philippines
| | - Susanna Dunachie
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Cecile C Dungog
- Department of Laboratories, University of the Philippines-Philippine General Hospital, Manila, Philippines
| | | | - Ivy Mae S Escasa
- Department of Medicine, Division of Hematology, University of the Philippines-Philippine General Hospital, Manila, Philippines
| | - Lise J Estcourt
- Clinical, Research and Development, NHS Blood and Transplant, Oxford, UK
- Radcliffe Department of Medicine and BRC Haematology Theme, University of Oxford, Oxford, UK
| | - Amy Evans
- Clinical Trials Unit, NHS Blood and Transplant, Cambridge, UK
| | - Agnes L M Evasan
- Department of Medicine, Division of Infectious Diseases, University of the Philippines-Philippine General Hospital, Manila, Philippines
| | - Christian J Fareli
- CENETEC (National Center for Health Technology Excellence), Mexico City, Mexico
| | | | - Claudia Galassi
- Department of Quality and Safety in Health Care, Unit of Clinical Epidemiology, University Hospital Città della Salute e della Scienza di Torino, Turin, Italy
| | | | - Patricia J Garcia
- Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Patricia L Garcia
- Servicio de Hemoterapia y Banco de Sangre, Instituto Nacional de Salud del Niño San Borja, Lima, Peru
| | - Jesus A Garcia
- Department of Haematology, Centro Transfusional Tejidos y Celulas de Granada, Granada, Spain
| | | | - Elvira Garza-Gonzalez
- Department of Infectious Diseases, Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Deonne Thaddeus V Gauiran
- Department of Medicine, Division of Hematology, University of the Philippines-Philippine General Hospital, Manila, Philippines
| | - Paula A Gaviria García
- Instituto Distrital de Ciencia Biotecnología e Investigación en Salud (IDCBIS), Bogotá, Colombia
| | | | | | - Anthony C Gordon
- Surgery and Cancer, Anaesthetics, Pain Medicine and Intensive Care, Imperial College London, London, UK
- Intensive Care, Imperial College Healthcare NHS Trust, London, UK
| | - André Gothot
- Immunohematology, Liège University Hospital, Liège, Belgium
| | | | - Cameron Green
- ANZIC-RC, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - David Grimaldi
- Intensive Care Medicine, Cliniques Universitaires de Bruxelles-Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Naomi E Hammond
- The George Institute for Global Health, Sydney and New Delhi, Sydney, Australia
| | - Heli Harvala
- Microbiology Services, NHS Blood and Transplant, London, UK
| | - Francisco M Heralde
- Department of Biochemistry and Molecular Biology, University of the Philippines, Manila, Philippines
| | - Jesica Herrick
- Medicine, Division of Infectious Diseases, Immunology, and International Medicine, University of Illinois at Chicago, Chicago, USA
| | - Alisa M Higgins
- ANZIC-RC, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Thomas E Hills
- Medical Research Institute of New Zealand, Wellington, New Zealand
- Auckland City Hospital, Auckland, New Zealand
| | - Jennifer Hines
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Henry Ford Hospital, Detroit, USA
| | - Karin Holm
- Division of Infection Medicine, Department of Clinical Sciences, Lund University, Lund, Sweden
- Infectious Diseases, Skåne University Hospital, Lund, Sweden
| | - Ashraful Hoque
- Blood Transfusion, Sheikh Hasina National Institute of Burn and Plastic Surgery, Dhaka, Bangladesh
| | - Eric Hoste
- Intensive Care Medicine, Gand University Hospital, Gent, Belgium
| | - Jose M Ignacio
- Department of Neumology and Pulmonology, Hospital Quiron de Marbella, Málaga, Spain
| | - Alexander V Ivanov
- Center for Precision Genome Editing and Genetic Technologies for Biomedicine, Engelhardt Institute of Molecular Biology of the Russian Academy of Sciences, Moscow, Russian Federation
| | - Maike Janssen
- Department of Hematology, Oncology and Rheumatology, Internal Medicine V, University Hospital Heidelberg, Heidelberg, Germany
| | - Jeffrey H Jennings
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Henry Ford Hospital, Detroit, USA
| | - Vivekanand Jha
- The George Institute for Global Health, Sydney and New Delhi, New Delhi, India
- School of Public Health, Imperial College, London, UK
- Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India
| | - Ruby Anne N King
- Department of Biochemistry and Molecular Biology, University of the Philippines, Manila, Philippines
| | - Jens Kjeldsen-Kragh
- Clinical Immunology and Transfusion Medicine, University and Regional Laboratories, Region Skåne, Lund, Sweden
| | - Paul Klenerman
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Aditya Kotecha
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Henry Ford Hospital, Detroit, USA
| | - Fiorella Krapp
- Facultad de Medicina, Instituto de Medicina Tropical Alexander Von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Luciana Labanca
- Department of Laboratory Medicine, Blood Bank, University Hospital Città della Salute e della Scienza di Torino, Turin, Italy
| | - Emma Laing
- Clinical Trials Unit, NHS Blood and Transplant, Cambridge, UK
| | - Mona Landin-Olsson
- Department of Clinical Sciences, Lund University, Lund, Sweden
- Department of Endocrinology, Skåne University Hospital, Lund, Sweden
| | | | | | - Jodor Lim
- Department of Medicine, Division of Infectious Diseases, University of the Philippines-Philippine General Hospital, Manila, Philippines
| | - Oskar Ljungquist
- Clinical Sciences, Clinical Infection Medicine, Lund University, Malmo, Sweden
| | - Jorge M Llaca-Díaz
- Department of Clinical Pathology, Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Concepción López-Robles
- Department of Infectious Diseases, Hospital Universitario Virgen de Las Nieves, Granada, Spain
| | - Salvador López-Cárdenas
- Department of Infectious Diseases, Hospital Universitario de Jerez de La Frontera, Jerez de la Frontera, Spain
| | - Ileana Lopez-Plaza
- Division of Transfusion Medicine, Department of Pathology, Henry Ford Hospital, Detroit, USA
| | - Josephine Anne C Lucero
- Department of Medicine, Division of Hematology, University of the Philippines-Philippine General Hospital, Manila, Philippines
| | - Maria Lundgren
- Clinical Immunology and Transfusion Medicine, University and Regional Laboratories, Region Skåne, Lund, Sweden
| | - Juan Macías
- Department of Infectious Diseases, Hospital Universitario de Valme, Sevilla, Spain
| | - Sandy C Maganito
- Department of Laboratories, University of the Philippines-Philippine General Hospital, Manila, Philippines
| | - Anna Flor G Malundo
- Department of Medicine, Division of Infectious Diseases, University of the Philippines-Philippine General Hospital, Manila, Philippines
| | - Rubén D Manrique
- Epidemiology and Biostatistics Research Group, Universidad CES, Medellín, Colombia
| | - Paola M Manzini
- Department of Laboratory Medicine, Unit of Transfusion Medicine, University Hospital Città della Salute e della Scienza di Torino, Turin, Italy
| | - Miguel Marcos
- Department of Internal Medicine, Hospital Quiron de Malaga, Málaga, Spain
| | - Ignacio Marquez
- Department of Infectious Diseases, Hospital Regional Universitario de Malaga, Málaga, Spain
| | | | - Ana M Mata
- Department of Internal Medicine, Hospital San Juan de Dios del Aljarafe, Bormujos, Spain
| | - Colin J McArthur
- Department of Critical Care Medicine, Auckland City Hospital, Auckland, New Zealand
| | - Zoe K McQuilten
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
- Department of Haematology, Monash Health, Melbourne, Australia
| | - Bryan J McVerry
- Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, USA
| | - David K Menon
- University Division of Anaesthesia, Addenbrooke's Hospital Cambridge, University of Cambridge, Cambridge, UK
| | - Geert Meyfroidt
- Intensive Care Medicine, Leuven University Hospital, Leuven, Belgium
| | - Ma Angelina L Mirasol
- Department of Medicine, Division of Hematology, University of the Philippines-Philippine General Hospital, Manila, Philippines
| | - Benoît Misset
- Intensive Care Medicine, Liège University Hospital, Liège, Belgium
| | | | - Alric V Mondragon
- Department of Medicine, Division of Allergy and Immunology, University of the Philippines-Philippine General Hospital, Manila, Philippines
| | - Diana M Monsalve
- Center for Autoimmune Diseases Research (CREA), Universidad del Rosario, Bogotá, Colombia
| | - Parastoo Moradi Choghakabodi
- Thalassemia and Hemoglobinopathy Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Thalassemia and Hemoglobinopathy Research Center, Health Research Institute, Ahvaz, Iran
| | | | - Paul R Mouncey
- Clinical Trials Unit, Intensive Care National Audit and Research Centre, London, UK
| | - Michel Moutschen
- Intensive Care Medicine, Liège University Hospital, Liège, Belgium
| | - Carsten Müller-Tidow
- Department of Hematology, Oncology and Rheumatology, Internal Medicine V, University Hospital Heidelberg, Heidelberg, Germany
| | - Erin Murphy
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Henry Ford Hospital, Detroit, USA
| | | | - Alistair D Nichol
- School of Medicine and Medical Sciences, University College Dublin-Clinical Research Centre, University College Dublin, Dublin, Ireland
- Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Intensive Care Medicine, Alfred Health, Melbourne, Australia
| | - Henrik Nielsen
- Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark
| | - Richard M Novak
- Medicine, Division of Infectious Diseases, Immunology, and International Medicine, University of Illinois at Chicago, Chicago, USA
| | - Matthew V N O'Sullivan
- Institute of Clinical Pathology and Medical Research, NSW Health Pathology, Westmead, Australia
- Centre for Infectious Diseases and Microbiology, Westmead Hospital, Westmead, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Julian Olalla
- Department of Internal Medicine, Hospital Costa del Sol, Málaga, Spain
| | - Akin Osibogun
- College of Medicine, University of Lagos, Lagos, Nigeria
| | | | - Salvador Oyonarte
- Department of Infectious Diseases, Centro Transfusional Tejidos y Celulas de Sevilla, Sevilla, Spain
| | - Juan M Pardo-Oviedo
- Hospital Universitario Mayor Méderi, Universidad del Rosario, Bogotá, Colombia
| | - Mahesh C Patel
- Medicine, Division of Infectious Diseases, Immunology, and International Medicine, University of Illinois at Chicago, Chicago, USA
| | - David L Paterson
- Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, Australia
| | | | | | - Eduardo Pérez-Alba
- Department of Infectious Diseases, Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Anastasia Perkina
- Pulmonary Division, Federal Scientific and Clinical Center of Specialized Medical Care and Medical Technologies of the Federal Medical and Biological Agency, Moscow, Russian Federation
- Laboratory of Personalized Medicine, Pulmonology Scientific and Research Institute under Federal Medical and Biological Agency, Moscow, Russian Federation
| | - Naomi Perry
- Doherty Department, University of Melbourne, The Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
| | - Mandana Pouladzadeh
- Emergency Medicine Department, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Inmaculada Poyato
- Department of Internal Medicine, Hospital Universitario Torrecardenas, Almería, Spain
| | - David J Price
- Doherty Department, University of Melbourne, Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Anne Kristine H Quero
- Department of Medicine, Division of Hematology, University of the Philippines-Philippine General Hospital, Manila, Philippines
| | - Md M Rahman
- Internal Medicine, Dhaka Medical College, Dhaka, Bangladesh
| | - Md S Rahman
- Pharmacology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Mayur Ramesh
- Department of Internal Medicine, Division of Infectious Diseases, Henry Ford Hospital, Detroit, USA
| | | | - Magnus Rasmussen
- Division of Infection Medicine, Department of Clinical Sciences, Lund University, Lund, Sweden
- Infectious Diseases, Skåne University Hospital, Lund, Sweden
| | - Megan A Rees
- Department of Medicine, University of Melbourne, Melbourne, Australia
- Royal Melbourne Hospital, Melbourne Health, Melbourne, Australia
| | - Eduardo Rego
- Instituto D'Or de Pesquisa e Ensino (IDOR), São Paulo, Brazil
| | - Jason A Roberts
- Hospital Universitario Mayor Méderi, Universidad del Rosario, Bogotá, Colombia
- Departments of Pharmacy and Intensive Care Medicine, Royal Brisbane and Women's Hospital, Brisbane, Australia
- Division of Anaesthesiology Critical Care Emergency and Pain Medicine, Nîmes University Hospital, University of Montpellier, Nîmes, France
| | - David J Roberts
- Radcliffe Department of Medicine and BRC Haematology Theme, University of Oxford, Oxford, UK
- Clinical and Research and Development, NHS Blood and Transplant, Oxford, UK
| | - Yhojan Rodríguez
- Center for Autoimmune Diseases Research (CREA), Universidad del Rosario, Bogotá, Colombia
- Clinica del Occidente, Bogotá, Colombia
| | - Jesús Rodríguez-Baño
- Infectious Diseases and Clinical Microbiology Unit, Hospital Universitario Virgen Macarena, Sevilla, Spain
- Department of Medicine, University of Sevilla-IBiS, Sevilla, Spain
| | - Benjamin A Rogers
- Monash University, Melbourne, Australia
- Monash Health, Melbourne, Australia
| | - Manuel Rojas
- Center for Autoimmune Diseases Research (CREA), Universidad del Rosario, Bogotá, Colombia
| | - Alberto Romero
- Department of Infectious Diseases, Hospital Universitario de Puerto Real, Cádiz, Spain
| | - Kathryn M Rowan
- Intensive Care National Audit and Research Centre (ICNARC), London, UK
| | - Fabio Saccona
- Department of Quality and Safety in Health Care, Unit of Clinical Epidemiology, University Hospital Città della Salute e della Scienza di Torino, Turin, Italy
| | - Mehdi Safdarian
- Nanotechnology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Maria Clariza M Santos
- Department of Medicine, Division of Hematology, University of the Philippines-Philippine General Hospital, Manila, Philippines
| | - Joe Sasadeusz
- Victorian Infectious Diseases Service, The Royal Melbourne Hospital, Melbourne, Australia
- Doherty Department, University of Melbourne, The Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
| | - Gitana Scozzari
- Department of Medical Hospital Direction, Unit of Medical Direction, University Hospital Città della Salute e della Scienza di Torino, Turin, Italy
| | - Manu Shankar-Hari
- St Thomas' Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
- School of Immunology and Microbial Sciences, Kings College London, London, UK
| | - Gorav Sharma
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Henry Ford Hospital, Detroit, USA
| | - Thomas Snelling
- Menzies School of Health Research, Casuarina, Australia
- Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Nedlands, Australia
- Sydney School of Public Health, University of Sydney, Camperdown, Australia
- Sydney Children's Hospital Network, Westmead, Australia
| | - Alonso Soto
- Facultad de Medicina Humana, Instituto de Investigación en Ciencias Biomédicas (INICIB), Universidad Ricardo Palma, Lima, Peru
- Department of Internal Medicine, Hospital Nacional Hipolito Unanue, Lima, Peru
| | - Pedrito Y Tagayuna
- Department of Laboratories, University of the Philippines-Philippine General Hospital, Manila, Philippines
| | - Amy Tang
- Public Health Sciences, Henry Ford Hospital, Detroit, USA
| | - Geneva Tatem
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Henry Ford Hospital, Detroit, USA
| | - Luciana Teofili
- Transfusion Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Steven Y C Tong
- Victorian Infectious Diseases Service, The Royal Melbourne Hospital, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
- Department of Infectious Diseases, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
| | - Alexis F Turgeon
- Department of Anesthesiology and Critical Care Medicine, Division of Critical Care Medicine, Université Laval, Quebec City, QC, Canada
| | - Januario D Veloso
- Department of Medicine, Division of Hematology, University of the Philippines-Philippine General Hospital, Manila, Philippines
| | - Balasubramanian Venkatesh
- The George Institute for Global Health, Sydney and New Delhi, Sydney, Australia
- Faculty of Medicine, University of New South Wales, Sydney, Australia
- Wesley and Princess Alexandra Hospitals, University of Queensland, Brisbane, Australia
| | | | - Steve A Webb
- School of Medicine and Medical Sciences, University College Dublin-Clinical Research Centre, University College Dublin, Dublin, Ireland
- St John of God Hospital, Subiaco, Subiaco, Australia
| | - Lothar Wiese
- Department of Infectious Diseases, Zealand University Hospital, Roskilde, Denmark
| | - Christian Wikén
- Infectious Diseases, Skåne University Hospital, Lund, Sweden
| | - Erica M Wood
- Department of Clinical Haematology, Monash Health, Melbourne, Australia
| | - Gaukhar M Yusubalieva
- Cell Culture Laboratory, Biomedical Research, Federal Scientific and Clinical Center of Specialized Medical Care and Medical Technologies of the Federal Medical and Biological Agency, Moscow, Russian Federation
| | - Kai Zacharowski
- Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Ryan Zarychanski
- Department of Internal Medicine, Critical Care and Hematology/Medical Oncology, University of Manitoba, Winnipeg, Canada
| | - Nina Khanna
- Division of Infectious Diseases and Hospital Hygiene and Infection Biology Laboratory, University Hospital Basel and University of Basel, Basel, Switzerland
| | - David Moher
- Centre for Journalology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Steven N Goodman
- Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, USA
- Stanford University School of Medicine, Stanford, USA
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, USA
| | - John P A Ioannidis
- Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, USA
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, USA
- Department of Biomedical Data Science, Stanford University School of Medicine, Stanford, USA
- Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, USA
- Meta-Research Innovation Center Berlin (METRIC-B), Berlin Institute of Health, Berlin, Germany
| | - Lars G Hemkens
- Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, USA.
- Department of Clinical Research, University Hospital Basel, University of Basel, Spitalstrasse 12, 4031, Basel, Switzerland.
- Meta-Research Innovation Center Berlin (METRIC-B), Berlin Institute of Health, Berlin, Germany.
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Jahn K, Sava M, Sommer G, Schumann DM, Bassetti S, Siegemund M, Battegay M, Stolz D, Tamm M, Khanna N, Hostettler KE. Exercise capacity-impairment after COVID-19 pneumonia is mainly caused by deconditioning. Eur Respir J 2021; 59:13993003.01136-2021. [PMID: 34737222 PMCID: PMC8573604 DOI: 10.1183/13993003.01136-2021] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 10/10/2021] [Indexed: 02/02/2023]
Abstract
Not pulmonary factors, but physical deconditioning is the main limiting factor of exercise capacity in patients after severe COVID-19 pneumonitis. This underscores the importance of an early rehabilitative intervention in these patients.https://bit.ly/2XVvr6C
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Affiliation(s)
- Kathleen Jahn
- Clinics of Respiratory Medicine, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Mihaela Sava
- Division of Infectious Diseases & Hospital Epidemiology, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Gregor Sommer
- Department of Radiology, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Desiree M Schumann
- Clinics of Respiratory Medicine, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Stefano Bassetti
- Division of Internal Medicine, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Martin Siegemund
- Department of Clinical Research, University Hospital Basel and University of Basel, Basel, Switzerland.,Department of Intensive Care Medicine, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Manuel Battegay
- Division of Infectious Diseases & Hospital Epidemiology, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Daiana Stolz
- Clinics of Respiratory Medicine, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Michael Tamm
- Clinics of Respiratory Medicine, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Nina Khanna
- Division of Infectious Diseases & Hospital Epidemiology, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Katrin E Hostettler
- Clinics of Respiratory Medicine, University Hospital Basel and University of Basel, Basel, Switzerland
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McCall N, Eng T, Shelton J, Hanasoge S, Patel P, Patel A, McCook A, Switchenko J, Cole T, Khanna N, Han C, Gordon A, Starbuck K, Remick J. Severe Toxicity and Provider-Reported Subjective Symptoms in Patients With Vulvar Cancer Receiving Curative-Intent Radiotherapy. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Adam KM, Osthoff M, Lamoth F, Conen A, Erard V, Boggian K, Schreiber PW, Zimmerli S, Bochud PY, Neofytos D, Fleury M, Fankhauser H, Goldenberger D, Mühlethaler K, Riat A, Zbinden R, Kronenberg A, Quiblier C, Marchetti O, Khanna N. Trends of the Epidemiology of Candidemia in Switzerland: A 15-Year FUNGINOS Survey. Open Forum Infect Dis 2021; 8:ofab471. [PMID: 34660836 PMCID: PMC8514178 DOI: 10.1093/ofid/ofab471] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 09/15/2021] [Indexed: 11/25/2022] Open
Abstract
Background The increasing incidence of candidemia and emergence of drug-resistant Candida species are major concerns worldwide. Long-term surveillance studies are needed. Methods The Fungal Infection Network of Switzerland (FUNGINOS) conducted a 15-year (2004–2018), nationwide, epidemiological study of candidemia. Hospital-based incidence of candidemia, Candida species distribution, antifungal susceptibility, and consumption were stratified in 3 periods (2004–2008, 2009–2013, 2014–2018). Population-based incidence over the period 2009–2018 derived from the Swiss Antibiotic Resistance Surveillance System (ANRESIS). Results A total of 2273 Candida blood isolates were studied. Population and hospital-based annual incidence of candidemia increased from 2.96 to 4.20/100 000 inhabitants (P = .022) and 0.86 to 0.99/10 000 patient-days (P = .124), respectively. The proportion of Candida albicans decreased significantly from 60% to 53% (P = .0023), whereas Candida glabrata increased from 18% to 27% (P < .0001). Other non-albicans Candida species remained stable. Candida glabrata bloodstream infections occurred predominantly in the age group 18–40 and above 65 years. A higher proportional increase of C glabrata was recorded in wards (18% to 29%, P < .0001) versus intensive care units (19% to 24%, P = .22). According to Clinical and Laboratory Standards Institute, nonsusceptibility to fluconazole in C albicans was observed in 1% of isolates, and anidulafungin and micafungin nonsusceptibility was observed in 2% of C albicans and C glabrata. Fluconazole consumption, the most frequently used antifungal, remained stable, whereas use of mold-active triazoles and echinocandins increased significantly in the last decade (P < .0001). Conclusions Over the 15-year period, the incidence of candidemia increased. A species shift toward C glabrata was recently observed, concurring with increased consumption of mold-active triazoles.
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Affiliation(s)
- Kai-Manuel Adam
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Basel, Basel, Switzerland
| | - Michael Osthoff
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Basel, Basel, Switzerland.,Department of Clinical Research, University Basel, Basel, Switzerland
| | - Frédéric Lamoth
- Infectious Diseases Service, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.,Institute of Microbiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Anna Conen
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital of Aarau, Aarau, Switzerland
| | - Véronique Erard
- Infectious Diseases Service, Department of Medicine, Cantonal Hospital, Fribourg, Switzerland
| | - Katia Boggian
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital, St. Gallen, Switzerland
| | - Peter W Schreiber
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Zurich and University of Zurich, Zurich, Switzerland
| | - Stefan Zimmerli
- Department of Infectious Diseases, Bern University Hospital, Bern, Switzerland.,Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Pierre-Yves Bochud
- Infectious Diseases Service, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Dionysios Neofytos
- Infectious Diseases Service, University Hospital and University of Geneva, Geneva, Switzerland
| | - Mapi Fleury
- Department of Oncology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Hans Fankhauser
- Institute of Laboratory Medicine, Cantonal Hospital of Aarau, Aarau, Switzerland
| | - Daniel Goldenberger
- Clinical Bacteriology and Mycology, University Hospital of Basel and University of Basel, Basel, Switzerland
| | - Konrad Mühlethaler
- Department of Infectious Diseases, Bern University Hospital, Bern, Switzerland.,Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Arnaud Riat
- Division of Laboratory Medicine, Laboratory of Bacteriology, University Hospital of Geneva, Geneva, Switzerland
| | - Reinhard Zbinden
- Institute of Medical Microbiology, University of Zürich, Zürich, Switzerland
| | - Andreas Kronenberg
- Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Chantal Quiblier
- Institute of Medical Microbiology, University of Zürich, Zürich, Switzerland
| | - Oscar Marchetti
- Infectious Diseases Service, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.,Department of Medicine, Ensemble Hospitalier de la Côte, Morges, Switzerland
| | - Nina Khanna
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Basel, Basel, Switzerland.,Department of Clinical Research, University Basel, Basel, Switzerland
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47
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Pagano L, Salmanton-García J, Marchesi F, Busca A, Corradini P, Hoenigl M, Klimko N, Koehler P, Pagliuca A, Passamonti F, Verga L, Víšek B, Ilhan O, Nadali G, Weinbergerová B, Córdoba-Mascuñano R, Marchetti M, Collins GP, Farina F, Cattaneo C, Cabirta A, Gomes-Silva M, Itri F, van Doesum J, Ledoux MP, Čerňan M, Jakšić O, Duarte RF, Magliano G, Omrani AS, Fracchiolla NS, Kulasekararaj A, Valković T, Poulsen CB, Machado M, Glenthøj A, Stoma I, Ráčil Z, Piukovics K, Navrátil M, Emarah Z, Sili U, Maertens J, Blennow O, Bergantim R, García-Vidal C, Prezioso L, Guidetti A, del Principe MI, Popova M, de Jonge N, Ormazabal-Vélez I, Fernández N, Falces-Romero I, Cuccaro A, Meers S, Buquicchio C, Antić D, Al-Khabori M, García-Sanz R, Biernat MM, Tisi MC, Sal E, Rahimli L, Čolović N, Schönlein M, Calbacho M, Tascini C, Miranda-Castillo C, Khanna N, Méndez GA, Petzer V, Novák J, Besson C, Duléry R, Lamure S, Nucci M, Zambrotta G, Žák P, Seval GC, Bonuomo V, Mayer J, López-García A, Sacchi MV, Booth S, Ciceri F, Oberti M, Salvini M, Izuzquiza M, Nunes-Rodrigues R, Ammatuna E, Obr A, Herbrecht R, Núñez-Martín-Buitrago L, Mancini V, Shwaylia H, Sciumè M, Essame J, Nygaard M, Batinić J, Gonzaga Y, Regalado-Artamendi I, Karlsson LK, Shapetska M, Hanakova M, El-Ashwah S, Borbényi Z, Çolak GM, Nordlander A, Dragonetti G, Maraglino AME, Rinaldi A, De Ramón-Sánchez C, Cornely OA. COVID-19 infection in adult patients with hematological malignancies: a European Hematology Association Survey (EPICOVIDEHA). J Hematol Oncol 2021; 14:168. [PMID: 34649563 PMCID: PMC8515781 DOI: 10.1186/s13045-021-01177-0] [Citation(s) in RCA: 156] [Impact Index Per Article: 52.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 09/25/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Patients with hematological malignancies (HM) are at high risk of mortality from SARS-CoV-2 disease 2019 (COVID-19). A better understanding of risk factors for adverse outcomes may improve clinical management in these patients. We therefore studied baseline characteristics of HM patients developing COVID-19 and analyzed predictors of mortality. METHODS The survey was supported by the Scientific Working Group Infection in Hematology of the European Hematology Association (EHA). Eligible for the analysis were adult patients with HM and laboratory-confirmed COVID-19 observed between March and December 2020. RESULTS The study sample includes 3801 cases, represented by lymphoproliferative (mainly non-Hodgkin lymphoma n = 1084, myeloma n = 684 and chronic lymphoid leukemia n = 474) and myeloproliferative malignancies (mainly acute myeloid leukemia n = 497 and myelodysplastic syndromes n = 279). Severe/critical COVID-19 was observed in 63.8% of patients (n = 2425). Overall, 2778 (73.1%) of the patients were hospitalized, 689 (18.1%) of whom were admitted to intensive care units (ICUs). Overall, 1185 patients (31.2%) died. The primary cause of death was COVID-19 in 688 patients (58.1%), HM in 173 patients (14.6%), and a combination of both COVID-19 and progressing HM in 155 patients (13.1%). Highest mortality was observed in acute myeloid leukemia (199/497, 40%) and myelodysplastic syndromes (118/279, 42.3%). The mortality rate significantly decreased between the first COVID-19 wave (March-May 2020) and the second wave (October-December 2020) (581/1427, 40.7% vs. 439/1773, 24.8%, p value < 0.0001). In the multivariable analysis, age, active malignancy, chronic cardiac disease, liver disease, renal impairment, smoking history, and ICU stay correlated with mortality. Acute myeloid leukemia was a higher mortality risk than lymphoproliferative diseases. CONCLUSIONS This survey confirms that COVID-19 patients with HM are at high risk of lethal complications. However, improved COVID-19 prevention has reduced mortality despite an increase in the number of reported cases.
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Affiliation(s)
- Livio Pagano
- Hematology, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS – Università Cattolica del Sacro Cuore, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - Jon Salmanton-García
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Excellence Center for Medical Mycology (ECMM), University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
- Cologne Excellence Cluster On Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Francesco Marchesi
- Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Alessandro Busca
- Stem Cell Transplant Center, AOU Citta’ Della Salute E Della Scienza, Turin, Italy
| | - Paolo Corradini
- University of Milan and Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - Martin Hoenigl
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, San Diego, CA USA
- Clinical and Translational Fungal-Working Group, University of California San Diego, La Jolla, CA USA
- Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Nikolai Klimko
- North-Western State Medical University Named After Iliá Ilich Méchnikov, Saint-Petersburg, Russia
| | - Philipp Koehler
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Excellence Center for Medical Mycology (ECMM), University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
- Cologne Excellence Cluster On Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Antonio Pagliuca
- Department of Hematological Medicine, King’s College Hospital NHS Foundation Trust, London, UK
| | - Francesco Passamonti
- Department of Medicine and Surgery, University of Insubria, ASST Sette Laghi, Ospedale Di Circolo of Varese, Varese, Italy
| | - Luisa Verga
- Azienda Ospedaliera San Gerardo - Monza, Monza, Italy
- Università Milano-Bicocca, Milan, Italy
| | - Benjamin Víšek
- University Hospital Hradec Králové, Hradec Králové, Czech Republic
| | | | | | - Barbora Weinbergerová
- Department of Internal Medicine, Hematology and Oncology, Masaryk University and University Hospital Brno, Brno, Czech Republic
| | - Raúl Córdoba-Mascuñano
- Fundacion Jimenez Díaz University Hospital, Health Research Institute IIS-FJD, Madrid, Spain
| | - Monia Marchetti
- Hematology and BMT Unit, Azienda Ospedaliera Nazionale SS. Antonio E Biagio E Cesare Arrigo, Alessandria, Italy
| | - Graham P. Collins
- NIHR Oxford Biomedical Research Centre, Churchill Hospital, Oxford, UK
| | - Francesca Farina
- Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - Alba Cabirta
- Department of Hematology, Vall d’Hebron Hospital Universitari, Experimental Hematology, Vall d’Hebron Institute of Oncology (VHIO), Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain
- Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | | | - Federico Itri
- San Luigi Gonzaga Hospital - Orbassano, Orbassano, Italy
| | | | | | - Martin Čerňan
- Department of Hemato-Oncology, Faculty of Medicine and Dentistry, Palacky University and University Hospital Olomouc, Olomouc, Czech Republic
| | - Ozren Jakšić
- Department of Hematology, University Hospital Dubrava, Zagreb, Croatia
| | | | | | - Ali S. Omrani
- Communicable Disease Center, Hamad Medical Corporation, Doha, Qatar
| | | | | | - Toni Valković
- University Hospital Centre Rijeka, Rijeka, Croatia
- Croatian Cooperative Group for Hematological Diseases (CROHEM), Zagreb, Croatia
- Faculty of Medicine and Faculty of Health Studies, University of Rijeka, Rijeka, Croatia
| | | | - Marina Machado
- Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | - Igor Stoma
- Gomel State Medical University, Gomel, Belarus
| | - Zdeněk Ráčil
- Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | - Klára Piukovics
- Department of Internal Medicine, Albert Szent-Györgyi Health Center, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | | | - Ziad Emarah
- Oncology Center, Mansoura University, Mansoura, Egypt
| | | | | | - Ola Blennow
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Rui Bergantim
- 3S-Instituto de Investigação E Inovação Em Saúde, Universidade Do Porto, Porto, Portugal
- Cancer Drug Resistance Group, IPATIMUP-Institute of Molecular Pathology and Immunology, University of Porto, Porto, Portugal
- Clinical Hematology, Centro Hospitalar E Universitário São João, Porto, Portugal
- Clinical Hematology, Faculty of Medicine, University of Porto, Porto, Portugal
| | | | - Lucia Prezioso
- U.O. Ematologia E Centro Trapianti Midollo Osseo, Ospedale Maggiore, Parma, Italy
| | - Anna Guidetti
- Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | | | - Marina Popova
- Hematology and Transplantation, Raisa Gorbacheva Research Institute of Pediatric Oncology, Pavlov University, St. Petersburg, Russia
| | - Nick de Jonge
- Amsterdam UMC, Location VUmc, Amsterdam, Netherlands
| | | | - Noemí Fernández
- Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | | | - Annarosa Cuccaro
- Hematology Unit, Center for Translational Medicine, Azienda USL Toscana NordOvest, Livorno, Italy
| | | | | | - Darko Antić
- Clinic of Hematology, University Clinical Center of Serbia, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | | | - Ramón García-Sanz
- Hematology Department, Hospital Universitario de Salamanca, Salamanca, Spain
- IBSAL, Centro de Investigación del Cáncer-IBMCC (USAL-CSIC), Salamanca, Spain
| | - Monika M. Biernat
- Department of Haematology, Blood Neoplasms, and Bone Marrow Transplantation, Wroclaw Medical University, Wrocław, Poland
| | | | - Ertan Sal
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Excellence Center for Medical Mycology (ECMM), University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
- Cologne Excellence Cluster On Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Laman Rahimli
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Excellence Center for Medical Mycology (ECMM), University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
- Cologne Excellence Cluster On Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Natasa Čolović
- Clinic of Hematology, University Clinical Center of Serbia, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Martin Schönlein
- Department of Oncology, Hematology and Bone Marrow Transplantation With Section of Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Carlo Tascini
- Azienda Sanitaria Universitaria del Friuli Centrale, Udine, Italy
| | | | - Nina Khanna
- Division of Infectious Diseases and Hospital Epidemiology, Department of Clinical Research, University and University Hospital of Basel, Basel, Switzerland
| | | | - Verena Petzer
- Department of Hematology and Oncology, Medical University of Innsbruck, Innsbruck, Austria
| | - Jan Novák
- University Hospital of Královské Vinohrady, Prague, Czech Republic
| | | | - Rémy Duléry
- Service d’Hématologie Clinique Et de Thérapie Cellulaire, Hôpital Saint Antoine, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Inserm UMRs 938, Paris, France
| | - Sylvain Lamure
- Departement d’Hematologie Clinique, CHU de Montpellier, UMR-CNRS 5535, Universite de Montpellier, Montpellier, France
| | - Marcio Nucci
- Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Giovanni Zambrotta
- Azienda Ospedaliera San Gerardo - Monza, Monza, Italy
- Università Milano-Bicocca, Milan, Italy
| | - Pavel Žák
- University Hospital Hradec Králové, Hradec Králové, Czech Republic
| | | | | | - Jiří Mayer
- Department of Internal Medicine, Hematology and Oncology, Masaryk University and University Hospital Brno, Brno, Czech Republic
| | - Alberto López-García
- Fundacion Jimenez Diaz University Hospital, Health Research Institute IIS-FJD, Madrid, Spain
| | - Maria Vittoria Sacchi
- Hematology and BMT Unit, Azienda Ospedaliera Nazionale SS. Antonio E Biagio E Cesare Arrigo, Alessandria, Italy
| | - Stephen Booth
- NIHR Oxford Biomedical Research Centre, Churchill Hospital, Oxford, UK
| | - Fabio Ciceri
- Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - Marco Salvini
- Department of Medicine and Surgery, University of Insubria, ASST Sette Laghi, Ospedale Di Circolo of Varese, Varese, Italy
| | - Macarena Izuzquiza
- Department of Hematology, Vall d’Hebron Hospital Universitari, Experimental Hematology, Vall d’Hebron Institute of Oncology (VHIO), Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain
- Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | | | | | - Aleš Obr
- Department of Hemato-Oncology, Faculty of Medicine and Dentistry, Palacky University and University Hospital Olomouc, Olomouc, Czech Republic
| | | | | | | | - Hawraa Shwaylia
- National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
| | - Mariarita Sciumè
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | | | - Josip Batinić
- Croatian Cooperative Group for Hematological Diseases (CROHEM), Zagreb, Croatia
- University Hospital Centre Zagreb, Zagreb, Croatia
- Faculty of Medicine, University of Zagreb, Zagreb, Croatia
| | - Yung Gonzaga
- Hematology Service, Instituto Nacional Do Cancer, Rio de Janeiro, Brazil
| | - Isabel Regalado-Artamendi
- Haematology and Haemotherapy Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | - Maryia Shapetska
- Scientific and Practical Center for Surgery, Transplantology and Hematology, Minsk, Belarus
| | - Michaela Hanakova
- Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | | | - Zita Borbényi
- Department of Internal Medicine, Albert Szent-Györgyi Health Center, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | | | - Anna Nordlander
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
- Department of Cell Therapy and Allogenic Stem Cell Transplantation (CAST), Karolinska University Hospital, Stockholm, Sweden
| | - Giulia Dragonetti
- Hematology, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS – Università Cattolica del Sacro Cuore, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - Alessio Maria Edoardo Maraglino
- Hematology, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS – Università Cattolica del Sacro Cuore, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - Amelia Rinaldi
- U.O. Ematologia E Centro Trapianti Midollo Osseo, Ospedale Maggiore, Parma, Italy
| | - Cristina De Ramón-Sánchez
- Centro de Investigación del Cáncer-IBMCC (USAL-CSIC), Hospital Universitario de Salamanca, IBSAL, Salamanca, Spain
| | - Oliver A. Cornely
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Excellence Center for Medical Mycology (ECMM), University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
- Chair Translational Research, Cologne Excellence Cluster On Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
- Clinical Trials Centre Cologne (ZKS Köln), University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
- German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
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48
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Averbuch D, De Greef J, Duréault A, Wendel L, Tridello G, Lebeaux D, Mikulska M, Gil L, Knelange N, Zuckerman T, Roussel X, Robin C, Xhaard A, Aljurf M, Beguin Y, Le Bourgeois A, Botella-Garcia C, Khanna N, Van Praet J, Kröger N, Blijlevens N, Ducastelle Leprêtre S, Ho A, Roos-Weil D, Yeshurun M, Lortholary O, Fontanet A, de la Camara R, Coussement J, Maertens J, Styczynski J. Nocardia infections in hematopoietic cell transplant recipients: a multicenter international retrospective study of the Infectious Diseases Working Party (IDWP) of the European Society for Blood and Marrow Transplantation (EBMT). Clin Infect Dis 2021; 75:88-97. [PMID: 34596213 DOI: 10.1093/cid/ciab866] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Nocardiosis is rare after hematopoietic cell transplantation (HCT). Little is known regarding its presentation, management, and outcome in this population. METHODS In this retrospective international study, we reviewed nocardiosis episodes in HCT recipients (01.01.2000-31.12.2018; 135 transplant centers; 33 countries) and described their clinical, microbiological, radiological, and outcome characteristics. RESULTS We identified 81 nocardiosis episodes in 74 allo- and 7 auto-HCT recipients. Nocardiosis occurred at a median of 8 (IQR 4-18) months post-HCT. The most frequently involved organs were lungs (70/81; 86%) and brain (30/81; 37%); 29 (36%) patients were afebrile; 46/81 (57%) had disseminated infections. The most common lung imaging findings were consolidations (33/68; 49%) or nodules (32/68; 47%); and brain imaging findings were multiple brain abscesses (19/30; 63%). 10/30 (33%) patients with brain involvement lacked neurological symptoms. 14/48 (29%) patients were bacteremic. N. farcinica was the most common among molecularly identified species (27%, 12/44). Highest susceptibility rates were reported to linezolid 45/45 (100%), amikacin 56/57 (98%), trimethoprim-sulfamethoxazole 57/63 (90%), and imipenem 49/57 (86%).One-year and last follow-up (IQR: 4-42.5 months) all-cause mortality were 40% (32/81) and 52% (42/81), respectively. In the multivariable analysis, underlying disease not in complete remission (HR 2.81, 95%CI 1.32-5.95), and prior bacterial infection (HR 3.42, 95%CI 1.62-7.22) were associated with higher one-year all-cause mortality. CONCLUSIONS Nocardiosis is a late post-HCT infection usually manifesting as a pulmonary disease with frequent dissemination, brain infection and bacteremia. Brain imaging should be performed in HCT recipients with nocardiosis regardless of neurological symptoms. Overall mortality is high.
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Affiliation(s)
- D Averbuch
- Pediatric Infectious Diseases Faculty of Medicine, Hebrew University of Jerusalem; Hadassah Medical Center, Jerusalem, Israel
| | - J De Greef
- Department of Internal Medicine and Infectious Diseases, Cliniques universitaires Saint-Luc, Université catholique de Louvain (UCLouvain), Brussels, Belgium
| | - A Duréault
- Centre d'Infectiologie Necker Pasteur, Hôpital Necker-Enfants Malades, APHP, Université Paris Descartes, Paris, France
| | - L Wendel
- EBMT Data Office, Leiden, Netherlands
| | - G Tridello
- Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - D Lebeaux
- Université de Paris, F-75006 Paris, France.,Service de Microbiologie, Unité Mobile d'Infectiologie, AP-HP, Hôpital Européen Georges Pompidou, 20 rue Leblanc, 75015 Paris, Paris, France
| | - M Mikulska
- Division of Infectious Diseases, University of Genoa and Ospedale Policlinico San Martino, Genova, Italy
| | - L Gil
- University of Medical Sciences, Poznan, Poland
| | | | | | - X Roussel
- University hospital of Besançon, hematology department, Besançon, France
| | - C Robin
- Henri Mondor University Hospital, Creteil, France
| | - A Xhaard
- Hematology-transplantation, Hospital St-Louis, Paris Diderot University, Paris, France
| | - M Aljurf
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Y Beguin
- CHU of Liège and University of Liège, Liège, Belgium
| | | | | | - N Khanna
- Division of Infectious Diseases and Hospital Epidemiology. University and University Hospital of Basel, Basel, Switzerland
| | - J Van Praet
- Department of Nephrology and Infectious Diseases, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium
| | - N Kröger
- Department of Stem Cell Transplantation, University Medical Center, Hamburg, Germany
| | - N Blijlevens
- Radboud university medical center, Nijmegen, The Netherlands
| | | | - A Ho
- Singapore General Hospital, Singapore, Singapore
| | - D Roos-Weil
- Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France
| | - M Yeshurun
- Institution of Hematology, Rabin medical Center, Petah Tikva, Israel and Sacker School of Medicine, Tel Aviv University, Israel
| | - O Lortholary
- Paris University, Necker Pasteur Center for Infectious Diseases and Tropical Medicine, IHU Imagine, Necker Enfants malades University Hospital, Paris, France.,National Reference Center for Invasive Mycoses and Antifungals, Molecular Mycology Unit, CNRS UMR 2000, Institut Pasteur, Paris, France
| | - A Fontanet
- Institut Pasteur, Emerging Diseases Epidemiology Unit, Global Health Department, Paris, France.,PACRI Unit, Conservatoire National des Arts et Métiers, Paris, France
| | | | - J Coussement
- Department of Infectious Diseases, Peter MacCallum Cancer Centre, Melbourne, Australia.,National Centre for Infection in Cancer, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - J Maertens
- Department of Haematology, Universitaire Ziekenhuizen Leuven, Leuven, Belgium
| | - J Styczynski
- Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz, Poland
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49
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Zweifel SA, Wiest MRJ, Toro MD, Hasler P, Maloca P, Hasse B, Khanna N, Rejdak R. Long-Term Clinical and Multimodal Imaging Findings in Patients with Disseminated Mycobacterium Chimaera Infection. J Clin Med 2021; 10:jcm10184178. [PMID: 34575289 PMCID: PMC8464780 DOI: 10.3390/jcm10184178] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 09/10/2021] [Accepted: 09/13/2021] [Indexed: 11/16/2022] Open
Abstract
Background: To analyze long-term ophthalmic clinical and multimodal imaging findings of disseminated Mycobacterium (M.) chimaera infection after cardiothoracic surgery among the Swiss Cohort. Methods: Systemic and multimodal ophthalmic imaging and clinical findings including rate of recurrence were reviewed and correlated to a previously proposed classification system of choroidal lesions and classification of ocular disease. Main Outcomes Measures: long-term clinical and multimodal ocular imaging findings of M. chimaera. Results: Twelve patients suffering from systemic infection from M. chimaera were included. Mean age at the first ophthalmic examination was 59 years (range from 48 to 66 years). Mean duration of the follow-up was 22.63 ± 17.8 months. All patients presented with bilateral chorioretinal lesions at baseline; 5 patients had additional signs, including optic disc swelling (2), choroidal neovascularization (1), retinal neovascularization (1) and cilioretinal vascular occlusion (1). Four recurrence events after discontinuation or adjustment of the antibiotic treatment were observed. Progressive choroiditis was seen in 5 patients under treatment, 4 of them deceased. Conclusions: Expertise from ophthalmologists is not only relevant but also critical for the assessment of the adverse drug effect of antimycobacterial treatment along with monitoring therapeutic response and identifying recurrences.
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Affiliation(s)
- Sandrine Anne Zweifel
- Department of Ophthalmology, University Hospital Zurich, 8091 Zurich, Switzerland; (M.R.J.W.); (M.D.T.)
- Department of Ophthalmology, University of Zurich, 8091 Zurich, Switzerland
- Correspondence:
| | - Maximilian Robert Justus Wiest
- Department of Ophthalmology, University Hospital Zurich, 8091 Zurich, Switzerland; (M.R.J.W.); (M.D.T.)
- Department of Ophthalmology, University of Zurich, 8091 Zurich, Switzerland
| | - Mario Damiano Toro
- Department of Ophthalmology, University Hospital Zurich, 8091 Zurich, Switzerland; (M.R.J.W.); (M.D.T.)
- Department of Ophthalmology, University of Zurich, 8091 Zurich, Switzerland
- Department of General and Pediatric Ophthalmology, Medical University of Lublin, 20079 Lublin, Poland;
| | - Pascal Hasler
- Institute of Molecular and Clinical Ophthalmology Basel, 4023 Basel, Switzerland; (P.H.); (P.M.)
- Department of Ophthalmology, University Hospital Basel, 4023 Basel, Switzerland
| | - Peter Maloca
- Institute of Molecular and Clinical Ophthalmology Basel, 4023 Basel, Switzerland; (P.H.); (P.M.)
- Department of Ophthalmology, University Hospital Basel, 4023 Basel, Switzerland
| | - Barbara Hasse
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, 8091 Zurich, Switzerland;
| | - Nina Khanna
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, 4023 Basel, Switzerland;
| | - Robert Rejdak
- Department of General and Pediatric Ophthalmology, Medical University of Lublin, 20079 Lublin, Poland;
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Sava M, Sommer G, Daikeler T, Woischnig AK, Martinez AE, Leuzinger K, Hirsch H, Erlanger T, Wiencierz A, Bassetti S, Tamm M, Tschudin-Sutter S, Stoeckle M, Pargger H, Siegemund M, Boss R, Zimmer G, Vu DL, Kaiser L, Dell-Kuster S, Weisser M, Battegay M, Hostettler K, Khanna N. Ninety-day outcome of patients with severe COVID-19 treated with tocilizumab - a single centre cohort study. Swiss Med Wkly 2021; 151:w20550. [PMID: 34375986 DOI: 10.4414/smw.2021.20550] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES Patients with severe COVID-19 may be at risk of longer term sequelae. Long-term clinical, immunological, pulmonary and radiological outcomes of patients treated with anti-inflammatory drugs are lacking. METHODS In this single-centre prospective cohort study, we assessed 90-day clinical, immunological, pulmonary and radiological outcomes of hospitalised patients with severe COVID-19 treated with tocilizumab from March 2020 to May 2020. Criteria for tocilizumab administration were oxygen saturation <93%, respiratory rate >30/min, C-reactive protein levels >75 mg/l, extensive area of ground-glass opacities or progression on computed tomography (CT). Descriptive analyses were performed using StataIC 16. RESULTS Between March 2020 and May 2020, 50 (27%) of 186 hospitalised patients had severe COVID-19 and were treated with tocilizumab. Of these, 52% were hospitalised on the intensive care unit (ICU) and 12% died. Eleven (22%) patients developed at least one microbiologically confirmed super-infection, of which 91% occurred on ICU. Median duration of hospitalisation was 15 days (interquartile range [IQR] 10–24) with 24 days (IQR 14–32) in ICU patients and 10 days (IQR 7–15) in non-ICU patients. At day 90, 41 of 44 survivors (93%) were outpatients. No long-term adverse events or late-onset infections were identified after acute hospital care. High SARS-CoV-2 antibody titres were found in all but one patient, who was pretreated with rituximab. Pulmonary function tests showed no obstructive patterns, but restrictive patterns in two (5.7%) and impaired diffusion capacities for carbon monoxide in 11 (31%) of 35 patients, which predominated in prior ICU patients. Twenty-one of 35 (60%) CT-scans at day 90 showed residual abnormalities, with similar distributions between prior ICU and non-ICU patients. CONCLUSIONS In this cohort of severe COVID-19 patients, no tocilizumab-related long-term adverse events or late-onset infections were identified. Although chest CT abnormalities were highly prevalent at day 90, the majority of patients showed normal lung function. TRIAL REGISTRATION ClinicalTrials.gov NCT04351503.
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Affiliation(s)
- Mihaela Sava
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel and University of Basel, Switzerland / Department of Infectious Diseases, West German Centre of Infectious Diseases, University Hospital Essen, Germany
| | - Gregor Sommer
- Clinic of Radiology and Nuclear Medicine, University Hospital Basel and University of Basel, Switzerland
| | - Thomas Daikeler
- Division of Rheumatology, University Hospital of Basel, Switzerland / Department of Clinical Research, University Hospital Basel, Switzerland
| | - Anne-Kathrin Woischnig
- Infection Biology Laboratory, Department of Biomedicine, University of Basel, Switzerland
| | - Aurelien E Martinez
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel and University of Basel, Switzerland
| | - Karoline Leuzinger
- Division of Clinical Virology, University Hospital Basel, Switzerland / Transplantation and Clinical Virology, Department Biomedicine, University of Basel, Switzerland
| | - Hans Hirsch
- Division of Clinical Virology, University Hospital Basel, Switzerland / Transplantation and Clinical Virology, Department Biomedicine, University of Basel, Switzerland
| | - Tobias Erlanger
- Department of Clinical Research, University Hospital Basel, Switzerland
| | - Andrea Wiencierz
- Department of Clinical Research, University Hospital Basel, Switzerland
| | - Stefano Bassetti
- Division of Internal Medicine, University Hospital Basel, Switzerland
| | - Michael Tamm
- Clinics of Respiratory Medicine, University Hospital Basel and University of Basel, Switzerland
| | - Sarah Tschudin-Sutter
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel and University of Basel, Switzerland / Department of Clinical Research, University Hospital Basel, Switzerland
| | - Marcel Stoeckle
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel and University of Basel, Switzerland
| | - Hans Pargger
- Department of Intensive Care Medicine, University Hospital Basel, Switzerland
| | - Martin Siegemund
- Department of Clinical Research, University Hospital Basel, Switzerland / Department of Intensive Care Medicine, University Hospital Basel, Switzerland
| | - Renate Boss
- Federal Food Safety and Veterinary Office, Bern, Switzerland
| | - Gert Zimmer
- Institute of Virology and Immunology (IVI), Mittelhäusern, Switzerland / Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Switzerland
| | - Diem-Lan Vu
- Division of Infectious Disease, Geneva University Hospitals, Geneva, Switzerland / Laboratory of Virology, Geneva University Hospitals, Geneva, Switzerland
| | - Laurent Kaiser
- Division of Infectious Disease, Geneva University Hospitals, Geneva, Switzerland / Laboratory of Virology, Geneva University Hospitals, Geneva, Switzerland
| | - Salome Dell-Kuster
- Department of Clinical Research, University Hospital Basel, Switzerland / Department of Anaesthesiology, Prehospital Emergency Medicine and Pain Therapy, University Hospital Basel, Switzerland / Institute for Clinical Epidemiology and Biostatistics, University Hospital Basel, Switzerland
| | - Maja Weisser
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel and University of Basel, Switzerland / Department of Clinical Research, University Hospital Basel, Switzerland
| | - Manuel Battegay
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel and University of Basel, Switzerland
| | - Katrin Hostettler
- Clinics of Respiratory Medicine, University Hospital Basel and University of Basel, Switzerland
| | - Nina Khanna
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel and University of Basel, Switzerland / Department of Clinical Research, University Hospital Basel, Switzerland / Infection Biology Laboratory, Department of Biomedicine, University of Basel, Switzerland
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