scholarly journals Strongyloides stercoralis Infection Incidence, Risk Factors and Outcomes Among Solid Organ Transplant Candidates and Recipients; a Florida Center Experience

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S10-S11 ◽  
Author(s):  
Robert Castro ◽  
Sadaf Aslam ◽  
Christopher Albers ◽  
Louise Gutierrez ◽  
Marijesmar Gonzalez ◽  
...  
Keyword(s):  
Risk Factors ◽  
Universal Screening ◽  
Organ Transplant ◽  
Strongyloides Stercoralis ◽  
Solid Organ ◽  
Travel History ◽  
Transplant Patients ◽  
Incidence Risk ◽  
Traditional Risk Factors ◽  
Associated Risk Factors

Abstract Background Most infections of Strongyloides stercoralis are asymptomatic but can be fulminant in the immunosuppressed. Fatal infections in transplant patients have been reported in United States but incidence estimates are lacking. Our protocol for Strongyloides until 2009 screened immigrants and those with travel history to endemic areas. In 2010, we began universal screening of SOT candidates due to a case of disseminated Strongyloidiasis in an unscreened lung transplant recipient with unknown risk factors. We calculated the incidence of Strongyloides stercoralis in our SOT candidates and associated risk factors, treatment, and outcomes since protocol change. Methods A retrospective review was performed of patients who underwent transplant evaluation from January 2014 to July 2016. Patients positive for Strongyloides stercoralis were reviewed for age, sex, ethnicity, place of birth, travel history, occupation, eosinophilia, treatment, and outcome. We report descriptive statistics. Results Of a total of 2,351 SOT patients, 116 tested positive (heart 33, lung 24, kidney 26, liver 31, pancreas 2) with an incidence of 4.9%. A total of 113 charts were available for review. The characteristics of the patients are summarized in Table 1. Fifty patients had traditional risk factors (44%) and 63 lacked them (56%). Eosinophilia was present in 15% of cases. Of those transplanted, 87% received prophylaxis and none developed active Strongyloidiasis. Conclusion Our results show that S. stercoralis infection has a relatively high incidence in SOT patients and universal screening identified a substantial number that otherwise would go undetected, placing the transplant patient at risk of a fatal, yet preventable complication. Disclosures All authors: No reported disclosures.

scholarly journals 2692. Comparison of Demographics and Risk factors Between Strongyloides stercoralis Seropositive and Seronegative Solid-Organ Transplant Candidates: Experience from a Tertiary Acute Care Center in Florida

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S946-S946
Author(s):  
Carlos J Perez-Lopez ◽  
Sally Alrabaa ◽  
Sadaf Aslam ◽  
Greg Matthew E Teo ◽  
Teayoung Kim ◽  
...  
Keyword(s):  
United States ◽  
Risk Factors ◽  
Universal Screening ◽  
Organ Transplant ◽  
Strongyloides Stercoralis ◽  
Solid Organ Transplant ◽  
Demographic Characteristics ◽  
Solid Organ ◽  
Significant Difference ◽  
Transplant Candidates

Abstract Background Strongyloides stercoralis is a nematode endemic to the tropical and subtropical regions. In the United States, it is mostly found at southeastern states. Most infections are asymptomatic but disseminated and fatal infections have been reported in immunocompromised patients. At our institution, universal screening through Strongyloides antibody detection in serum among solid-organ transplant candidates began since 2010 and all seropositive candidates are treated before transplantation. We previously determined our incidence to be about 5%. The aim of this study was to determine demographic characteristics and risk factors that can be used for more cost-effective targeted screening. Methods We performed a retrospective cohort study of patients who underwent transplant evaluation from 2014 to 2016. A total of 228 charts were reviewed for Strongyloides serology status, eosinophilia, demographics and risk factors. Chi-square and Fisher exact tests were used to do a comparative analysis between Strongyloides seropositive and seronegative cohorts. Results We identified 113 seropositive (SP) patients and 115 seronegative (SN) patients. There were more males in the seropositive group (79%) compared with seronegative group (62%) (P = 0.005). Caucasians predominated in both groups (SP 71% vs. SN 57%; P = 0.286). No significant difference was found between both groups with regards to occupation with soil or water contact (SP 38% vs. SN 30%; P = 0.281), birthplace outside USA or travel outside of United States (SP 31% vs. SN 36%; P = 0.732). Eosinophilia occurred less in the seropositive group compared with the seronegative group (SP 16% vs. SN 30%; P = 0.030). Conclusion The study did not find any statistically significant difference in the demographic characteristics or risk factors that can be used for prediction of Strongyloides seropositivity among solid-organ transplant candidates. Hence, our institution will continue universal screening for Strongyloides stercoralis for all our transplant candidates. Our findings further question donor screening for Strongyloides that uses a similar questionnaire which may not be reliable to identify those infected with this parasite. This would put recipients at risk for a donor-transmitted infection. Disclosures All authors: No reported disclosures.

scholarly journals Tuberculosis after Solid‐Organ Transplant: Incidence, Risk Factors, and Clinical Characteristics in the RESITRA (Spanish Network of Infection in Transplantation) Cohort

2009 ◽  
Vol 48 (12) ◽  
pp. 1657-1665 ◽  
Author(s):  
Julián Torre‐Cisneros ◽  
Antonio Doblas ◽  
José María Aguado ◽  
Rafael San Juan ◽  
Marino Blanes ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Characteristics ◽  
Organ Transplant ◽  
Solid Organ Transplant ◽  
Solid Organ ◽  
Incidence Risk

Incidence and risk factors for mucormycosis in renal transplant patients

2021 ◽  
pp. jim-2021-001933
Author(s):  
Melissa Rachel Downey ◽  
Varsha Taskar ◽  
Daniel F Linder ◽  
Stephanie L Baer ◽  
Jennifer L Waller ◽  
...  
Keyword(s):  
Risk Factors ◽  
Renal Transplant ◽  
Iron Overload ◽  
Organ Transplant ◽  
Deceased Donor ◽  
Solid Organ ◽  
Hispanic Ethnicity ◽  
Transplant Patients ◽  
Increased Risk ◽  
Renal Transplant Patients

AbstractBackgroundRenal transplant patients are at increased risk for mucormycosis. Diabetes, neutropenia, deferoxamine therapy, and immunosuppressive medications have been associated with increased risk of mucormycosis in studies of solid organ transplant recipients. To focus on renal transplant patients, the US Renal Data System (USRDS) was queried to determine the incidence and risk factors for mucormycosis.MethodsAll renal transplant patients in the USRDS from 1988 to 2015 were queried for a diagnosis of mucormycosis after the first transplant date using ICD-9 and ICD-10 codes. The International Classification of Diseases (ICD) codes, which currently exist in the ninth and tenth revisions, are a global system of classification used to code diagnoses, procedures, and symptoms. We defined proven mucormycosis by a histopathologic or fungal stain procedure code within 7 days of the diagnosis code. Logistic regression controlling for person-years at risk was used to examine demographic and clinical diagnosis risk factors for mucormycosis.ResultsOf the 306,482 renal transplant patients, 222 (0.07%) had codes consistent with proven mucormycosis. The incidence of mucormycosis increased from 1990 to 2000 (peak 17.6 per 100,000 person-years) and subsequently demonstrated more variability. Hispanic ethnicity (OR=1.45), age 65 years or greater (OR=1.64), other or black race compared with white race (OR=1.96 and 1.74), cadaver or other donor type (OR=2.41), and receiving tacrolimus (OR=2.09) were associated with increased risk. Comorbidities associated with decreased risk of mucormycosis included female sex (OR=0.68), iron overload (OR=0.56), and receiving mycophenolate mofetil (OR=0.67) or azathioprine (OR=0.53).ConclusionsIn renal transplant patients, age, deceased donor graft transplant, tacrolimus administration, race other than white, and Hispanic ethnicity were associated with increased risk of mucormycosis. Unexpectedly, iron overload was protective. Mucormycosis is a rare infection in renal transplant patients which should be considered in patients with the above risk factors after more common infections have been ruled out.

Evaluation of Pulmonary Infections in Solid Organ Transplant Patients: 12 Years of Experience

2013 ◽  
Vol 45 (10) ◽  
pp. 3458-3461 ◽  
Author(s):  
F.Ö. Eyüboğlu ◽  
E. Küpeli ◽  
Ş.S. Bozbaş ◽  
Z.E. Özen ◽  
E.S. Akkurt ◽  
...  
Keyword(s):  
Organ Transplant ◽  
Solid Organ Transplant ◽  
Solid Organ ◽  
Years Of Experience ◽  
Pulmonary Infections ◽  
Transplant Patients
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