Detection of Toxoplasma Gondii Antibodies and DNA Among Renal Transplant Recipient and blood donor in Khartoum State, Sudan

2021 ◽  
pp. 135-141
Author(s):  
Elghazali Mohammed ◽  
Mustafa Yassin ◽  
Khalid Anan ◽  
Dina N Abdelrahman ◽  
Abdelrahim M. ElHussein ◽  
...  
Keyword(s):  
Toxoplasma Gondii ◽  
Renal Transplant ◽  
Transplant Recipient ◽  
Renal Transplant Recipient ◽  
Blood Donor ◽  
Blood Donors ◽  
Solid Organ ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Toxoplasma Gondii Infection

Background and Aim: Toxoplasma gondii infection arises in transplant recipient groups, but at varying frequencies. Reactivation of latent T. gondii infection in transplant patients is uncommon, but does occur. The incidence of reactivation is greater in patient groups receiving more aggressive immunosuppressive therapy. Early diagnosis and treatment should be considered in T. gondii-antibody-positive patients subjected to solid organ transplantation. The aim of this study was to estimate the seroprevalence of Toxoplasma gondii infection in renal transplant recipients in Khartoum, Sudan, using serological and molecular methods. Methods: This was a descriptive cross sectional, hospital based study, blood sample were collected from 108 participants; out of them 58 renal transplant recipient individuals and 50 healthy Blood donor attending Sudanese Kidney Association Hospital and Sudan Heart Center Blood Bank. Demographic data were collected by structured questionnaire. All samples were tested for anti-Toxoplasma IgG and IgM antibodies using ELISA, and PCR for detection of Toxoplasma DNA was performed. Results: The seropositivity of IgG anti-T. gondii antibodies was higher in renal transplant recipients than in blood donors (36.2% vs 32.0%). Anti-toxoplasma IgM was positive in one renal transplant recipient individual (1.70%), and no samples exhibit reactive IgM antibody for blood donors. None of the samples exhibited positivity to T.gondii DNA. Conclusion: the study showed a relatively high seroprevalence of T.gondii antibodies in renal transplant recipients and blood donor volunteers, on the other hand, the prevalence was much higher in the study conducted in pregnant woman in Sudan. Our study highlighted that asymptomatic blood donors, may constitute a significant risk of transmitting toxoplasmosis to susceptible recipients.

scholarly journals Severe hyperparathyroidism associated with prolonged hungry bone syndrome in a renal transplant recipient.

1997 ◽  
Vol 8 (10) ◽  
pp. 1626-1631
Author(s):  
A M Miles ◽  
M S Markell ◽  
N Sumrani ◽  
J Hong ◽  
E A Friedman
Keyword(s):  
Renal Transplantation ◽  
Renal Transplant ◽  
Transplant Recipient ◽  
Renal Transplant Recipient ◽  
Pathological Fracture ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Hungry Bone Syndrome ◽  
Persistent Hyperparathyroidism ◽  
Hungry Bone

Although widely believed to resolve within 6 to 12 months of successful renal transplantation, hyperparathyroidism may persist or develop after renal transplantation and eventually require parathyroidectomy. Avid calcium retention by demineralized bones (hungry bone syndrome) is well-recognized after parathyroidectomy and usually resolves after a few weeks. This report documents the case of a renal transplant recipient with persistent hyperparathyroidism who developed a pathological fracture of the pelvis and required parathyroidectomy 1 year after transplant and then manifested severe and prolonged hungry bone syndrome lasting for more than 20 months postoperatively. The clinical features and treatment of hyperparathyroidism in renal transplant recipients are discussed, as are diagnosis, pathogenesis, and management of hungry bone syndrome. Recognition of renal transplant recipients at greater risk for severe hungry bone syndrome should permit earlier and more aggressive management of this sometimes protracted complication of parathyroid surgery.

scholarly journals Slow Recovery from Critical Coronavirus Disease 2019 Pneumonia in an Immunosuppressed Renal Transplant Recipient with Early Acute Cardiorenal Syndrome

2020 ◽  
Vol 10 (6) ◽  
pp. 470-475 ◽  
Author(s):  
Lan Zhu ◽  
Hongge Shu ◽  
Huijun Li ◽  
Tao Qiu ◽  
Jiangqiao Zhou ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Transplant Recipient ◽  
Renal Transplant Recipient ◽  
Immunosuppressive Agents ◽  
Kidney Injury ◽  
Cardiorenal Syndrome ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Slow Recovery ◽  
Global Spread

With the global spread of SARS-Cov-2 infections, increasing numbers of COVID-19 cases have been reported in transplant recipients. However, reports are lacking concerning the treatment and prognosis of COVID-19 pneumonia in renal transplant recipients with acute cardiorenal syndrome. We report here the complete clinical course of a renal transplant recipient with critical COVID-19 pneumonia. In the early phase of SARS-Cov-2 infection, the patient exhibited extensive lung lesions and significant acute kidney and heart injuries, which required treatment in the ICU. After correcting the arrhythmia and heart failure, the patient recovered quickly from the acute kidney injury with a treatment of intensive diuresis and strict control of fluid intake. Without cessation of oral immunosuppressive agents, the patient presented a delayed and low antibody response against SARS-Cov-2 and reappeared positive for the virus twice after being discharged. Nevertheless, the patient’s pneumonia continued to improve and he fully recovered in 69 days. This effectively treated case may be meaningful and referable for the treatment of COVID-19 pneumonia in other transplant recipients with acute cardiorenal syndrome.

scholarly journals Pacemaker-related Candida parapsilosis fungaemia in an immunosuppressed renal transplant recipient

2021 ◽  
Vol 14 (7) ◽  
pp. e242917
Author(s):  
Josephine Hebert ◽  
Ellen Barr ◽  
Colm Magee
Keyword(s):  
Renal Transplant ◽  
Transplant Recipient ◽  
Renal Transplant Recipient ◽  
Candida Parapsilosis ◽  
Opportunistic Infections ◽  
Blood Cultures ◽  
Renal Transplant Recipients ◽  
Pulmonary Emboli ◽  
Transplant Recipients ◽  
Pacemaker Leads

Renal transplant recipients are at risk for opportunistic infections due to their immunosuppressed state. We describe the case of a 59-year-old renal transplant recipient who presented with sepsis and bilateral pulmonary emboli due to Candida parapsilosis. She was treated with intravenous caspofungin and had a transoesophageal echocardiogram, which revealed vegetations on her pacemaker leads. She then underwent surgery to replace her pacemaker; however, her blood cultures remained positive for C. parapsilosis postoperatively. Her antifungal was switched to liposomal amphotericin B and flucytosine for 6 weeks, which yielded sterile blood cultures, and she was then initiated on lifelong fluconazole. Her recovery was complicated by tacrolimus toxicity 1 month after discharge due to fluconazole-induced CYP3A inhibition.

scholarly journals 1078. Renal Transplant Recipient Resistomes Reveal Expansive Sub-Clinical Burden of Resistance After Treatment for ESBL-Producing Bacterial Infections

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S566-S567
Author(s):  
Michael Woodworth ◽  
Roth Conrad ◽  
Amanda F Strudwick ◽  
Ahmed Babiker ◽  
Stephanie M Pouch ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Antimicrobial Resistance ◽  
Transplant Recipient ◽  
Renal Transplant Recipient ◽  
Antibiotic Treatment ◽  
Median Number ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Gene Profiles ◽  
Stool Samples

Abstract Background Renal transplant recipients have frequent infection and colonization with antibiotic resistant (AR) bacteria. However, little is known about the burden of AR following targeted antibiotic treatment. Methods This was a prospective study conducted as part of a single center clinical trial at Emory University. Demographic and clinical data regarding transplant and AR bacterial infection were abstracted. Stool samples were collected from renal transplant recipients treated with antibiotics for ESBL-producing gram negative infections. Bacterial cultures with AR-selective media and Illumina short-read sequencing were performed on stool samples. Confirmatory phenotypic isolate AR testing was performed with the Vitek2 platform. Resistome profiles were produced by assembling short reads into scaffolds using MetaSPAdes, predicting protein coding sequences using Prodigal and classifying proteins as antimicrobial resistance determinants using AMRFinderPlus. AMRFinderPlus results for patients were then compared to fecal metagenomes from 3 healthy Human Microbiome Project controls. Differences in AR genes in renal transplant patients vs controls were compared. Results Metagenome sequencing was performed for 6 (5 female) patient stool samples. Stools were collected a median of 30 days after infection. The median number of AR genes per patient metagenome was 48.5 (range 23 to 87 genes). The median number of AR genes per control metagenome was 24 (range 16 to 25 genes). We detected 97 unique AR genes across all samples, 63 of which (65%) were detected in patient samples but not controls. All AR genes found in control metagenomes were present in at least one patient metagenome. No AR genes detected in patients were common to all patients. Subsets of clinically relevant genes corresponded with patient stool AR bacteria culture results. Antimicrobial resistance gene detection heatmap for renal transplant recipient stool samples after antibiotic treatment for ESBL infection. Conclusion Viable AR bacteria and diverse AR gene profiles were frequently detected from renal transplant recipient stool samples after antibiotic treatment for infection. These data suggest that AR bacterial colonization and AR gene profiles may require distinct treatments other than systemic antibiotics for eradication. Disclosures All Authors: No reported disclosures

P0863TYPE OF PROTON PUMP INHIBITOR AND RISK OF IRON DEFICIENCY IN RENAL TRANSPLANT RECIPIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Rianne M. Douwes ◽  
Joanna Sophia Jacoline Vinke ◽  
António W Gomes-Neto ◽  
Hans Blokzijl ◽  
Stefan P Berger ◽  
...  
Keyword(s):  
Cohort Study ◽  
Renal Transplant ◽  
Iron Deficiency ◽  
Proton Pump ◽  
Ferritin Level ◽  
Solid Organ ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Increased Risk ◽  
Different Types

Abstract Background and Aims Use of proton-pump inhibitors (PPIs) is common practice in renal transplant recipients (RTRs). Emerging data suggest several adverse effects of use of PPIs, including development of iron deficiency (ID). Although the latter has been shown with respect to PPIs, specific analyses for different types of PPIs and the associated risk of ID have not been performed. Method We used data from the TransplantLines Biobank and Cohort study, an ongoing prospective cohort study among all types of solid organ transplant recipients. For the current study, we used data from stable RTRs with a functional graft for more than 1 year post transplantation (n=795). We excluded RTRs who used any form of iron supplementation (n=54) and EPO-stimulating agents (n=24), resulting in 728 RTRs eligible for analyses. Use of PPIs was subdivided in different types of PPIs, i.e. omeprazole, esomeprazole, pantoprazole, and rabeprazole. ID was defined as TSAT<20% and ferritin <300 µg/L. Logistic regression analysis was used to assess the associations between PPIs and ID. Results We included 728 RTRs (age 56±13 years, 61% males), with a mean eGFR of 53±18 ml/min/1.73m2, a median [interquartile range] ferritin level of 96 (44 – 191) µg/L and mean TSAT of 24±10%. PPIs were used by 504 (69%) of the included RTRs, of which 398 (79%), 55 (11%), 49 (10%), and 2 (0.4%) respectively used omeprazole, pantoprazole, esomeprazole, and rabeprazole. Use of PPIs was strongly associated with ID (OR, 2.20; 95%CI 1.48 – 3.28; P<0.001), independent of adjustment for age, sex, BMI, eGFR, hs-CRP, smoking, alcohol use, use of calcineurine inhibitors, prednisolone, antiplatelet drugs, and antihypertensives. When subdividing the PPIs into the different types, both omeprazole (OR, 1.98; 95%CI 1.39 – 2.83; P<0.001) and esomeprazole (OR, 2.11; 95%CI 1.09 – 4.07; P=0.03) were independently associated with iron deficiency, whereas pantoprazole was not associated (OR, 0.89; 95%CI 0.47 – 1.70; P=0.73). Conclusion Omeprazole and esomeprazole, but not pantoprazole, are associated with an increased risk of ID. Our results are in line with previous reports that pantoprazole has the lowest potency with least increase in intragastric pH, thereby possibly interfering less with reduction of ferric to ferrous iron, and subsequently iron absorption. Future studies are warranted to confirm our present findings.

scholarly journals Targeting Asymptomatic Bacteriuria in Antimicrobial Stewardship: the Role of the Microbiology Laboratory

2020 ◽  
Vol 58 (5) ◽  
Author(s):  
Zanthia Wiley ◽  
Jesse T. Jacob ◽  
Eileen M. Burd
Keyword(s):  
Renal Transplant ◽  
Pregnant Women ◽  
Bacterial Species ◽  
Asymptomatic Bacteriuria ◽  
Urine Specimen ◽  
Diabetic Patients ◽  
Solid Organ ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Cord Injury

ABSTRACT This minireview focuses on the microbiologic evaluation of patients with asymptomatic bacteriuria, as well as indications for antibiotic treatment. Asymptomatic bacteriuria is defined as two consecutive voided specimens (preferably within 2 weeks) with the same bacterial species, isolated in quantitative counts of ≥105 CFU/ml in women, including pregnant women; a single voided urine specimen with one bacterial species isolated in a quantitative count ≥105 CFU/ml in men; and a single catheterized urine specimen with one or more bacterial species isolated in a quantitative count of ≥105 CFU/ml in either women or men (or ≥102 CFU/ml of a single bacterial species from a single catheterized urine specimen). Any urine specimen with ≥104 CFU/ml group B Streptococcus is significant for asymptomatic bacteriuria in a pregnant woman. Asymptomatic bacteriuria occurs, irrespective of pyuria, in the absence of signs or symptoms of a urinary tract infection. The two groups with the best evidence of adverse outcomes in the setting of untreated asymptomatic bacteriuria include pregnant women and patients who undergo urologic procedures with risk of mucosal injury. Screening and treatment of asymptomatic bacteriuria is not recommended in the following patient populations: pediatric patients, healthy nonpregnant women, older patients in the inpatient or outpatient setting, diabetic patients, patients with an indwelling urethral catheter, patients with impaired voiding following spinal cord injury, patients undergoing nonurologic surgeries, and nonrenal solid-organ transplant recipients. Renal transplant recipients beyond 1 month posttransplant should not undergo screening and treatment for asymptomatic bacteriuria. There is insufficient evidence to recommend for or against screening of renal transplant recipients within 1 month, patients with high-risk neutropenia, or patients with indwelling catheters at the time of catheter removal. Unwarranted antibiotics place patients at increased risk of adverse effects (including Clostridioides difficile diarrhea) and contribute to antibiotic resistance. Methods to reduce unnecessary screening for and treatment of asymptomatic bacteriuria aid in antibiotic stewardship.

scholarly journals Lower Respiratory Tract Infection in a Renal Transplant Recipient: Do not Forget Metapneumovirus

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
N. Noel ◽  
B. Rammaert ◽  
J. Zuber ◽  
N. Sayre ◽  
M. F. Mamzer-Bruneel ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Tract Infection ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Organ Transplant ◽  
Detection Methods ◽  
Solid Organ ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Solid Organ Transplant Recipients

Human metapneumovirus (hMPV) is emerging as a cause of a severe respiratory tract infection in immunocompromised patients. hMPVpneumonia has only been seldom reported in nonpulmonary solid organ transplanted patients, such as renal transplant recipients. We report here a case of a 39-year-old patient presenting with fever, cough, and interstitial opacities on CT scan diagnosed as a nonsevere hMPVpneumonia 11 years after a renal transplantation. Infection resolved spontaneously. Differential diagnosis withPneumocystispneumonia was discussed. We review the medical literature and discuss clinical presentation and detection methods that can be proposed in solid organ transplant recipients.

scholarly journals A 36-Year-Old Renal Transplant Recipient Female with Leg Ulcer: A Case Report and Brief Review

2018 ◽  
Vol 2018 ◽  
pp. 1-6
Author(s):  
Ali Monfared ◽  
Eftekhari Hojat ◽  
Seyed Alireza Mesbah ◽  
Abbas Darjani ◽  
Seyyede Zeinab Azimi
Keyword(s):  
Renal Transplant ◽  
Transplant Recipient ◽  
Renal Transplant Recipient ◽  
Opportunistic Infections ◽  
Rare Complication ◽  
Organ Transplant ◽  
Transplant Recipients ◽  
Cutaneous Lesions ◽  
Case Presentation ◽  
High Clinical Suspicion

Background. Opportunistic infections are common in organ transplant recipients. After 6 months of transplantation, patients have the highest risk of opportunistic infections such as cryptococcosis. Case Presentation. The report presents the case of a 36-year-old female renal transplant recipient, with complaints of few subcutaneous painful and warm nodules and large, warm, erythematous, nontender plaques on the mildly edematous right leg and ankle. Incisional biopsy of the subcutaneous nodule over the leg showed panniculitis with small- to medium-sized vasculitis associated with round yeast forms, and culture of the fragments revealed C. neoformans var. grubii. Conclusions. This article also reviews in brief the treatment of this rare complication. Reviewing the literature showed that since the cryptococcal cutaneous lesions are often nonspecific, the clinical picture solely is not enough to construct a definite diagnosis and there must be a high clinical suspicion.

scholarly journals Gastropulmonary Fistula in a Renal Transplanted Patient! Who Knew?

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Ahad Qayyum ◽  
Marium Tahir ◽  
Fahad Mehmood ◽  
Ahmad Raza
Keyword(s):  
Renal Transplant ◽  
Transplant Recipient ◽  
Immunosuppressive Therapy ◽  
Renal Transplant Recipient ◽  
Cause Of Death ◽  
Organ Transplant ◽  
Klebsiella Pneumonia ◽  
Transplant Recipients ◽  
Life Threatening ◽  
Life Threatening Complication

Patients requiring immunosuppressive therapy after transplantation are susceptible to infection by a variety of common and uncommon pathogens, and infection has been the major cause of death in organ transplant recipients. Here we present one of a kind case where klebsiella pneumonia led to a fatal and life threatening complication i.e. gastro pulmonary fistula in a renal transplant recipient.

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