David W Eyre, Anna E Sheppard, Hilary Madder, Ian Moir, Ruth Moroney, T Phuong Quan, David Griffiths, Sophie George, Lisa Butcher, Marcus Morgan, Robert Newnham, Mary Sunderland, Tiphanie Clarke, Dona Foster, Peter Hoffman, Andrew M Borman, Elizabeth M Johnson, Ginny Moore, Colin S Brown, A Sarah Walker, Tim E A Peto, Derrick W Crook, Katie J M Jeffery
BACKGROUND: Candida auris is an emerging and multidrug-resistant pathogen. Here we report the epidemiology of a hospital outbreak of C. auris colonization and infection. METHODS: After identification of a cluster of C. auris infections in the neurosciences intensive care unit (ICU) of the Oxford University Hospitals, United Kingdom, we instituted an intensive patient and environmental screening program and package of interventions. Multivariable logistic regression was used to identify predictors of C...
October 4, 2018: New England Journal of Medicine
A Cusini, C Béguelin, S Stampf, K Boggian, C Garzoni, M Koller, O Manuel, P Meylan, N J Mueller, H H Hirsch, M Weisser, C Berger, C van Delden
Clostridium difficile infection (CDI) is a leading cause of infectious diarrhea in solid organ transplant recipients (SOT). We aimed to assess incidence, risk factors, and outcome of CDI within the Swiss Transplant Cohort Study (STCS). We performed a case-control study of SOT recipients in the STCS diagnosed with CDI between May 2008 and August 2013. We matched 2 control subjects per case by age at transplantation, sex, and transplanted organ. A multivariable analysis was performed using conditional logistic regression to identify risk factors and evaluate outcome of CDI...
July 2018: American Journal of Transplantation
Yao-Wen Cheng, Emmalee Phelps, Vincent Ganapini, Noor Khan, Fangqian Ouyang, Huiping Xu, Sahil Khanna, Raseen Tariq, Rachel J Friedman-Moraco, Michael H Woodworth, Tanvi Dhere, Colleen S Kraft, Dina Kao, Justin Smith, Lien Le, Najwa El-Nachef, Nirmal Kaur, Sree Kowsika, Adam Ehrlich, Michael Smith, Nasia Safdar, Elizabeth Ann Misch, Jessica R Allegretti, Ann Flynn, Zain Kassam, Asif Sharfuddin, Raj Vuppalanchi, Monika Fischer
Fecal microbiota transplant (FMT) is recommended for Clostridium difficile infection (CDI) treatment; however, use in solid organ transplantation (SOT) patients has theoretical safety concerns. This multicenter, retrospective study evaluated FMT safety, effectiveness, and risk factors for failure in SOT patients. Primary cure and overall cure were defined as resolution of diarrhea or negative C difficile stool test after a single FMT or after subsequent FMT(s) ± anti-CDI antibiotics, respectively. Ninety-four SOT patients underwent FMT, 78% for recurrent CDI and 22% for severe or fulminant CDI...
February 2019: American Journal of Transplantation
Rebekah M Dedrick, Carlos A Guerrero-Bustamante, Rebecca A Garlena, Daniel A Russell, Katrina Ford, Kathryn Harris, Kimberly C Gilmour, James Soothill, Deborah Jacobs-Sera, Robert T Schooley, Graham F Hatfull, Helen Spencer
A 15-year-old patient with cystic fibrosis with a disseminated Mycobacterium abscessus infection was treated with a three-phage cocktail following bilateral lung transplantation. Effective lytic phage derivatives that efficiently kill the infectious M. abscessus strain were developed by genome engineering and forward genetics. Intravenous phage treatment was well tolerated and associated with objective clinical improvement, including sternal wound closure, improved liver function, and substantial resolution of infected skin nodules...
May 2019: Nature Medicine
Nancy Law, Cathy Logan, Gordon Yung, Carrie-Lynn Langlais Furr, Susan M Lehman, Sandra Morales, Francisco Rosas, Alexander Gaidamaka, Igor Bilinsky, Paul Grint, Robert T Schooley, Saima Aslam
INTRODUCTION: We describe the use of bacteriophage therapy in a 26-year-old cystic fibrosis (CF) patient awaiting lung transplantation. HOSPITAL COURSE: The patient developed multidrug resistant (MDR) Pseudomonas aeruginosa pneumonia, persistent respiratory failure, and colistin-induced renal failure. We describe the use of intravenous bacteriophage therapy (BT) along with systemic antibiotics in this patient, lack of adverse events, and clinical resolution of infection with this approach...
August 2019: Infection
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