2024
Successful combination therapy for recurrent refractory cytomegalovirus treatment in a kidney transplant recipient
Marvin J, Trubin P, Azar M. Successful combination therapy for recurrent refractory cytomegalovirus treatment in a kidney transplant recipient. Transplant Infectious Disease 2024, 26: e14329. PMID: 38971997, DOI: 10.1111/tid.14329.Peer-Reviewed Original ResearchAtypical pneumonia testing in transplant recipients
Feller F, Trubin P, Malinis M, Vogel J, Merwede J, Peaper D, Azar M. Atypical pneumonia testing in transplant recipients. Transplant Infectious Disease 2024, 26: e14256. PMID: 38430482, DOI: 10.1111/tid.14256.Peer-Reviewed Original ResearchHematopoietic stem cell transplantationTransplant recipientsPathogens of pneumoniaAtypical pneumoniaAugmented immunosuppressionAtypical pathogensTest positivity rateChimeric antigen receptor T cellsHematopoietic stem cell transplant recipientsDiagnosis of atypical pneumoniaPositive rateCases of mycoplasma infectionStem cell transplantationSolid organ transplantationRetrospective cohort studyMycoplasma infectionImmunocompromised patientsCell transplantationAnalysis of diagnostic testsDiagnostic yieldTransplant cohortPost-transplantationT cellsCohort studyRates of testingClinical outcomes of SARS‐CoV‐2 infection in kidney transplant recipients on belatacept: a single‐center experience
Feller F, Azar M, Marvin J, Cohen E, Virmani S, Malinis M. Clinical outcomes of SARS‐CoV‐2 infection in kidney transplant recipients on belatacept: a single‐center experience. Transplant Infectious Disease 2024, 26: e14253. PMID: 38351494, DOI: 10.1111/tid.14253.Peer-Reviewed Original ResearchThe respiratory syncytial virus vaccines are here: Implications for solid organ transplantation
Trubin P, Azar M, Kotton C. The respiratory syncytial virus vaccines are here: Implications for solid organ transplantation. American Journal Of Transplantation 2024, 24: 897-904. PMID: 38341028, DOI: 10.1016/j.ajt.2024.02.003.Peer-Reviewed Original ResearchRespiratory syncytial virusSolid organ transplantationLower respiratory tract diseaseHigh risk of infectious complicationsBurden of RSV diseaseOrgan transplantationRisk of infectious complicationsRespiratory syncytial virus vaccineRespiratory tract diseaseCenters for Disease Control and Prevention's Advisory CommitteeOrgan transplant recipientsSolid organ recipientsPoor clinical outcomesFood and Drug AdministrationRSV F glycoproteinRespiratory virus vaccinesRSV diseaseInfectious complicationsTransplant recipientsClinical outcomesSyncytial virusClinical decision-makingImmunocompromised individualsOrgan recipientsImmunization Practices
2023
Active and Passive Immunization Approaches in Transplant Recipients
Ringer M, Azar M, Malinis M. Active and Passive Immunization Approaches in Transplant Recipients. Current Transplantation Reports 2023, 10: 188-198. DOI: 10.1007/s40472-023-00406-4.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsSolid organ transplant recipientsImmune responseTransplant recipientsActive immunizationReviewThe COVID-19 pandemicMonoclonal antibodiesSARS-CoV2 vaccinesOrgan transplant recipientsDose of vaccinePassive immunization approachesTiming of vaccinationPassive immunization strategiesUse of adjuvantsBooster dosesConvalescent plasmaClinical efficacyPassive immunizationPoor outcomePassive immunityImmunization approachVaccinationImmunization strategiesImmunizationFurther studiesCOVID-19 pandemicRapid antimicrobial resistance detection methods for bloodstream infection in solid organ transplantation: Proposed clinical guidance, unmet needs, and future directions
Turbett S, Banach D, Bard J, Gandhi R, Letourneau A, Azar M. Rapid antimicrobial resistance detection methods for bloodstream infection in solid organ transplantation: Proposed clinical guidance, unmet needs, and future directions. Transplant Infectious Disease 2023, 25: e14113. PMID: 37594214, DOI: 10.1111/tid.14113.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsUnmet needSolid organ transplant recipientsOrgan transplant recipientsSolid organ transplantationTransplant infectious diseasesEffective antimicrobial therapyPositive blood culturesFast institutionSOT recipientsTransplant recipientsDiagnostic stewardshipBloodstream infectionsAntimicrobial therapyBlood culturesClinical guidanceOrgan transplantationConsensus conferenceClinical practiceInfectious diseasesClinical microbiologyAmerican SocietyTransplantationResistance detectionBacterial resistanceRecipientsCurrent Concepts in the Diagnosis and Management of Pneumocystis Pneumonia in Solid Organ Transplantation
Trubin P, Azar M. Current Concepts in the Diagnosis and Management of Pneumocystis Pneumonia in Solid Organ Transplantation. Infectious Disease Clinics Of North America 2023, 37: 617-640. PMID: 37142510, DOI: 10.1016/j.idc.2023.03.005.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsSolid organ transplant recipientsOrgan transplant recipientsFirst-choice agentsSolid organ transplantationAppropriate clinical contextTransplant recipientsInterstitial pneumoniaTrimethoprim-sulfamethoxazoleOptimal treatmentPneumocystis pneumoniaOrgan transplantationInfection manifestsPrevention strategiesNucleic acid amplificationDiagnostic testingRadiographic imagingTissue samplingClinical contextLung fluidCurrent conceptsHost susceptibilityPneumoniaAcid amplificationTreatmentProphylaxis
2022
535. Evaluation of the BioFire Blood Culture Identification (BCID2) panel for transplant recipients with a bloodstream infection
Palacios C, Peaper D, Malinis M, Malinis M, Perreault S, Cohen E, Vogel J, Azar M. 535. Evaluation of the BioFire Blood Culture Identification (BCID2) panel for transplant recipients with a bloodstream infection. Open Forum Infectious Diseases 2022, 9: ofac492.588. PMCID: PMC9752191, DOI: 10.1093/ofid/ofac492.588.Peer-Reviewed Original ResearchBone marrow transplant recipientsTransplant recipientsBloodstream infectionsBlood culturesPositive blood culturesClinical trialsPrimary investigatorSolid organ recipientsMarrow transplant recipientsRetrospective chart reviewYear of transplantationAntimicrobial susceptibility resultsBlood Culture Identification PanelBSI eventsChart reviewOptimal therapyOrgan recipientsMean ageMultiplex PCR panelSame patientGeneral populationPolymicrobial culturesCandida sppPeripheral sitesRecipientsOverall Infectious Complications Related to Belatacept Conversion in Comparison to Tacrolimus in Kidney Transplant Recipients
Marvin JE, Azar MM, Belfield KD, Do V, Formica R, Cohen EA. Overall Infectious Complications Related to Belatacept Conversion in Comparison to Tacrolimus in Kidney Transplant Recipients. Progress In Transplantation 2022, 32: 351-356. PMID: 36039533, DOI: 10.1177/15269248221122894.Peer-Reviewed Original ResearchConceptsKidney transplant recipientsProportion of patientsBelatacept conversionInfectious complicationsTransplant recipientsExact testLong-term infectious complicationsFavorable side effect profileOverall infectious complicationsSide effect profileTime of transplantFisher's exact testT-testStudent's t-testMann-Whitney UInduction immunosuppressionTacrolimus patientsKidney transplantMore patientsPrimary outcomeEffect profileTacrolimusOutcome dataHigh incidenceRetrospective evaluationA consensus conference to define the utility of advanced infectious disease diagnostics in solid organ transplant recipients
Azar MM, Turbett S, Gaston D, Gitman M, Razonable R, Koo S, Hanson K, Kotton C, Silveira F, Banach DB, Basu SS, Bhaskaran A, Danziger-Isakov L, Bard JD, Gandhi R, Hanisch B, John TM, John A, Letourneau AR, Luong M, Maron G, Miller S, Prinzi A, Schwartz I, Simner P, Kumar D, Group O. A consensus conference to define the utility of advanced infectious disease diagnostics in solid organ transplant recipients. American Journal Of Transplantation 2022, 22: 3150-3169. PMID: 35822346, DOI: 10.1111/ajt.17147.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsOrgan transplant recipientsTransplant recipientsConsensus conferenceSolid organ transplant recipientsInfectious diseasesSetting of transplantationInfectious disease diagnosticsTransplant infectious diseasesHigh-quality evidenceEvidence-based recommendationsMultiplex molecular assaysNext-generation sequencing assayDiagnostic stewardshipConsensus statementUnmet needMass spectrometry-based assayClinical useRecipientsClinical microbiologyMolecular assaysAmerican SocietyTransplantationFinancial barriersDiseaseSequencing assaysEvaluating clinical effectiveness of SARS‐CoV‐2 vaccine in solid organ transplant recipients: A propensity score matched analysis
Tucker M, Azar MM, Cohen E, Gan G, Deng Y, Palacios C, Malinis M. Evaluating clinical effectiveness of SARS‐CoV‐2 vaccine in solid organ transplant recipients: A propensity score matched analysis. Transplant Infectious Disease 2022, 24: e13876. PMID: 35684932, PMCID: PMC9348300, DOI: 10.1111/tid.13876.Peer-Reviewed Original ResearchConceptsSolid organ transplant recipientsSARS-CoV-2 infectionOrgan transplant recipientsCritical COVID-19Clinical effectivenessTransplant recipientsVaccine eraVaccinated solid organ transplant recipientsCOVID-19Propensity score-matched cohortSARS-CoV-2 vaccinationSevere coronavirus disease 2019Cause-specific Cox regression modelsCOVID-19-related mortalitySARS-CoV-2 vaccinesSARS-CoV-2 infection ratesCurrent vaccine recommendationsKey preventative strategiesPrimary vaccine seriesRetrospective cohort studyDoses of mRNACox regression modelCoronavirus disease 2019Poisson regression modelsVaccine seriesInto the unknown: Diagnosing mysterious brain lesions
Kassab I, Isada C, Azar MM, Sarsam N, Jiang M, Camelo‐Piragua S, Kaul D, Malinis M. Into the unknown: Diagnosing mysterious brain lesions. Transplant Infectious Disease 2022, 24: e13829. PMID: 35307917, DOI: 10.1111/tid.13829.Peer-Reviewed Case Reports and Technical NotesConceptsBrain abscessesImmune statusPancreas-kidney transplant recipientsCentral nervous system infectionBartonella henselaeMetagenomic next-generation sequencingCSF metagenomic next-generation sequencingMultiple brain abscessesVisceral organ involvementPatient's immune statusNervous system infectionCat-scratch diseaseTransplant recipientsOcular involvementOrgan involvementSystem infectionNeurological manifestationsCat bitesBrain lesionsDiagnostic approachNext-generation sequencingAbscessZoonotic pathogensClinicopathological conferenceHenselaeReal‐world experience with available, outpatient COVID‐19 therapies in solid organ transplant recipients during the omicron surge
Radcliffe C, Palacios CF, Azar MM, Cohen E, Malinis M. Real‐world experience with available, outpatient COVID‐19 therapies in solid organ transplant recipients during the omicron surge. American Journal Of Transplantation 2022, 22: 2458-2463. PMID: 35583664, PMCID: PMC9348251, DOI: 10.1111/ajt.17098.Peer-Reviewed Original ResearchConceptsSolid organ transplant recipientsOral antiviral agentsOrgan transplant recipientsOutpatient therapyTransplant recipientsAntiviral agentsCOVID-19-related morbidityMonoclonal antibodiesKidney transplant recipientsRate of hospitalizationCOVID-19 therapyReal-world effectivenessSARS-CoV-2 pandemicCOVID-19 diagnosisModerate diseaseRetrospective reviewMean ageOutpatient settingClinical trialsSubstantial burdenTherapyCoronavirus diseaseMean timeHealthcare systemReal-world experienceDematiaceous fungal infections in solid organ transplantation: Systematic review and Bayesian meta‐analysis
Radcliffe C, Radcliffe AJ, Azar MM, Grant M. Dematiaceous fungal infections in solid organ transplantation: Systematic review and Bayesian meta‐analysis. Transplant Infectious Disease 2022, 24: e13819. PMID: 35253959, DOI: 10.1111/tid.13819.Peer-Reviewed Original ResearchConceptsSolid organ transplant recipientsDematiaceous fungal infectionSoft tissue infectionsFungal infectionsInfectious syndromesSystematic reviewEarly post-transplant periodCentral nervous system infectionCommon infectious syndromesPost-transplant periodNervous system infectionOrgan transplant recipientsSolid organ transplantationEnglish-language reportsInfection typeKidney recipientsLiver recipientsPediatric reportsTransplant recipientsPulmonary infectionSystem infectionTissue infectionsWorse prognosisDisseminated infectionMean ageRectal screening for azole non‐susceptible Candida species in patients undergoing liver transplantation
Radcliffe C, Patel KK, Azar MM, Koff A, Belfield KD, Peaper DR, Topal JE, Malinis M. Rectal screening for azole non‐susceptible Candida species in patients undergoing liver transplantation. Transplant Infectious Disease 2022, 24: e13811. PMID: 35184347, DOI: 10.1111/tid.13811.Peer-Reviewed Original ResearchConceptsAppropriate antifungal prophylaxisAntifungal prophylaxisRisk factorsTransplant recipientsRectal swabsSolid organ transplant recipientsCommon invasive fungal infectionYale-New Haven HospitalDays of LTTime of LTLiver transplant recipientsOrgan transplant recipientsRetrospective chart reviewMore risk factorsMultiple risk factorsInvasive fungal infectionsNew Haven HospitalPrimary LTLiver transplantationAdult patientsChart reviewLT candidatesRectal screeningCandida infectionsMedian numberDelayed Mortality Among Solid Organ Transplant Recipients Hospitalized for COVID-19
Heldman MR, Kates OS, Safa K, Kotton CN, Multani A, Georgia SJ, Steinbrink JM, Alexander BD, Blumberg EA, Haydel B, Hemmige V, Hemmersbach-Miller M, La Hoz RM, Moni L, Condor Y, Flores S, Munoz CG, Guitierrez J, Diaz EI, Diaz D, Vianna R, Guerra G, Loebe M, Yabu JM, Kramer KH, Tanna SD, Ison MG, Rakita RM, Malinis M, Azar MM, McCort ME, Singh PP, Velioglu A, Mehta SA, van Duin D, Goldman JD, Lease ED, Wald A, Limaye AP, Fisher CE, Besharatian B, Crespo M, Tomic R, Sehgal S, Weisshaar D, Girgis R, Lawrence C, Nelson J, Bennett W, Leandro J, Sait A, Rumore A, West P, Jeng A, Bajrovic V, Bilgili E, Anderson-Haag T, Nastase A, Badami A, Alvarez-Garcia J, Bowman-Anger L, Julien L, Ortiz-Bautista C, Friedman-Morocco R, Gajurel K, Cahuayme-Zuniga L, Wakefield M, Fung M, Theodoropoulos N, Chuang S, Bhandaram S, Veroux M, Chopra B, Florescu D, Witteck D, Diaz D, Ripley K, Saharia K, Akkina S, McCarty T, Webb A, Arya A, Vedula G, El-Amm J, Dokus M, Narayanan A, de Camargo P, Ouseph R, Breuckner A, Luk A, Aujayeb A, Ganger D, Keith D, Meloni F, Haidar G, Zapernick L, Morales M, Goyal N, Sharma T, Malhotra U, Kuo A, Rossi A, Edwards A, Keller B, Beneri C, Derringer D, Dominguez E, Carlson E, Hashim F, Murad H, Wilkens H, Neumann H, Gani I, Kahwaji J, Popoola J, Michaels M, Jakharia N, De la Cruz O, Puing A, Motallebzadeh R, Velagapudi R, Kapoor R, Allam S, Silveira F, Vora S, Kelly U, Reddy U, Dharnidharka V, Wadei H, Zurabi L. Delayed Mortality Among Solid Organ Transplant Recipients Hospitalized for COVID-19. Clinical Infectious Diseases 2022, 78: 711-718. PMID: 35212363, PMCID: PMC9383518, DOI: 10.1093/cid/ciac159.Peer-Reviewed Original ResearchSOT recipientsDay 28Day 90Multivariable Cox proportional hazards modelsSolid organ transplant recipientsCOVID-19Cox proportional hazards modelCOVID-19 focusOrgan transplant recipientsChronic lung diseaseBody mass indexProportional hazards modelSARS-CoV-2 detectionLung transplantMulticenter registryTransplant recipientsHeart failureMass indexIllness onsetVital statusLung diseaseRisk factorsDay 29Lower mortalityMortalityClinical effectiveness of additional primary SARS‐CoV‐2 vaccine doses for solid organ transplant recipients
Radcliffe C, Azar MM, Cohen E, Tucker M, Grubaugh ND, Malinis M. Clinical effectiveness of additional primary SARS‐CoV‐2 vaccine doses for solid organ transplant recipients. Clinical Transplantation 2022, 36: e14601. PMID: 35064939, DOI: 10.1111/ctr.14601.Commentaries, Editorials and LettersAn outbreak of SARS‐CoV‐2 on a transplant unit in the early vaccination era
Roberts SC, Palacios C, Grubaugh ND, Alpert T, Ott IM, Breban MI, Initiative Y, Martinello RA, Smith C, Davis MW, Mcmanus D, Tirmizi S, Topal JE, Azar MM, Malinis M. An outbreak of SARS‐CoV‐2 on a transplant unit in the early vaccination era. Transplant Infectious Disease 2022, 24: e13782. PMID: 34969164, DOI: 10.1111/tid.13782.Peer-Reviewed Original ResearchConceptsSARS-CoV-2Infection prevention practicesSARS-CoV-2 outbreakTransplant unitCOVID-19-associated morbiditySolid organ transplant recipientsSARS-CoV-2 vaccinationPrevention practicesHospital day 18Potential index casesOrgan transplant recipientsInfection prevention behaviorsMonoclonal antibody therapyCOVID-19SARS-CoV-2 clustersHospital staff membersWhole-genome sequencingAsymptomatic patientsTransplant recipientsPositive patientsAtypical presentationImmunocompromised patientsAntibody therapyVaccination eraDisease progression
2021
Longitudinal Immune Profiling of a Severe Acute Respiratory Syndrome Coronavirus 2 Reinfection in a Solid Organ Transplant Recipient
Klein J, Brito AF, Trubin P, Lu P, Wong P, Alpert T, Peña-Hernández MA, Haynes W, Kamath K, Liu F, Vogels CBF, Fauver JR, Lucas C, Oh J, Mao T, Silva J, Wyllie AL, Muenker MC, Casanovas-Massana A, Moore AJ, Petrone ME, Kalinich CC, Dela Cruz C, Farhadian S, Ring A, Shon J, Ko AI, Grubaugh ND, Israelow B, Iwasaki A, Azar MM, Team F. Longitudinal Immune Profiling of a Severe Acute Respiratory Syndrome Coronavirus 2 Reinfection in a Solid Organ Transplant Recipient. The Journal Of Infectious Diseases 2021, 225: 374-384. PMID: 34718647, PMCID: PMC8807168, DOI: 10.1093/infdis/jiab553.Peer-Reviewed Original ResearchConceptsSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reinfectionLongitudinal immune profilingTransplant recipientsImmune profilingPrimary SARS-CoV-2 infectionCD4 T cell poolMale renal transplant recipientSolid organ transplant recipientsSARS-CoV-2 reinfectionSARS-CoV-2 antibodiesSARS-CoV-2 infectionWhole viral genome sequencingRenal transplant recipientsImmune escape mutationsOrgan transplant recipientsT cell poolTime of reinfectionCoronavirus disease 2019Lower neutralization titersHumoral memory responsesViral genome sequencingInitial diagnosisImmunologic deficiencyHumoral responseImmunologic investigationsNocardiosis and elevated beta-d-glucan in solid organ transplant recipients
Ringer M, Radcliffe C, Kerantzas CA, Malinis M, Azar MM. Nocardiosis and elevated beta-d-glucan in solid organ transplant recipients. IDCases 2021, 26: e01322. PMID: 34786341, PMCID: PMC8577490, DOI: 10.1016/j.idcr.2021.e01322.Peer-Reviewed Case Reports and Technical NotesSOT recipientsBeta-d-glucan (BDG) testingSolid organ transplantation recipientsSolid organ transplant recipientsElevated BDG levelsOrgan transplant recipientsOrgan transplantation recipientsCases of nocardiosisFuture prospective studiesCases of patientsInvasive fungal infectionsBDG testingTransplant recipientsTransplantation recipientsClinical courseCase seriesProspective studyCase definitionIdentified causeElevated betaBDG levelsNocardiosisCausal associationFungal infectionsRecipients