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 investigationsIncreased Detection of Mycobacterium tuberculosis Disease Using a Tissue-Based Laboratory-Developed Polymerase Chain Reaction Assay Compared to Standard Diagnostics.
Mackow NA, Abi-Raad R, Kerantzas CA, Hui P, Malinis M, Azar MM. Increased Detection of Mycobacterium tuberculosis Disease Using a Tissue-Based Laboratory-Developed Polymerase Chain Reaction Assay Compared to Standard Diagnostics. American Journal Of Tropical Medicine And Hygiene 2021, 105: 1657-1661. PMID: 34544041, PMCID: PMC8641361, DOI: 10.4269/ajtmh.21-0104.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedCulture TechniquesFemaleHumansLungLymph NodesMaleMiddle AgedMycobacterium tuberculosisPleuraReal-Time Polymerase Chain ReactionReference StandardsRetrospective StudiesSensitivity and SpecificitySputumTuberculosisTuberculosis, Lymph NodeTuberculosis, Multidrug-ResistantTuberculosis, PleuralTuberculosis, PulmonaryConceptsComposite reference standardMTB PCRAFB cultureMycobacterium tuberculosisPolymerase chain reactionAcid-fast bacilli smearMycobacterium tuberculosis diseasePositive AFB cultureChain reactionReal-time polymerase chain reactionStandard diagnosticsBacilli smearMTB casesTuberculosis diseaseClinical sensitivityLong turnaround timeXpertClinical performanceReference standardPCRVariable sensitivityTurnaround timeLymphPatientsTuberculosisIncidence and associated risk factors for invasive fungal infections and other serious infections in patients on ibrutinib
Holowka T, Cheung H, Malinis M, Gan G, Deng Y, Perreault S, Isufi I, Azar MM. Incidence and associated risk factors for invasive fungal infections and other serious infections in patients on ibrutinib. Journal Of Infection And Chemotherapy 2021, 27: 1700-1705. PMID: 34389223, DOI: 10.1016/j.jiac.2021.08.005.Peer-Reviewed Original ResearchConceptsInvasive fungal infectionsSerious infectionsRisk factorsHematologic malignanciesAdvanced ageMultivariate analysis risk factorsSmall molecule tyrosine kinase inhibitorsSingle tertiary care centerFungal infectionsConcurrent useCytotoxic agentsMolecule tyrosine kinase inhibitorsAnalysis risk factorsTertiary care centerTyrosine kinase inhibitorsElectronic medical recordsResult of infectionMost patientsClinical featuresInfected patientsMedical recordsCare centerImmune effectorsPatientsViral infectionCOVID‐19 in hospitalized lung and non‐lung solid organ transplant recipients: A comparative analysis from a multicenter study
Heldman MR, Kates OS, Safa K, Kotton CN, Georgia SJ, Steinbrink JM, Alexander BD, Hemmersbach‐Miller M, Blumberg EA, Crespo MM, Multani A, Lewis AV, Beaird O, Haydel B, La Hoz RM, Moni L, Condor Y, Flores S, Munoz CG, Guitierrez J, Diaz EI, Diaz D, Vianna R, Guerra G, Loebe M, Rakita RM, Malinis M, Azar MM, Hemmige V, McCort ME, Chaudhry ZS, Singh P, Hughes K, Velioglu A, Yabu JM, Morillis JA, Mehta SA, Tanna SD, Ison MG, Tomic R, Derenge A, van Duin D, Maximin A, Gilbert C, Goldman JD, Sehgal S, Weisshaar D, Girgis RE, Nelson J, Lease ED, Limaye AP, Fisher CE, Team T. COVID‐19 in hospitalized lung and non‐lung solid organ transplant recipients: A comparative analysis from a multicenter study. American Journal Of Transplantation 2021, 21: 2774-2784. PMID: 34008917, PMCID: PMC9215359, DOI: 10.1111/ajt.16692.Peer-Reviewed Original ResearchConceptsSolid organ transplant recipientsLung transplant recipientsOrgan transplant recipientsTransplant recipientsRisk factorsAllograft dysfunctionAdult solid organ transplant recipientsCOVID-19High mortalityChronic lung allograft dysfunctionOnly independent risk factorMultivariable logistic regression modelChronic allograft dysfunctionComorbidity-adjusted mortalityLung allograft dysfunctionMulticenter cohort studyIndependent risk factorCoronavirus disease 2019Logistic regression modelsLung transplantCohort studyHeart failureMulticenter studyDisease 2019MortalityA retrospective matched cohort single‐center study evaluating outcomes of COVID‐19 and the impact of immunomodulation on COVID‐19‐related cytokine release syndrome in solid organ transplant recipients
Ringer M, Azmy V, Kaman K, Tang D, Cheung H, Azar MM, Price C, Malinis M. A retrospective matched cohort single‐center study evaluating outcomes of COVID‐19 and the impact of immunomodulation on COVID‐19‐related cytokine release syndrome in solid organ transplant recipients. Transplant Infectious Disease 2021, 23: e13556. PMID: 33378571, PMCID: PMC7883059, DOI: 10.1111/tid.13556.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overAntibodies, Monoclonal, HumanizedCase-Control StudiesCohort StudiesComorbidityCOVID-19COVID-19 Drug TreatmentCytokine Release SyndromeFemaleGlucocorticoidsGraft RejectionHeart TransplantationHospitalizationHumansImmunologic FactorsImmunosuppressive AgentsInterleukin-10Interleukin-6Kidney TransplantationLiver TransplantationMaleMiddle AgedReceptors, Interleukin-2Retrospective StudiesSARS-CoV-2Severity of Illness IndexTreatment OutcomeYoung AdultConceptsCytokine release syndromeBody mass indexNon-SOT patientsSOT groupSOT patientsRelease syndromeInterleukin-6COVID-19-related cytokine release syndromeSoluble interleukin-2 receptor levelsControl groupInterleukin-2 receptor levelsSolid organ transplant patientsSolid organ transplant recipientsImpact of immunomodulationInterleukin-10 levelsOrgan transplant recipientsOrgan transplant patientsCritical care needsMulti-center studyCoronavirus disease 2019COVID-19Interleukin levelsIndex hospitalizationTransplant patientsTransplant recipients
2020
Clinicopathologic Features of Tissue Granulomas in Transplant Recipients: A Single Center Study in a Nontuberculosis Endemic Region.
Nussbaum EZ, Patel KK, Assi R, Raad RA, Malinis M, Azar MM. Clinicopathologic Features of Tissue Granulomas in Transplant Recipients: A Single Center Study in a Nontuberculosis Endemic Region. Archives Of Pathology & Laboratory Medicine 2020, 145: 988-999. PMID: 33290524, DOI: 10.5858/arpa.2020-0271-oa.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedBartonellaBiopsyCommunicable DiseasesConnecticutCytomegalovirusFemaleGranulomaHematopoietic Stem Cell TransplantationHumansMaleMiddle AgedOrgan TransplantationPrevalenceRetrospective StudiesRisk AssessmentRisk FactorsTime FactorsTransplantation, HomologousTreatment OutcomeYoung AdultConceptsEpidemiologic risk factorsPresence of symptomsInfectious etiologyAsymptomatic patientsTransplant recipientsTissue granulomasClinicopathologic featuresRisk factorsAllogeneic hematopoietic stem cell transplant recipientsHematopoietic stem cell transplant recipientsStem cell transplant recipientsYale-New Haven HospitalCommon infectious etiologiesLarge transplant populationCell transplant recipientsSingle-center studyCryptogenic organizing pneumoniaNew Haven HospitalRoutine disease surveillancePaucity of literatureCytomegalovirus hepatitisPosttransplant specimensBiopsy indicationOrganizing pneumoniaTransplant patientsTocilizumab Treatment for Cytokine Release Syndrome in Hospitalized Patients With Coronavirus Disease 2019 Survival and Clinical Outcomes
Price CC, Altice FL, Shyr Y, Koff A, Pischel L, Goshua G, Azar MM, Mcmanus D, Chen SC, Gleeson SE, Britto CJ, Azmy V, Kaman K, Gaston DC, Davis M, Burrello T, Harris Z, Villanueva MS, Aoun-Barakat L, Kang I, Seropian S, Chupp G, Bucala R, Kaminski N, Lee AI, LoRusso PM, Topal JE, Dela Cruz C, Malinis M. Tocilizumab Treatment for Cytokine Release Syndrome in Hospitalized Patients With Coronavirus Disease 2019 Survival and Clinical Outcomes. CHEST Journal 2020, 158: 1397-1408. PMID: 32553536, PMCID: PMC7831876, DOI: 10.1016/j.chest.2020.06.006.Peer-Reviewed Original ResearchConceptsCytokine release syndromeTocilizumab-treated patientsSevere diseaseRelease syndromeTocilizumab treatmentInflammatory biomarkersNonsevere diseaseSoluble IL-2 receptor levelsHigh-sensitivity C-reactive proteinIL-2 receptor levelsConsecutive COVID-19 patientsIL-6 receptor antagonistMechanical ventilation outcomesC-reactive proteinCOVID-19 patientsHigher admission levelsRace/ethnicityMV daysVentilation outcomesAdverse eventsChart reviewClinical responseMedian ageWhite patientsClinical outcomesDaptomycin perioperative prophylaxis for the prevention of vancomycin‐resistant Enterococcus infection in colonized liver transplant recipients
Sarwar S, Koff A, Malinis M, Azar MM. Daptomycin perioperative prophylaxis for the prevention of vancomycin‐resistant Enterococcus infection in colonized liver transplant recipients. Transplant Infectious Disease 2020, 22: e13280. PMID: 32216015, DOI: 10.1111/tid.13280.Peer-Reviewed Original ResearchConceptsLiver transplant recipientsDays of LTVRE infectionTransplant recipientsPerioperative prophylaxisRisk factorsLT periodVancomycin-resistant enterococcus infectionAntibiotic prophylaxis regimenDays post-LTAcute cellular rejectionPrimary graft failureLiver transplantation recipientsRenal replacement therapyRetrospective chart reviewIntensive care unitMultiple risk factorsVancomycin-resistant EnterococcusCellular rejectionLT morbidityPost-LTPre-LTProphylaxis regimenCause mortalityVRE bacteremiaDisseminated, yet dissembled: Rare infections behind the veil of classical hairy cell leukemia
Shallis RM, Patel TH, Podoltsev NA, Xu ML, Azar MM, Gore SD. Disseminated, yet dissembled: Rare infections behind the veil of classical hairy cell leukemia. Leukemia Research 2020, 90: 106315. PMID: 32036123, DOI: 10.1016/j.leukres.2020.106315.Peer-Reviewed Case Reports and Technical Notes
2017
Clinical and epidemiological characterization of histoplasmosis cases in a nonendemic area, Connecticut, United States
Azar MM, Zhang X, Assi R, Hage C, Wheat LJ, Malinis MF. Clinical and epidemiological characterization of histoplasmosis cases in a nonendemic area, Connecticut, United States. Medical Mycology 2017, 56: 896-899. PMID: 29228334, DOI: 10.1093/mmy/myx120.Peer-Reviewed Original ResearchConceptsHuman immunodeficiency virusHistoplasmosis casesEpidemiology of histoplasmosisNon-endemic areasSymptom onsetAntigen testingMedian timeImmunodeficiency virusActive histoplasmosisNonendemic areasRetrospective analysisEndemic areasEpidemiological characterizationHistoplasmosisNew HavenDaysPatientsEpidemiologyDiagnosisCasesCase 34-2017
Lyons JL, Schaefer PW, Cho TA, Azar MM. Case 34-2017. New England Journal Of Medicine 2017, 377: 1878-1886. PMID: 29117489, DOI: 10.1056/nejmcpc1707557.Peer-Reviewed Case Reports and Technical NotesCase 30-2017
Bhattacharyya RP, Flores EJ, Azar MM. Case 30-2017. New England Journal Of Medicine 2017, 377: 1274-1282. PMID: 28953442, DOI: 10.1056/nejmcpc1706100.Peer-Reviewed Case Reports and Technical NotesDonor-Derived Transmission of Candida auris During Lung Transplantation
Azar MM, Turbett SE, Fishman JA, Pierce VM. Donor-Derived Transmission of Candida auris During Lung Transplantation. Clinical Infectious Diseases 2017, 65: 1040-1042. PMID: 28520901, DOI: 10.1093/cid/cix460.Peer-Reviewed Case Reports and Technical NotesConceptsStringent infection control measuresCandida aurisImportant public health implicationsDonor-derived transmissionLung transplant recipientsInfection control measuresPrevention of transmissionPublic health implicationsLung transplantationTransplant recipientsHigh mortalityC. aurisResistant pathogensHealth implicationsTransplantationAurisControl measuresInfectionMortalityRecipientsPrevention
2016
Disseminated Mycobacterium tuberculosis following renal transplant with alemtuzumab induction
Baghban A, Azar MM, Bernardo RM, Malinis M. Disseminated Mycobacterium tuberculosis following renal transplant with alemtuzumab induction. BMJ Case Reports 2016, 2016: bcr2016217998. PMID: 27852682, PMCID: PMC5129162, DOI: 10.1136/bcr-2016-217998.Peer-Reviewed Case Reports and Technical NotesConceptsMycobacterium tuberculosisDisseminated Mycobacterium tuberculosisIsoniazid preventative therapyHigh-risk patientsSolid organ transplantsOngoing risk factorsAlemtuzumab inductionDisseminated tuberculosisInduction immunosuppressionPeritransplant periodRenal transplantRenal transplantationPulmonary tuberculosisTuberculosis infectionPreventative therapyRisk factorsOrgan transplantsTuberculosisPatientsTransplantAvailable literatureImmunosuppressionTransplantationUnique challengesTherapyIntegrase strand transferase inhibitors: the preferred antiretroviral regimen in HIV-positive renal transplantation
Azar MM, Malinis MF, Moss J, Formica RN, Villanueva MS. Integrase strand transferase inhibitors: the preferred antiretroviral regimen in HIV-positive renal transplantation. International Journal Of STD & AIDS 2016, 28: 447-458. PMID: 27193421, DOI: 10.1177/0956462416651528.Peer-Reviewed Original ResearchConceptsInhibitor-based regimensRenal transplantationHIV/AIDSAntiretroviral regimenAntiretroviral therapyGraft survivalHIV-positive renal transplant recipientsEnd-stage renal diseaseHIV-positive patientsRenal transplant recipientsChronic kidney diseaseThree-year survivalInhibitor-based therapyNon-nucleoside reverseDrug-drug interactionsTransferase inhibitorsImmunosuppressive medicationsKidney transplantationTransplant recipientsAllograft rejectionGraft failureRenal diseaseCalcineurin inhibitorsClinical outcomesImmunosuppressive drugsDisseminated Histoplasmosis with Skin Lesions and Osteomyelitis in a Patient from the Philippines.
Azar MM, Malinis MF. Disseminated Histoplasmosis with Skin Lesions and Osteomyelitis in a Patient from the Philippines. American Journal Of Tropical Medicine And Hygiene 2016, 95: 70-4. PMID: 26976880, PMCID: PMC4944712, DOI: 10.4269/ajtmh.16-0063.Peer-Reviewed Case Reports and Technical NotesConceptsBone involvementDisseminated histoplasmosisFoot woundsPapular rashProtean manifestationsFinal diagnosisUnusual manifestationSkin lesionsDimorphic fungus Histoplasma capsulatumHistoplasmosisFungus Histoplasma capsulatumHistoplasma capsulatumDiseaseManifestationsRashOsteomyelitisPatientsLesionsDiagnosis
2015
Fungal Mycotic Aneurysm of the Internal Carotid Artery Associated with Sphenoid Sinusitis in an Immunocompromised Patient: A Case Report and Review of the Literature
Azar MM, Assi R, Patel N, Malinis MF. Fungal Mycotic Aneurysm of the Internal Carotid Artery Associated with Sphenoid Sinusitis in an Immunocompromised Patient: A Case Report and Review of the Literature. Mycopathologia 2015, 181: 425-433. PMID: 26687073, DOI: 10.1007/s11046-015-9975-1.Peer-Reviewed Case Reports and Technical NotesConceptsInternal carotid arteryFungal mycotic aneurysmsMycotic aneurysmSphenoid sinusitisICA aneurysmsSphenoid sinusEORTC/MSG criteriaInternal Carotid Artery AssociatedFungal sphenoid sinusitisLiposomal amphotericin B.Parent vessel sacrificeInvasive fungal infectionsDuration of antimicrobialsEffective antifungal therapyDevastating complicationSurgical debridementEndoscopic resectionAngioinvasive infectionVessel sacrificeCase reportAntifungal therapyCoil embolizationIdeal treatmentCavernous sinusCarotid arteryBlastomycosis in Indiana Clinical and Epidemiologic Patterns of Disease Gleaned from a Multicenter Retrospective Study
Azar MM, Assi R, Relich RF, Schmitt BH, Norris S, Wheat LJ, Hage CA. Blastomycosis in Indiana Clinical and Epidemiologic Patterns of Disease Gleaned from a Multicenter Retrospective Study. CHEST Journal 2015, 148: 1276-1284. PMID: 26020566, DOI: 10.1378/chest.15-0289.Peer-Reviewed Original ResearchConceptsDiabetes mellitusEpidemiologic patternsIncidence of blastomycosisMulticenter retrospective studyCases of blastomycosisMultilobar pneumoniaICU admissionExtrapulmonary diseaseRetrospective studyMean ageIncidence rateFungal antigensEndemic areasLarge seriesAmphotericin BBlastomycosisTotal mortalityIncidenceMellitusPneumoniaSignificant increaseDiseaseIndiana ClinicalARDSImmunosuppressionAre Nectarines to Blame? A Case Report and Literature Review of Spontaneous Bacterial Peritonitis Due to Listeria monocytogenes.
How J, Azar MM, Meyer JP. Are Nectarines to Blame? A Case Report and Literature Review of Spontaneous Bacterial Peritonitis Due to Listeria monocytogenes. Connecticut Medicine 2015, 79: 31-6. PMID: 25960571, PMCID: PMC4423821.Peer-Reviewed Case Reports and Technical NotesConceptsSpontaneous bacterial peritonitisBacterial peritonitisRisk factorsEnd-stage liver diseaseFoodborne outbreaksPatient risk factorsThird-generation cephalosporinsIntrinsic resistanceListeria peritonitisDeadly complicationLiver diseaseUnusual causeCase reportParticular management challengeSBP treatmentEpidemiologic investigationsListeria monocytogenesNonenteric organismsPeritonitisFuture episodesExposure riskLiterature reviewOutbreakCirrhosisAscites