2022
The cascade of care in testing and treatment of latent tuberculosis infection in liver transplant candidates
Palacios C, Medvedeva N, Cheung H, Cohen E, Azar M, Malinis M. The cascade of care in testing and treatment of latent tuberculosis infection in liver transplant candidates. Transplant Infectious Disease 2022, 25: e13999. PMID: 36484433, DOI: 10.1111/tid.13999.Peer-Reviewed Original ResearchMeSH KeywordsGoldHumansInterferon-gamma Release TestsLatent TuberculosisLiver TransplantationRetrospective StudiesTuberculin TestTuberculosisConceptsLatent tuberculosis infectionLT candidatesIndeterminate IGRALTBI testingTuberculosis infectionCascade of carePost-liver transplantLiver transplant candidatesProportion of patientsRetrospective chart reviewTB-endemic countriesInterferon-gamma releaseTreatment completion ratesCompletion ratesLTBI treatmentPositive IGRATB reactivationCare cascadeTreatment-naïveChart reviewSecondary outcomesTransplant candidatesPrimary outcomeTreatment initiationChest imagingReal-world assessment of the clinical utility of whole body 18F-FDG PET/CT in the diagnosis of infection.
Medvedeva N, Radcliffe C, Malinis M, Chen M, Azar M. Real-world assessment of the clinical utility of whole body 18F-FDG PET/CT in the diagnosis of infection. PLOS ONE 2022, 17: e0277403. PMID: 36374789, PMCID: PMC9662742, DOI: 10.1371/journal.pone.0277403.Peer-Reviewed Original ResearchConceptsPET/CTClinical impactFDG PET/CTRetrospective chart reviewEmission tomography/Evaluation of infectionDiagnosis of infectionVariety of syndromesInfectious indicationsChart reviewCommon indicationTomography useUnknown etiologyEndovascular infectionTomography/Antimicrobial managementClinical indicationsReal-world assessmentInclusion criteriaClinical utilityPatientsTreatment managementUnknown originInfectionCTOverall 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 ResearchMeSH KeywordsAbataceptGraft RejectionGraft SurvivalHumansImmunosuppressive AgentsKidney TransplantationRetrospective StudiesTacrolimusTransplant RecipientsConceptsKidney 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 evaluationEvaluating 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 seriesRectal 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 ResearchMeSH KeywordsAdolescentAdultAntifungal AgentsAzolesCandidaHumansLiver TransplantationRetrospective StudiesConceptsAppropriate 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 number
2021
Increased 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 timeLymphPatientsTuberculosisA 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 patientsClinical implications of SARS-CoV-2 cycle threshold values in solid organ transplant recipients
Gaston DC, Malinis M, Osborn R, Peaper DR, Landry M, Juthani-Mehta M, Azar MM. Clinical implications of SARS-CoV-2 cycle threshold values in solid organ transplant recipients. American Journal Of Transplantation 2020, 21: 1304-1311. PMID: 33043603, PMCID: PMC7675520, DOI: 10.1111/ajt.16357.Peer-Reviewed Original ResearchConceptsSolid organ transplant recipientsOrgan transplant recipientsClinical implicationsCycle threshold valuesSOT patientsTransplant recipientsSymptom onsetYale New Haven Health SystemUpper respiratory tract samplesSARS-CoV-2 viral RNASARS-CoV-2 viral dynamicsAdult SOT recipientsRetrospective chart reviewRespiratory tract samplesSARS-CoV-2 cycle threshold valuesInfection prevention measuresCOVID-19 severityViral RNAHigher clinical acuityPrimary diagnostic testRT-PCR assaysSOT recipientsChart reviewViral loadAdmission severityDaptomycin 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 bacteremiaOrally Administered Human Immunoglobulin Therapy for Norovirus Enteritis in Solid Organ Transplant Recipients: A Case Series at a Single Academic Transplant Center
Nussbaum EZ, Azar M, Cohen E, McManus D, Topal J, Malinis M. Orally Administered Human Immunoglobulin Therapy for Norovirus Enteritis in Solid Organ Transplant Recipients: A Case Series at a Single Academic Transplant Center. Clinical Infectious Diseases 2020, 71: e206-e209. PMID: 31999825, DOI: 10.1093/cid/ciaa093.Peer-Reviewed Original ResearchMeSH KeywordsEnteritisHumansImmunization, PassiveImmunoglobulinsNorovirusOrgan TransplantationRetrospective StudiesTransplant RecipientsConceptsSolid organ transplant recipientsOrgan transplant recipientsNorovirus enteritisTransplant recipientsAcademic transplant centersHuman immunoglobulin therapyEffective treatment modalityImmunoglobulin therapySOT recipientsCase seriesTransplant centersIntractable diarrheaTreatment modalitiesMedical recordsHuman immunoglobulinEnteritisRecipientsDiarrheaTherapyImmunoglobulin
2019
Use of Routine Complete Blood Count Results to Rule Out Anaplasmosis Without the Need for Specific Diagnostic Testing
Turbett SE, Anahtar MN, Pattanayak V, Azar MM, Coffey KC, Eng G, Rudolf JW, Lewandrowski KB, Baron J, Rosenberg ES, Branda JA. Use of Routine Complete Blood Count Results to Rule Out Anaplasmosis Without the Need for Specific Diagnostic Testing. Clinical Infectious Diseases 2019, 70: 1215-1221. PMID: 31044232, PMCID: PMC7346887, DOI: 10.1093/cid/ciz346.Peer-Reviewed Original ResearchMeSH KeywordsAnaplasma phagocytophilumAnaplasmosisAnimalsBlood Cell CountDiagnostic Techniques and ProceduresHumansProspective StudiesRetrospective StudiesConceptsComplete blood countWhite blood cellsPolymerase chain reactionBlood countLiver function test resultsRoutine complete blood countMedical record reviewSpecific diagnostic testingFunction test resultsRoutine laboratory testsPositive PCR resultsTrue positive casesTrue negative casesLaboratory abnormalitiesRecord reviewRetrospective reviewPlatelet countClinical criteriaTime of testingProspective phasePCR testingPLT countStewardship programsClinical situationsDiagnostic testing
2018
Central nervous system histoplasmosis
Wheat J, Myint T, Guo Y, Kemmer P, Hage C, Terry C, Azar MM, Riddell J, Ender P, Chen S, Shehab K, Cleveland K, Esguerra E, Johnson J, Wright P, Douglas V, Vergidis P, Ooi W, Baddley J, Bamberger D, Khairy R, Vikram H, Jenny-Avital E, Sivasubramanian G, Bowlware K, Pahud B, Sarria J, Tsai T, Assi M, Mocherla S, Prakash V, Allen D, Passaretti C, Huprikar S, Anderson A. Central nervous system histoplasmosis. Medicine 2018, 97: e0245. PMID: 29595679, PMCID: PMC5895412, DOI: 10.1097/md.0000000000010245.Peer-Reviewed Original ResearchConceptsCentral nervous system histoplasmosisPercent of patientsCerebrospinal fluidAmphotericin BCentral nervous system involvementSingle-center case seriesNervous system involvementLiposomal amphotericin BCenter case seriesOutcome of treatmentAnti-Histoplasma antibodiesRecognition of infectionPatients 54 yearsCNS histoplasmosisDeoxycholate formulationDisseminated histoplasmosisMost patientsAntigen testingAntibody testingCase seriesImmunodeficiency syndromeHistoplasma antigenHistoplasmosis infectionSystem involvementYear survival
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 ResearchMeSH KeywordsAdultAgedConnecticutFemaleHistoplasmosisHIV InfectionsHumansImmunocompromised HostMaleMiddle AgedRetrospective StudiesTravel-Related IllnessConceptsHuman immunodeficiency virusHistoplasmosis casesEpidemiology of histoplasmosisNon-endemic areasSymptom onsetAntigen testingMedian timeImmunodeficiency virusActive histoplasmosisNonendemic areasRetrospective analysisEndemic areasEpidemiological characterizationHistoplasmosisNew HavenDaysPatientsEpidemiologyDiagnosisCases
2016
Integrase 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 drugs
2015
Blastomycosis 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 ResearchMeSH KeywordsAdolescentAdultAgedBlastomycesBlastomycosisFemaleHumansIncidenceIndianaMaleMiddle AgedRetrospective StudiesYoung AdultConceptsDiabetes mellitusEpidemiologic patternsIncidence of blastomycosisMulticenter retrospective studyCases of blastomycosisMultilobar pneumoniaICU admissionExtrapulmonary diseaseRetrospective studyMean ageIncidence rateFungal antigensEndemic areasLarge seriesAmphotericin BBlastomycosisTotal mortalityIncidenceMellitusPneumoniaSignificant increaseDiseaseIndiana ClinicalARDSImmunosuppression