6 results on '"Coussement, J."'
Search Results
2. Cytomegalovirus DNAemia and disease: current-era epidemiology, clinical characteristics and outcomes in cancer patients other than allogeneic haemopoietic transplantation
- Author
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Tay, KH, Slavin, MA, Thursky, KA, Coussement, J, Worth, LJ, Teh, BW, Khot, A, Tam, CS, Yong, MK, Tay, KH, Slavin, MA, Thursky, KA, Coussement, J, Worth, LJ, Teh, BW, Khot, A, Tam, CS, and Yong, MK
- Abstract
BACKGROUND: High-intensity chemotherapy and advances in novel immunotherapies have seen the emergence of cytomegalovirus (CMV) infections in cancer patients other than allogeneic haemopoietic cell transplantation (HCT). Aim To evaluate the epidemiology, clinical characteristics and outcomes of CMV infection in this population. METHODS: A retrospective review of cancer patients other than allogeneic HCT who had CMV DNAemia and/or disease from July 2013 till May 2020 at a quaternary cancer centre was performed. RESULTS: Of 11 485 cancer patients who underwent treatment during this period, 953 patients had CMV DNA testing performed and 238 of them had CMV DNAemia. After excluding patients with allogeneic HCT, 62 patients with CMV DNAemia were identified, of whom 10 had concurrent CMV disease. The most frequent underlying malignancies were B-cell lymphoproliferative disease (LPD) (31%; 19/62), T-cell LPD (21%; 13/62), chronic lymphocytic leukaemia (11%; 7/62) and multiple myeloma (10%; 6/62). Most patients had lymphopenia (77%; 48/62), multiple cancer therapies (63%; 39/62 received ≥2 previous therapies), co-infection (56%; 35/62 had ≥1 co-infection) and corticosteroid therapy (48%; 30/62) within 1 month before CMV diagnosis. CMV DNAemia and disease were observed in patients receiving novel immunotherapies, including bispecific antibody therapy, chimeric-antigen receptor T-cell therapy and immune checkpoint inhibitors. CONCLUSION: Patients with haematological malignancy, particularly B-cell LPD, T-cell LPD, chronic lymphocytic leukaemia and multiple myeloma, were frequently identified to have CMV DNAemia and disease. Lymphopenia, multiple cancer therapies, co-infection and recent receipt of systemic corticosteroids were also commonly observed. Future studies are necessary to determine optimal identification and management of CMV in these patients.
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- 2022
3. Predictors of mortality in solid organ transplant recipients with bloodstream infections due to carbapenemase-producing Enterobacterales : The impact of cytomegalovirus disease and lymphopenia
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Perez-Nadales, Elena, Gutierrez-Gutierrez, Belen, Natera, Alejandra M., Abdala, Edson, Magalhaes, Maira Reina, Mularoni, Alessandra, Monaco, Francesco, Pierrotti, Ligia Camera, Freire, Maristela Pinheiro, Iyer, Ranganathan N., Steinke, Seema Mehta, Calvi, Elisa Grazia, Tumbarello, Mario, Falcone, Marco, Fernandez-Ruiz, Mario, Maria Costa-Mateo, Jose, Rana, Meenakshi M., Varejao Strabelli, Tania Mara, Paul, Mical, Carmen Farinas, Maria, Clemente, Wanessa Trindade, Roilides, Emmanuel, Munoz, Patricia, Dewispelaere, Laurent, Loeches, Belen, Lowman, Warren, Tan, Ban Hock, Escudero-Sanchez, Rosa, Bodro, Marta, Grossi, Paolo Antonio, Soldani, Fabio, Gunseren, Filiz, Nestorova, Nina, Pascual, Alvaro, Martinez-Martinez, Luis, Maria Aguado, Jose, Rodriguez-Bano, Jesus, Torre-Cisneros, Julian, Song, A. T. Wan, Andraus, W., Carneiro D'Albuquerque, L. A., David-Neto, E., de Paula, F. Jota, Rossi, F., Ostrander, D., Avery, R., Rizzi, M., Losito, A. R., Raffaelli, F., Del Giacomo, P., Tiseo, G., Lora-Tamayo, J., San-Juan, R., Gracia-Ahufinger, I, Caston, J., Ruiz, Y. A., Altman, D. R., Campos, S. , V, Bar-Sinai, N., Koppel, F., de las Revillas Almajano, F. Arnaiz, Gonzalez Rico, C., Fernandez Martinez, M., Mourao, P. H. O., Neves, F. A., Ferreira, J., Pyrpasopoulou, A., Iosifidis, E., Romiopoulos, I, Minero, M. , V, Sanchez-Carrillo, C., Lardo, S., Coussement, J., Dodemont, M., Jiayun, K., Martin-Davila, P., Fortun, J., Almela, M., Moreno, A., Linares, L., Gasperina, D. D., Balsamo, M. L., Rovelli, C., Concia, E., Chiesi, S., Salerno, D. N., Ogunc, D., Pilmis, B., Seminari, E. M., Carratala, J., Dominguez, A., Cordero, E., Lepe, J. A., Montejo, M., Merino de Lucas, E., Eriksson, Britt-Marie, van Delden, C., Manuel, O., Arslan, H., Tufan, Z. Kocak, Kazak, E., David, M., Lease, E., Cornaglia, G., Akova, M., Perez-Nadales, Elena, Gutierrez-Gutierrez, Belen, Natera, Alejandra M., Abdala, Edson, Magalhaes, Maira Reina, Mularoni, Alessandra, Monaco, Francesco, Pierrotti, Ligia Camera, Freire, Maristela Pinheiro, Iyer, Ranganathan N., Steinke, Seema Mehta, Calvi, Elisa Grazia, Tumbarello, Mario, Falcone, Marco, Fernandez-Ruiz, Mario, Maria Costa-Mateo, Jose, Rana, Meenakshi M., Varejao Strabelli, Tania Mara, Paul, Mical, Carmen Farinas, Maria, Clemente, Wanessa Trindade, Roilides, Emmanuel, Munoz, Patricia, Dewispelaere, Laurent, Loeches, Belen, Lowman, Warren, Tan, Ban Hock, Escudero-Sanchez, Rosa, Bodro, Marta, Grossi, Paolo Antonio, Soldani, Fabio, Gunseren, Filiz, Nestorova, Nina, Pascual, Alvaro, Martinez-Martinez, Luis, Maria Aguado, Jose, Rodriguez-Bano, Jesus, Torre-Cisneros, Julian, Song, A. T. Wan, Andraus, W., Carneiro D'Albuquerque, L. A., David-Neto, E., de Paula, F. Jota, Rossi, F., Ostrander, D., Avery, R., Rizzi, M., Losito, A. R., Raffaelli, F., Del Giacomo, P., Tiseo, G., Lora-Tamayo, J., San-Juan, R., Gracia-Ahufinger, I, Caston, J., Ruiz, Y. A., Altman, D. R., Campos, S. , V, Bar-Sinai, N., Koppel, F., de las Revillas Almajano, F. Arnaiz, Gonzalez Rico, C., Fernandez Martinez, M., Mourao, P. H. O., Neves, F. A., Ferreira, J., Pyrpasopoulou, A., Iosifidis, E., Romiopoulos, I, Minero, M. , V, Sanchez-Carrillo, C., Lardo, S., Coussement, J., Dodemont, M., Jiayun, K., Martin-Davila, P., Fortun, J., Almela, M., Moreno, A., Linares, L., Gasperina, D. D., Balsamo, M. L., Rovelli, C., Concia, E., Chiesi, S., Salerno, D. N., Ogunc, D., Pilmis, B., Seminari, E. M., Carratala, J., Dominguez, A., Cordero, E., Lepe, J. A., Montejo, M., Merino de Lucas, E., Eriksson, Britt-Marie, van Delden, C., Manuel, O., Arslan, H., Tufan, Z. Kocak, Kazak, E., David, M., Lease, E., Cornaglia, G., and Akova, M.
- Abstract
Treatment of carbapenemase-producing Enterobacterales bloodstream infections in solid organ transplant recipients is challenging. The objective of this study was to develop a specific score to predict mortality in solid organ transplant recipients with carbapenemase-producing Enterobacterales bloodstream infections. A multinational, retrospective (2004-2016) cohort study (INCREMENT-SOT, ClinicalTrials.gov NCT02852902) was performed. The main outcome variable was 30-day all-cause mortality. The INCREMENT-SOT-CPE score was developed using logistic regression. The global cohort included 216 patients. The final logistic regression model included the following variables: INCREMENT-CPE mortality score >= 8 (8 points), no source control (3 points), inappropriate empirical therapy (2 points), cytomegalovirus disease (7 points), lymphopenia (4 points), and the interaction between INCREMENT-CPE score >= 8 and CMV disease (minus 7 points). This score showed an area under the receiver operating characteristic curve of 0.82 (95% confidence interval [CI] 0.76-0.88) and classified patients into 3 strata: 0-7 (low mortality), 8-11 (high mortality), and 12-17 (very-high mortality). We performed a stratified analysis of the effect of monotherapy vs combination therapy among 165 patients who received appropriate therapy. Monotherapy was associated with higher mortality only in the very-high (adjusted hazard ratio [HR] 2.82, 95% CI 1.13-7.06, P = .03) and high (HR 9.93, 95% CI 2.08-47.40, P = .004) mortality risk strata. A score-based algorithm is provided for therapy guidance.
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- 2020
- Full Text
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4. Risk Factors Associated With Early Invasive Pulmonary Aspergillosis in Kidney Transplant Recipients: Results From a Multinational Matched Case-Control Study
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Lopez-Medrano, F, Silva, JT, Fernandez-Ruiz, M, Carver, PL, van Delden, C, Merino, E, Perez-Saez, MJ, Montero, M, Coussement, J, de Abreu Mazzolin, M, Cervera, C, Santos, L, Sabe, N, Scemla, A, Cordero, E, Cruzado-Vega, L, Martin-Moreno, PL, Len, O, Rudas, E, de Leon, AP, Arriola, M, Lauzurica, R, David, M, Gonzalez-Rico, C, Henriquez-Palop, F, Fortun, J, Nucci, M, Manuel, O, Pano-Pardo, JR, Montejo, M, Munoz, P, Sanchez-Sobrino, B, Mazuecos, A, Pascual, J, Horcajada, JP, Lecompte, T, Lumbreras, C, Moreno, A, Carratala, J, Blanes, M, Hernandez, D, Hernandez-Mendez, EA, Farinas, MC, Perello-Carrascosa, M, Morales, JM, Andres, A, Aguado, JM, Spanish Network Res Infect Dis, Spanish Soc Clinical Microbiology, European Soc Clinical Microbiology, and Swiss Transplant Cohort Study STCS
- Subjects
infection and infectious agents ,clinical research ,infectious disease ,fungal ,nephrology ,kidney transplantation ,epidemiology ,practice - Abstract
Risk factors for invasive pulmonary aspergillosis (IPA) after kidney transplantation have been poorly explored. We performed a multinational case-control study that included 51 kidney transplant (KT) recipients diagnosed with early (first 180 posttransplant days) IPA at 19 institutions between 2000 and 2013. Control recipients were matched (1:1 ratio) by center and date of transplantation. Overall mortality among cases was 60.8%, and 25.0% of living recipients experienced graft loss. Pretransplant diagnosis of chronic pulmonary obstructive disease (COPD; odds ratio [OR]: 9.96; 95% confidence interval [CI]: 1.09-90.58; p = 0.041) and delayed graft function (OR: 3.40; 95% CI: 1.08-10.73; p = 0.037) were identified as independent risk factors for IPA among those variables already available in the immediate peritransplant period. The development of bloodstream infection (OR: 18.76; 95% CI: 1.04-339.37; p = 0.047) and acute graft rejection (OR: 40.73, 95% CI: 3.63-456.98; p = 0.003) within the 3 mo prior to the diagnosis of IPA acted as risk factors during the subsequent period. In conclusion, pretransplant COPD, impaired graft function and the occurrence of serious posttransplant infections may be useful to identify KT recipients at the highest risk of early IPA. Future studies should explore the potential benefit of antimold prophylaxis in this group. A multinational case-control study in kidney transplant recipients finds that pretransplant diagnosis of chronic obstructive pulmonary disease, delayed graft function, bloodstream infection and acute graft rejection identify patients at the highest risk for early invasive pulmonary aspergillosis.
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- 2016
5. When polymerase chain reaction does not help: cytomegalovirus pneumonitis associated with very low or undetectable viral load in both blood and bronchoalveolar lavage samples after lung transplantation
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Coussement, J., primary, Steensels, D., additional, Nollevaux, M.‐C., additional, Bogaerts, P., additional, Dumonceaux, M., additional, Delaere, B., additional, and Froidure, A., additional
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- 2016
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6. Antibiotics for asymptomatic bacteriuria in kidney transplant recipients.
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Coussement J, Scemla A, Abramowicz D, Nagler EV, and Webster AC
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- Anti-Bacterial Agents therapeutic use, Asymptomatic Infections mortality, Bacteriuria mortality, Cause of Death, Drug Resistance, Bacterial, Graft Rejection epidemiology, Graft Rejection etiology, Humans, Kidney Transplantation mortality, Randomized Controlled Trials as Topic, Transplant Recipients, Urinary Tract Infections complications, Asymptomatic Infections therapy, Bacteriuria drug therapy, Kidney, Kidney Transplantation adverse effects, Urinary Tract Infections prevention & control
- Abstract
Background: Asymptomatic bacteriuria, defined as bacteriuria without signs or symptoms of urinary tract infection (UTI), occurs in 17% to 51% of kidney transplant recipients and is thought to increase the risk for a subsequent UTI. No consensus exists on the role of antibiotics for asymptomatic bacteriuria in kidney transplantation., Objectives: To assess the benefits and harms of treating asymptomatic bacteriuria in kidney transplant recipients with antimicrobial agents to prevent symptomatic UTI, all-cause mortality and the indirect effects of UTI (acute rejection, graft loss, worsening of graft function)., Search Methods: We searched the Cochrane Kidney and Transplant Register of Studies up to 1 September 2017 through contact with the Information Specialist using search terms relevant to this review. Studies in the Register are identified through searches of CENTRAL, MEDLINE, and EMBASE, conference proceedings, the International Clinical Trials Register (ICTRP) Search Portal, and ClinicalTrials.gov., Selection Criteria: All randomised controlled trials (RCTs) and quasi-RCTs in any language assessing treatment of asymptomatic bacteriuria in kidney transplant recipients at any time-point after transplantation., Data Collection and Analysis: Two authors independently determined study eligibility, assessed quality and extracted data. Primary outcomes were incidence of symptomatic UTI and incidence of antimicrobial resistance. Other outcomes included incidences of all-cause mortality, graft loss, graft rejection, graft function, hospitalisation for UTI, adverse reactions to antimicrobial agents and relapse or persistence of asymptomatic bacteriuria. We expressed dichotomous outcomes as absolute risk difference (RD) or risk ratio (RR) with 95% confidence intervals (CI) and continuous data as mean differences (MD) with 95% CI. Data were pooled using the random effects model., Main Results: We included two studies (212 participants) comparing antibiotics versus no treatment, and identified three on-going studies. Overall, incidence of symptomatic UTI varied between 19% and 31% in the groups not treated for asymptomatic bacteriuria. Antibiotic treatment had uncertain effects on preventing symptomatic UTI (2 studies, 200 participants: RR 0.86, 95% CI 0.51 to 1.45). Risk for selecting multidrug-resistant organisms was uncertain with antibiotic treatment (1 study, 112 participants: RR 1.21, 95% CI 0.60 to 2.41). Persistence of asymptomatic bacteriuria was high regardless of treatment. Antibiotics also have uncertain effects on other important patient and graft outcomes, for instance on all-cause mortality (1 study, 112 participants: RR 2.23, 95% CI 0.21 to 23.86), graft loss (1 study, 112 participants: RR 1.11, 95% CI 0.07 to 17.36), acute rejection (1 study, 112 participants: RR 0.93, 95% CI 0.44 to 1.97), hospitalisation for UTI (1 study, 112 participants: RR 0.74, 95% CI 0.13 to 4.27), graft function (2 studies, 200 participants, MD in serum creatinine concentration -0.06 mg/dL, 95% CI -0.19 to 0.08) and adverse reactions (1 study, 112 participants: no severe adverse event attributable to the antibiotic treatment). Evidence quality was low for all outcomes., Authors' Conclusions: Currently, there is insufficient evidence to support routinely treating kidney transplant recipients with antibiotics in case of asymptomatic bacteriuria after transplantation, but data are scarce. Further studies assessing routine antibiotic treatment would inform practice and we await the results of three ongoing randomised studies, which may help resolve existing uncertainties.
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- 2018
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