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58. Hypoalbuminemia is a risk factor for invasive fungal infections and poor outcomes in infected kidney transplant recipients.

Author

Santos, Angelie, Jorgenson, Margaret R., Osman, Fauzia, Srivastava, Aniruddha, Misch, Elizabeth Ann, Garg, Neetika, Aziz, Fahad, Swanson, Kurtis J., Mohamed, Maha, Djamali, Arjang, Mandelbrot, Didier, and Parajuli, Sandesh

Subjects
MYCOSES, KIDNEY transplantation, SERUM albumin, BLASTOMYCOSIS, HISTOPLASMOSIS, IMMUNOSUPPRESSION
Abstract

Introduction: Invasive fungal infections (IFI), are estimated to occur in 2%–14% of kidney transplant recipients (KTRs) in the current era of immune suppression and are associated with high mortality rates. We hypothesized that hypoalbuminemia in KTRs is a risk factor for IFI and would be associated with poor outcomes. Methods: In this study, using data from a prospective cohort registry, we describe the frequency of IFI due to Blastomycosis, Coccidioidomycosis, Histoplasmosis, Aspergillosis, and Cryptococcus in KTRs with serum albumin levels measured 3–6 months before diagnosis. Controls were selected based on incidence density sampling. KTRs were divided into three groups based on the pre‐IFI serum albumin level: normal (≥4 g/dL), mild (3–4 g/dL), or severe (<3 g/dL) hypoalbuminemia. Outcomes of interest were uncensored graft failure after IFI and overall mortality. Results: A total of 113 KTRs with IFI were compared with 348 controls. The incidence rate of IFI among individuals with normal, mild, and severe hypoalbuminemia was 3.6, 8.7, and 29.3 per 100 person‐years, respectively. After adjustment for multiple variables, the trend for risk of uncensored graft failure following IFI was greater in KTRS with mild (HR = 2.1; 95% CI,.75–6.1) and severe (HR = 4.47; 95% CI, 1.56–12.8) hypoalbuminemia (P‐trend <.001) compared to those with normal serum albumin. Similarly, mortality was higher in severe hypoalbuminemia (HR = 1.9; 95% CI,.67–5.6) compared to normal serum albumin (P‐trend <.001). Conclusion: Hypoalbuminemia precedes the diagnosis of IFI in KTRs, and is associated with poor outcomes following IFI. Hypoalbuminemia may be a useful predictor of IFI in KTRs and could be incorporated into screening algorithms. [ABSTRACT FROM AUTHOR]

Published
2023
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74. “Family planning in Rwanda is not seen as population control, but rather as a way to empower the people”: examining Rwanda’s success in family planning from the perspective of public and private stakeholders

Author

Schwandt, Hilary M., Feinberg, Seth, Akotiah, Akrofi, Douville, Tong Yuan, Gardner, Elliot V., Imbabazi, Claudette, McQuin, Erin, Mohamed, Maha, Rugoyera, Alexis, Musemakweli, Diuedonné, Nichols, Cliff Wes, Nyangezi, Nelly Uwajeneza, Arizmendi, Joshua Serrano, Welikala, Doopashika, Yamuragiye, Benjamin, and Zigo, Liliana

Published
2018
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77. In kidney recipients from the same deceased donor, discordance in delayed graft function is associated with the worst outcomes

Author

Yousif, Elsadig A. I., primary, Muth, Brenda, additional, Manchala, Venkata, additional, Turk, Jennifer, additional, Blazel, Justin, additional, Bloom, Margaret, additional, Garg, Neetika, additional, Aziz, Fahad, additional, Mohamed, Maha, additional, Djamali, Arjang, additional, Mandelbrot, Didier, additional, and Parajuli, Sandesh, additional

Published
2022
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81. Evaluation of the Antibiotic Resistance Pattern at the Medical Services Administration Hospital in Khartoum, Sudan, 2021

Author

Abdellatif, Ashraf O., Ali, Inas N., Mohamed, Maha A., Ibrahim, Maisoon A., Mohamed, Wlaa A., Abdellatif, Ashraf O., Ali, Inas N., Mohamed, Maha A., Ibrahim, Maisoon A., and Mohamed, Wlaa A.

Abstract

The number of antibiotics available is limited and does not cover the growing antibiotic resistance challenge. Misuse and overuse of antibiotics act as factors that help in improving and increasing the problem of resistance to those currently being prescribed by doctors. The study was carried out at the Medical Services Administration Hospital (MSAH) in Khartoum, Sudan to investigate the antibiotic resistance pattern for the period between Dec. 2020 and Jan. 2022. The results showed that, in a total of different clinical samples that were collected and processed, a total number of 980 organisms were isolated. The result indicated that 345 out of the total isolates (35.20%) were Klebsiella pneumonia, 326 (33.27%) Escherichia coli, 154 (15.71%) Pseudomonas aeruginosa, 130 (13.27%) Proteus mirabilis, and 25 (2.55%) Staphylococcus aureus. The results showed that K. pneumonia was quite resistant to piperacillin, cefuroxime, and azithromycin. The amikacin, imipenem, and meropenem antibiotics showed significant activity against K. pneumonia. The isolates of E. coli showed significant resistance to azithromycin and were more sensitive to imipenem and meropenem. P. aeruginosa was resistant to penicillin, amoxicillin/clavulanic acid, and azithromycin in a big way, but it was very sensitive to cefuroxime, the drug used to treat strep throat infections. P. mirabilis was found to be resistant to nalidixic acid, nitrofurantoin, amoxicillin/clavulanic acid, and azithromycin. It showed good sensitivity to amikacin, imipenem, and meropenem. It was clear that S. aureus was resistant to cefuroxime, ceftriaxone, nitrofurantoin, and norfloxacin, while tests showed that it was sensitive to imipenem.

Published
2022

84. Screening for latent tuberculosis among healthcare workers in an Egyptian hospital using tuberculin skin test and QuantiFERON-TB Gold In-Tube Test

Author

Anwar, Manal, Ahmed, Doaa, Elareed, Heba, Abdel-Latif, Radwa, Sheemy, Mostafa, Kamel, Nesreen, and Mohamed, Maha

Subjects
Medical tests -- Health aspects, BCG -- Health aspects, Workers -- Health aspects, Skin -- Health aspects, Medical personnel -- Health aspects, Tuberculosis -- Health aspects, Tuberculin, Environmental issues, Health
Abstract

Byline: Manal. Anwar, Doaa. Ahmed, Heba. Elareed, Radwa. Abdel-Latif, Mostafa. Sheemy, Nesreen. Kamel, Maha. Mohamed Background: Early detection of latent tuberculosis infection (LTBI) might prevent active TB development in healthcare [...]

Published
2019

85. Discordance in cytomegalovirus viremia in kidney recipients from the same donor is associated with the worst outcomes.

Author

Zona, Emily, Jorgenson, Margaret, Dolma, Sonam, Santos, Angelie, Garg, Neetika, Aziz, Fahad, Mohamed, Maha, Saddler, Christopher M., Smith, Jeannina A., Mandelbrot, Didier, and Parajuli, Sandesh

Subjects
VIREMIA, CYTOMEGALOVIRUSES, KIDNEY transplantation, KIDNEYS, VIRUS diseases
Abstract

Background: Cytomegalovirus (CMV) is a common viral infection in kidney transplant recipients (KTR) that has been associated with negative outcomes. The effect on outcomes of concordance versus discordance in CMV between two different recipients of kidneys from the same donor is largely unknown. Methods: We reviewed all adult deceased donor kidney transplant recipients (DDKTs) for which both kidneys were transplanted to two different recipients at our center between 2014 and 2019. Recipient pairs from each donor were divided into groups based on concordance or discordance for the development of CMV viremia between the pair; concordant no CMV (cc‐no‐CMV) if neither KTR developed CMV, concordant CMV (cc‐CMV) if both KTRs developed CMV. The discordant group was then further divided based on the individual development of CMV (dc‐CMV) or lack of development of CMV (dc‐no‐CMV). Patient mortality and death‐censored graft failure (DCGF) were outcomes of interest. Results: Of 578 KTRs, 67% were cc‐no‐CMV, 5% were cc‐CMV, 14% were dc‐no‐CMV, and 14% dc‐CMV. Some of the baseline characteristics differ among the groups including a higher prevalence of high‐risk serostatus (D+/R‐) in cc‐CMV (32%) and dc‐CMV (32%). In multivariate analysis, with reference to cc‐no‐CMV, dc‐CMV was associated with increased risk for DCGF (HR 3.13, 95% CI 1.58–6.19), and so was delayed graft function. Factors associated with increased risk of mortality were advanced recipient age and DGF. cc‐CMV was neither associated with mortality nor DCGF. Conclusions: These findings support that in certain contexts, CMV viremia has adverse allograft outcomes, and this is highlighted when illustrated via discordance in CMV between pair kidneys from the same deceased donor. [ABSTRACT FROM AUTHOR]

Published
2023
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