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Sermet K, Goeminne C, Hantz S, Assaf A, Faure E, Lazrek M, Faure K, Alain S, Vuotto F. Reliability of QuantiFERON®-CMV in predicting CMV recurrence in heart transplant recipients: A single-center retrospective study. Clin Transplant 2023; 37:e15109. [PMID: 37641575 DOI: 10.1111/ctr.15109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 08/08/2023] [Accepted: 08/16/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND Recurrence after Cytomegalovirus (CMV) infection in heart transplant recipients is difficult to predict, in spite of its high incidence. Secondary prophylaxis could reduce this burden; however, its duration remains unestablished. We evaluated the QuantiFERON®-CMV test to see if it could predict CMV recurrence and help optimize the duration of secondary prophylaxis. METHODS This observational retrospective single center study included all heart transplant recipients who developed CMV infection between 2019 and 2021, with the CD8+ T-cell-mediated CMV immunity QuantiFERON®-CMV test assessed at the time of (val)ganciclovir curative treatment completion. The main outcomes were CMV recurrence and duration of secondary prophylaxis. Secondary outcomes included immunosuppressive regimen, rejection, lymphocyte count, CMV viral load, infection type, and duration as possible confounding factors for recurrence. RESULTS Among the 15 patients included, five (33%) experienced recurrence, of whom three (60%) had a positive QuantiFERON®-CMV test. The duration of secondary prophylaxis was similar regardless of QF-CMV positivity. No confounding factor was significantly associated with CMV recurrence; however, it occurred in only 1/7 (14%) of the patients receiving an everolimus-containing immunosuppressive regimen. CONCLUSION In the population of heart transplant recipients, most of whom received ATG-based induction, the QuantiFERON®-CMV assay may not accurately predict CMV recurrence and would have not helped refining the duration of secondary prophylaxis in our patients. Other cell-mediated immunity tests and strategies in this specific population, including everolimus-containing regimens, may help predict and manage CMV recurrence.
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Affiliation(s)
- Kevin Sermet
- Service des maladies infectieuses et tropicales, CHU Lille, Lille, France
- CNRS, Inserm, Institut Pasteur Lille, U1019 - UMR 9017 - CIIL - Center for Infection and Immunity of Lille, University of Lille, Lille, France
| | - Céline Goeminne
- Department of Anesthesia and Intensive Care, CHU Lille, Lille, France
| | - Sébastien Hantz
- INSERM, CHU Limoges, RESINFIT, U1092, University of Limoges, Limoges, France
- Laboratoire de Bactériologie-Virologie-Hygiène, National Reference Center for Herpesviruses (NRCHV), CHU Limoges, Limoges, France
| | - Ady Assaf
- Service des maladies infectieuses et tropicales, CHU Lille, Lille, France
| | - Emmanuel Faure
- Service des maladies infectieuses et tropicales, CHU Lille, Lille, France
- CNRS, Inserm, Institut Pasteur Lille, U1019 - UMR 9017 - CIIL - Center for Infection and Immunity of Lille, University of Lille, Lille, France
| | - Mouna Lazrek
- CHU Lille, Laboratoire de Virologie ULR3610, Université de Lille, Lille, France
| | - Karine Faure
- Service des maladies infectieuses et tropicales, CHU Lille, Lille, France
- CNRS, Inserm, Institut Pasteur Lille, U1019 - UMR 9017 - CIIL - Center for Infection and Immunity of Lille, University of Lille, Lille, France
| | - Sophie Alain
- INSERM, CHU Limoges, RESINFIT, U1092, University of Limoges, Limoges, France
- Laboratoire de Bactériologie-Virologie-Hygiène, National Reference Center for Herpesviruses (NRCHV), CHU Limoges, Limoges, France
| | - Fanny Vuotto
- Service des maladies infectieuses et tropicales, CHU Lille, Lille, France
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Sermet K, Grandjean T, Bontemps E, Tardy M, Gosset P, Faure E. EpITRANS, impact of immunosuppressive drugs on epithelial immunity in acute respiratory infections of solid organ transplant recipients. Rev Mal Respir 2023. [DOI: 10.1016/j.rmr.2022.11.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
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Bauschert L, Sermet K, Fréalle E, Khodr J, Magro L, Yakoub-Agha I, Alfandari S, Beauvais D. A case of subacute bowel obstruction revealing slowly-evolutive gastro-intestinal mucormycosis following allogeneic hematopoietic cell transplantation. J Mycol Med 2022; 32:101312. [PMID: 35914432 DOI: 10.1016/j.mycmed.2022.101312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 07/20/2022] [Accepted: 07/22/2022] [Indexed: 11/16/2022]
Abstract
Gastro-intestinal mucormycosis (GIMM) is a highly lethal invasive fungal disease partly because of a challenging diagnosis. An allogeneic hematopoietic cell transplant recipient experienced bowel obstruction caused by slowly-evolutive gastro-intestinal mucormycosis and was successfully treated with surgery and antifungal therapy. Pathological findings revealed a granuloma without angio-invasion, which is unusual in this fungal disease and has incomplete similarities with an immune reconstitution inflammatory syndrome. Mucorales-specific PCR in both serum and resected tissue was positive and helped assessing the diagnosis. GIMM should be considered in front of unexplained granulomatosis or bowel obstruction in immunocompromised patients.
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Affiliation(s)
- Loïc Bauschert
- Department of Hematology, CHU Lille, Univ Lille, Lille, France
| | - Kevin Sermet
- Department of Infectious Disease, CHU Lille, Univ Lille, Lille, France
| | - Emilie Fréalle
- Department of Parasitology-Mycology, CHU Lille, Lille, France
| | - Justine Khodr
- Department of Visceral and Digestive Surgery, CHU Lille, Univ Lille, Lille, France
| | - Léonardo Magro
- Department of Hematology, CHU Lille, Univ Lille, Lille, France
| | - Ibrahim Yakoub-Agha
- Department of Hematology, CHU Lille, Univ Lille, Lille, France; Univ. Lille, CHU Lille, INSERM, Infinite, U1286, Lille, France
| | - Serge Alfandari
- Department of Infectious Diseases, Gustave Dron Hospital, Tourcoing, France
| | - David Beauvais
- Department of Hematology, CHU Lille, Univ Lille, Lille, France; Univ. Lille, CHU Lille, INSERM, Infinite, U1286, Lille, France.
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Sermet K, Demaeght F, Alcaraz I, Viget N, Dauenhauer J, Senneville E, Robineau O. A rare case of invasive non-typeable Haemophilus influenzae spondylodiscitis and periprosthetic joint infection. J Bone Jt Infect 2021; 6:207-209. [PMID: 34109104 PMCID: PMC8182662 DOI: 10.5194/jbji-6-207-2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 05/25/2021] [Indexed: 11/11/2022] Open
Abstract
A non-typeable Haemophilus influenzae (NTHi) was responsible for an invasive infection including bacteremia, spondylodiscitis with epidural abscess, and periprosthetic hip infection in a 79-year-old woman, triggered by a superinfected ethmo-orbital mucocele. Surgical drainage and antibiotic therapy allowed recovery. PET-scan full cartography of NTHi infection dissemination enabled the discovery of spondylodiscitis. This rare cause of spondylodiscitis and periprosthetic joint infection suggests a complete work-up is unavoidable.
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Affiliation(s)
- Kevin Sermet
- Gustave Dron Hospital, 59200, Tourcoing, France.,Department of Infectious Disease, University of Lille, 59000, Lille, France
| | | | | | | | | | - Eric Senneville
- Gustave Dron Hospital, 59200, Tourcoing, France.,Department of Infectious Disease, University of Lille, 59000, Lille, France
| | - Olivier Robineau
- Gustave Dron Hospital, 59200, Tourcoing, France.,Department of Infectious Disease, University of Lille, 59000, Lille, France
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Assaf A, Faure E, Sermet K, Loridant S, Leroy J, Goeminne C, Dozier A, Chopin MC, Panaget S, Faure K, Vuotto F. Successful treatment of Aspergillus fumigatus sternal osteomyelitis with isavuconazole in a heart transplant recipient. Transpl Infect Dis 2020; 22:e13313. [PMID: 32386273 DOI: 10.1111/tid.13313] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 04/24/2020] [Accepted: 04/25/2020] [Indexed: 12/23/2022]
Abstract
A 65-year-old man was diagnosed with an invasive Aspergillus fumigatus infection with sternal osteomyelitis 4 months after heart transplantation. Unfortunately, after 8 weeks patient developed severe cutaneous and neurological toxicities induced by voriconazole leading to drug discontinuation. Therefore, isavuconazole was chosen as second-line therapy. The patient presented a favorable outcome and tolerance was excellent after ten months monotherapy. Here, we report for a first time, an successful isavuconazole-based treatment of sternal osteomyelitis aspergillosis in a cardiac recipient.
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Affiliation(s)
- Ady Assaf
- Service de Maladies Infectieuses, Centre Hospitalier Universitaire de Lille, Lille, France
| | - Emmanuel Faure
- Service de Maladies Infectieuses, Centre Hospitalier Universitaire de Lille, Lille, France.,CNRS UMR9017, Inserm U1019, CHRU Lille, Institut Pasteur de Lille, CIIL - Center for Infection and Immunity of Lille, Universitaire de Lille, Lille, France
| | - Kevin Sermet
- Service de Maladies Infectieuses, Centre Hospitalier Universitaire de Lille, Lille, France
| | - Severine Loridant
- Laboratoire de Parasitologie Mycologie, Centre Hospitalier Universitaire de Lille, INSERM U995, LIRIC - Lille Inflammation Research International Centre, Universitaire de Lille, Lille, France
| | - Jordan Leroy
- Laboratoire de Parasitologie Mycologie, Centre Hospitalier Universitaire de Lille, INSERM U995, LIRIC - Lille Inflammation Research International Centre, Universitaire de Lille, Lille, France
| | - Celine Goeminne
- Service de Cardiologie, Hôpital cardiologique Centre Hospitalier Universitaire de Lille, Lille, France
| | - Aurelie Dozier
- Service de Maladies Infectieuses, Centre Hospitalier Universitaire de Lille, Lille, France
| | - Marie-Charlotte Chopin
- Service de Maladies Infectieuses, Centre Hospitalier Universitaire de Lille, Lille, France
| | - Sophie Panaget
- Service de Maladies Infectieuses, Centre Hospitalier Universitaire de Lille, Lille, France
| | - Karine Faure
- Service de Maladies Infectieuses, Centre Hospitalier Universitaire de Lille, Lille, France.,CNRS UMR9017, Inserm U1019, CHRU Lille, Institut Pasteur de Lille, CIIL - Center for Infection and Immunity of Lille, Universitaire de Lille, Lille, France
| | - Fanny Vuotto
- Service de Maladies Infectieuses, Centre Hospitalier Universitaire de Lille, Lille, France
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