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Article: Update on therapeutic approaches for invasive fungal infections in adults.

Boutin, Catherine-Audrey / Luong, Me-Linh

Therapeutic advances in infectious disease

2024 Volume 11, Page(s) 20499361231224980

Abstract: Invasive fungal infections are increasingly encountered with the expansion of iatrogenic immunosuppression, including not only solid organ and hematopoietic stem cell transplant recipients but also patients with malignancies or autoimmune diseases ... ...

Abstract	Invasive fungal infections are increasingly encountered with the expansion of iatrogenic immunosuppression, including not only solid organ and hematopoietic stem cell transplant recipients but also patients with malignancies or autoimmune diseases receiving immunomodulatory therapies, such as Bruton Tyrosine Kinase (BTK) inhibitor. Their attributable mortality remains elevated, part of which is a contribution from globally emerging resistance in both molds and yeasts. Because antifungal susceptibility test results are often unavailable or delayed, empiric and tailored antifungal approaches including choice of agent(s) and use of combination therapy are heterogeneous and often based on clinician experience with knowledge of host's net state of immunosuppression, prior antifungal exposure, antifungal side effects and interaction profile, clinical severity of disease including site(s) of infection and local resistance data. In this review, we aim to summarize previous recommendations and most recent literature on treatment of invasive mold and yeast infections in adults to guide optimal evidence-based therapeutic approaches. We review the recent data that support use of available antifungal agents, including the different triazoles that have now been studied in comparison to previously preferred agents. We discuss management of complex infections with specific emerging fungi such as
Language	English
Publishing date	2024-01-20
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2728410-4
ISSN	2049-937X ; 2049-9361
ISSN (online)	2049-937X
ISSN	2049-9361
DOI	10.1177/20499361231224980
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Systematic fungal biomarker or polymerase chain reaction testing in lung transplant recipients: Retrospective analysis to optimize their use.

Boutin, Catherine-Audrey / Ison, Michael G

Transplant infectious disease : an official journal of the Transplantation Society

2023 Volume 25, Issue 5, Page(s) e14136

Abstract: Background: Among lung transplant recipients, serial bronchoscopies are performed frequently. Often, serial galactomannan (GM), 1,3-β-d-glucan (BDG), and Pneumocystis jirovecii (PJ) testing is performed with these broncho-alveolar lavages (BALs) as ... ...

Abstract	Background: Among lung transplant recipients, serial bronchoscopies are performed frequently. Often, serial galactomannan (GM), 1,3-β-d-glucan (BDG), and Pneumocystis jirovecii (PJ) testing is performed with these broncho-alveolar lavages (BALs) as standard of care with limited data to support their routine use. Methods: After Institutional Review Board approval, we retrospectively collected all blood and BAL GM, BDG, and PJ test results from January 2015 to July 20, 2022. Primary data collection from the Northwestern Medicine EDW was supplemented by manual chart review. Results: During the study period, 236 lung transplant recipients were cared for by our center. Of these patients, 217 (91.9%) had 1418 GM tests performed; 61 (4.3%) were positive (index ≥1). Fungal cultures were requested for most BAL-GM (90.7%). Out of duplicates in same BAL, results discrepancy was minimal (3.4%). 172 (72.9%) had BDG tests were performed; 25.6% were positive. Thirteen patients had multiple BDG during one hospitalization (mean 2.3 tests); none of the negative test repeated became positive. Eleven negative BDG were seen in patients with invasive aspergillosis (IA). Note that, 577 PJ testing were performed (direct fluorescent antibody [n = 494] or polymerase chain reaction [PCR] [n = 80], or both [n = 3]) in 174 different patients. None were positive. Conclusion: Despite supplemental GM, BDG, and Pneumocystis jirovecii pneumonia PCR being performed routinely on lung transplant recipients undergoing BAL at our center, the data suggests a more tailored approach may be appropriate. There is no role for routine serial testing with these assays during a single hospitalization. BDG confers no added-value over GM with cultures for IA diagnosis.
MeSH term(s)	Humans ; Retrospective Studies ; Transplant Recipients ; Sensitivity and Specificity ; Lung ; Aspergillosis ; Polymerase Chain Reaction ; Pneumocystis carinii/genetics ; Invasive Fungal Infections ; Biomarkers ; beta-Glucans ; Mannans
Chemical Substances	Biomarkers ; beta-Glucans ; Mannans
Language	English
Publishing date	2023-08-22
Publishing country	Denmark
Document type	Journal Article
ZDB-ID	1476094-0
ISSN	1399-3062 ; 1398-2273
ISSN (online)	1399-3062
ISSN	1398-2273
DOI	10.1111/tid.14136
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Article ; Online: Utility of deceased donor cultures in solid organ transplantation in preventing donor-derived bacterial and fungal infectious diseases transmission.

Boutin, Catherine-Audrey / Pouch, Stephanie M / Ison, Michael G

Transplant infectious disease : an official journal of the Transplantation Society

2023 Volume 25, Issue 2, Page(s) e14032

Abstract: Deceased donor and organ perfusion fluid cultures are obtained in order to inform recipient antimicrobial management and therefore reduce the risk of donor-derived bacterial and fungal infections. However, important heterogeneity exists in laboratory ... ...

Abstract	Deceased donor and organ perfusion fluid cultures are obtained in order to inform recipient antimicrobial management and therefore reduce the risk of donor-derived bacterial and fungal infections. However, important heterogeneity exists in laboratory practice across organ procurement organizations and clinical management of culture results across transplant centers. While not standardized, the clinical approach to donors with positive bacterial and/or fungal cultures should be informed by the risk of donor-derived infection (DDI) and the consequence of organ non-utilization and account for potential unintended effects of antimicrobial use in the recipient. In this review, we summarize the literature on bacterial and fungal DDIs, describe the significance of positive cultures by anatomic site, and summarize current guidance on the management of positive cultures from donors or preservation fluids.
MeSH term(s)	Humans ; Organ Transplantation/adverse effects ; Tissue Donors ; Mycoses/prevention & control ; Bacteria ; Communicable Diseases
Language	English
Publishing date	2023-02-07
Publishing country	Denmark
Document type	Journal Article ; Review
ZDB-ID	1476094-0
ISSN	1399-3062 ; 1398-2273
ISSN (online)	1399-3062
ISSN	1398-2273
DOI	10.1111/tid.14032
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Article ; Online: A new direction for cytomegalovirus prophylaxis among transplant recipients: Benefits and nonviral outcomes of letermovir use as primary CMV prophylaxis.

Moore, W Justin / Boutin, Catherine-Audrey / Tanna, Sajal

Current opinion in infectious diseases

2023 Volume 36, Issue 6, Page(s) 514–521

Abstract: Purpose of review: Letermovir has changed the game of primary prophylaxis against cytomegalovirus (CMV) for hematopoietic stem cell transplant (HSCT) and more recently, solid organ transplant recipients. This is largely due to letermovir's similar ... ...

Abstract	Purpose of review: Letermovir has changed the game of primary prophylaxis against cytomegalovirus (CMV) for hematopoietic stem cell transplant (HSCT) and more recently, solid organ transplant recipients. This is largely due to letermovir's similar efficacy in protecting against CMV reactivation and disease, along with its superior safety profile, notably reduced myelotoxicity, and lack of renal dose adjustment compared to standard agents like valganciclovir. This review will describe the potential benefits and clinical considerations of letermovir as prophylaxis among transplant recipients, with a focus on recent evidence describing nonviral outcomes of CMV. Recent findings: Recent evidence has demonstrated improved safety (e.g., less myelosuppression) and tolerability with no difference in rates of CMV infection or disease in kidney transplant recipients given letermovir compared to valganciclovir. Real-world studies and meta-analyses in HSCT populations have explored various nonviral outcomes with letermovir use. Letermovir prophylaxis was associated with reduced mortality, lower rates of graft versus host disease, delayed CMV immune reconstitution, improved tolerability with extended durations, and decreased healthcare utilization. Summary: Letermovir is an effective antiviral agent for CMV prevention and has demonstrated enhanced safety, which may allow for extended durations of primary prophylaxis among transplant recipients along with other improved clinical outcomes by mitigating the indirect effects of CMV.
MeSH term(s)	Humans ; Cytomegalovirus ; Valganciclovir/pharmacology ; Valganciclovir/therapeutic use ; Transplant Recipients ; Hematopoietic Stem Cell Transplantation/adverse effects ; Cytomegalovirus Infections/drug therapy
Chemical Substances	Valganciclovir (GCU97FKN3R) ; letermovir (1H09Y5WO1F)
Language	English
Publishing date	2023-09-29
Publishing country	United States
Document type	Review ; Journal Article
ZDB-ID	645085-4
ISSN	1473-6527 ; 1535-3877 ; 0951-7375 ; 1355-834X
ISSN (online)	1473-6527 ; 1535-3877
ISSN	0951-7375 ; 1355-834X
DOI	10.1097/QCO.0000000000000983
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Zs.A 2462: Show issues

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Article ; Online: Update on Covid-19: vaccines, timing of transplant after COVID-19 infection and use of positive donors.

Boutin, Catherine-Audrey / Alamri, Maha / Ison, Michael G

Current opinion in organ transplantation

2023 Volume 28, Issue 2, Page(s) 76–84

Abstract: Purpose of review: SARS-CoV-2 resulted in a global pandemic that had a chilling effect on transplantation early in the pandemic and continues to result in significant morbidity and mortality of transplant recipients. Over the past 2.5 years, our ... ...

Abstract	Purpose of review: SARS-CoV-2 resulted in a global pandemic that had a chilling effect on transplantation early in the pandemic and continues to result in significant morbidity and mortality of transplant recipients. Over the past 2.5 years, our understanding of the clinical utility of vaccination and mAbs to prevent COVID-19 in solid organ transplant (SOT) recipients has been studied. Likewise, approach to donors and candidates with SARS-CoV-2 has been better understood. This review will attempt to summarize our current understanding of these important COVID-19 topics. Recent findings: Vaccination against SARS-CoV-2 is effective in reducing the risk of severe disease and death among transplant patients. Unfortunately, humoral and, to a lesser extent, cellular immune response to existing COVID-19 vaccines is reduced in SOT recipients compared with healthy controls. Additional doses of vaccine are required to optimize protection of this population and still may be insufficient in those who are highly immunosuppressed, those receiving belatacept, rituximab and other B-cell active mAbs. Until recently, mAbs were options for the prevention of SARS-CoV-2 but are markedly less effective with recent omicron variants. SARS-CoV-2-infected donors can generally be used for nonlung, nonsmall bowel transplants unless they have died of acute severe COVID-19 or COVID-19-associated clotting disorders. Summary: Our transplant recipients require a three-dose mRNA or adenovirus-vector and one dose of mRNA vaccine to be optimally protected initially; they then need to receive a bivalent booster 2+ months after completing their initial series. Most nonlung, nonsmall bowel donors with SARS-CoV-2 can be utilized as organ donors.
MeSH term(s)	Humans ; COVID-19 Vaccines ; COVID-19/epidemiology ; COVID-19/prevention & control ; SARS-CoV-2 ; Tissue Donors ; Vaccines ; Transplant Recipients ; Antibodies, Monoclonal
Chemical Substances	COVID-19 Vaccines ; Vaccines ; Antibodies, Monoclonal
Language	English
Publishing date	2023-02-15
Publishing country	United States
Document type	Review ; Journal Article
ZDB-ID	1390429-2
ISSN	1531-7013 ; 1087-2418
ISSN (online)	1531-7013
ISSN	1087-2418
DOI	10.1097/MOT.0000000000001056
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Zs.A 5609: Show issues

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Article ; Online: Fungal infection and chronic lung allograft dysfunction: A dangerous combination.

Boutin, Catherine-Audrey / Desjardins, Michaël / Luong, Me-Linh

Transplant infectious disease : an official journal of the Transplantation Society

2022 , Page(s) e13987

Language	English
Publishing date	2022-11-15
Publishing country	Denmark
Document type	Editorial
ZDB-ID	1476094-0
ISSN	1399-3062 ; 1398-2273
ISSN (online)	1399-3062
ISSN	1398-2273
DOI	10.1111/tid.13987
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Zs.A 5100: Show issues

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ab Jg. 2022: Lesesaal (EG)

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Article ; Online: Complexities and benefits of adopting next-generation sequencing-based tuberculosis diagnostics

Elysée Nouvet / Niaina Rakotosamimanana / Simon Grandjean Lapierre / Catherine-Audrey Boutin / Maxwell J Smith / Marie-Sylvianne Rabodoarivelo / Omar Mahboob

BMJ Open, Vol 13, Iss

a qualitative study among stakeholders in low and high-income countries

2023 Volume 4

Abstract: Objectives To clarify perceived benefits, barriers and facilitators of Mycobacterium tuberculosis next-generation sequencing implementation in Madagascar and Canada, towards informing implementation of this diagnostic technology in public health agencies ...

Abstract	Objectives To clarify perceived benefits, barriers and facilitators of Mycobacterium tuberculosis next-generation sequencing implementation in Madagascar and Canada, towards informing implementation of this diagnostic technology in public health agencies and clinical settings in and beyond these settings.Design This qualitative study involved conducting semistructured interviews with key stakeholders engaged with next-generation sequencing implementation in Madagascar and Canada. Team-based descriptive analysis supported by Nvivo V.12.0 was used to identify key themes.Setting The study was conducted with participants involved at the clinical, diagnostic and surveillance levels of tuberculosis (TB) management from Madagascar and Canada.Participants Eighteen participants were interviewed (nine Madagascar and nine Canada) and included individuals purposively sampled based on involvement with TB surveillance, laboratory diagnosis and clinical management.Results The following five themes emerged in the analysis of Malagasy and Canadian interviews: (1) heterogeneity in experience with established TB diagnostics, (2) variable understanding of new sequencing-based diagnostics potential; (3) further evidence as being key to expand adoption; (4) ethical arguments and concerns; (5) operational and system-level considerations.Conclusion There persists important lack of familiarity with TB next-generation sequencing (TB NGS) applications among stakeholders in Canada and Madagascar. This translates into skepticism on the evidence underlying its use and its true potential value added within global public health systems. If deployed, TB NGS testing should be integrated with clinical and surveillance programmes. Although this is perceived as a priority, leadership and funding responsibilities for this integration to happen remains unclear to clinical, laboratory and public health stakeholders.
Keywords	Medicine ; R
Subject code	306
Language	English
Publishing date	2023-04-01T00:00:00Z
Publisher	BMJ Publishing Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Complexities and benefits of adopting next-generation sequencing-based tuberculosis diagnostics: a qualitative study among stakeholders in low and high-income countries.

Grandjean Lapierre, Simon / Nouvet, Elysée / Boutin, Catherine-Audrey / Rabodoarivelo, Marie-Sylvianne / Mahboob, Omar / Smith, Maxwell J / Rakotosamimanana, Niaina

BMJ open

2023 Volume 13, Issue 4, Page(s) e066651

Abstract: Objectives: To clarify perceived benefits, barriers and facilitators of : Design: This qualitative study involved conducting semistructured interviews with key stakeholders engaged with next-generation sequencing implementation in Madagascar and ... ...

Abstract	Objectives: To clarify perceived benefits, barriers and facilitators of Design: This qualitative study involved conducting semistructured interviews with key stakeholders engaged with next-generation sequencing implementation in Madagascar and Canada. Team-based descriptive analysis supported by Nvivo V.12.0 was used to identify key themes. Setting: The study was conducted with participants involved at the clinical, diagnostic and surveillance levels of tuberculosis (TB) management from Madagascar and Canada. Participants: Eighteen participants were interviewed (nine Madagascar and nine Canada) and included individuals purposively sampled based on involvement with TB surveillance, laboratory diagnosis and clinical management. Results: The following five themes emerged in the analysis of Malagasy and Canadian interviews: (1) heterogeneity in experience with established TB diagnostics, (2) variable understanding of new sequencing-based diagnostics potential; (3) further evidence as being key to expand adoption; (4) ethical arguments and concerns; (5) operational and system-level considerations. Conclusion: There persists important lack of familiarity with TB next-generation sequencing (TB NGS) applications among stakeholders in Canada and Madagascar. This translates into skepticism on the evidence underlying its use and its true potential value added within global public health systems. If deployed, TB NGS testing should be integrated with clinical and surveillance programmes. Although this is perceived as a priority, leadership and funding responsibilities for this integration to happen remains unclear to clinical, laboratory and public health stakeholders.
MeSH term(s)	Humans ; Developed Countries ; Canada ; Tuberculosis/diagnosis ; Qualitative Research ; High-Throughput Nucleotide Sequencing
Language	English
Publishing date	2023-04-10
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2022-066651
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Article: Ketoacidosis in a Non-Diabetic Adult With Chronic EtOH Consumption.

Boutin, Catherine-Audrey / Laskine, Mikhael

Journal of clinical medicine research

2016 Volume 8, Issue 12, Page(s) 919–920

Abstract: Although much more rare than its diabetic counterpart, ketoacidosis secondary to alcohol withdrawal in the context of fasting has its own complex pathophysiology and can easily mimic the acute insulin deficiency presentation. We present here a rare case ... ...

Abstract	Although much more rare than its diabetic counterpart, ketoacidosis secondary to alcohol withdrawal in the context of fasting has its own complex pathophysiology and can easily mimic the acute insulin deficiency presentation. We present here a rare case of a non-diabetic alcoholic patient who presented in ketoacidosis after a period of reduced intake.
Language	English
Publishing date	2016-10-26
Publishing country	Canada
Document type	Case Reports
ZDB-ID	2548987-2
ISSN	1918-3011 ; 1918-3003
ISSN (online)	1918-3011
ISSN	1918-3003
DOI	10.14740/jocmr2751w
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Article ; Online: Pandoraea

Boutin, Catherine-Audrey / Cornut, Gilbert / Bilik Pinto, Véronica / Grandjean Lapierre, Simon

Journal of the Association of Medical Microbiology and Infectious Disease Canada = Journal officiel de l'Association pour la microbiologie medicale et l'infectiologie Canada

2020 Volume 5, Issue 3, Page(s) 177–181

Abstract: Diagnosis and clinical management of pulmonary infections in lung transplant patients are challenging. The increased diversity of bacterial species identified from clinical samples with novel proteomics-based systems can further complicate clinical ... ...

Abstract	Diagnosis and clinical management of pulmonary infections in lung transplant patients are challenging. The increased diversity of bacterial species identified from clinical samples with novel proteomics-based systems can further complicate clinical decision making in this highly vulnerable population. Whether newly recognized organisms are colonizers or true pathogens often remains controversial since symptoms causality and impact on lung function is often unknown. We present the case of a 48-year-old female lung transplant patient with
Language	English
Publishing date	2020-10-11
Publishing country	Canada
Document type	Case Reports
ISSN	2371-0888
ISSN (online)	2371-0888
DOI	10.3138/jammi-2020-0001
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