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  1. Article ; Online: BK polyomavirus-associated nephropathy, graft inflammation, and immunosuppression: Shedding light on the conundrum.

    Fernández-Ruiz, Mario

    Transplant infectious disease : an official journal of the Transplantation Society

    2024  Volume 26, Issue 2, Page(s) e14272

    MeSH term(s) Humans ; BK Virus ; Polyomavirus Infections ; Kidney Transplantation/adverse effects ; Immunosuppression Therapy/adverse effects ; Inflammation ; Tumor Virus Infections ; Kidney Diseases
    Language English
    Publishing date 2024-03-28
    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.14272
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    Zs.A 5100: Show issues Location:
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  2. Article ; Online: Pharmacological management of invasive mold infections in solid organ transplant recipients.

    Fernández-Ruiz, Mario

    Expert opinion on pharmacotherapy

    2024  Volume 25, Issue 3, Page(s) 239–254

    Abstract: Introduction: Solid organ transplant (SOT) recipients face an increased susceptibility to invasive fungal infection (IFI) due to filamentous fungi. Post-transplant invasive aspergillosis (IA) and mucormycosis are related to exceedingly high mortality ... ...

    Abstract Introduction: Solid organ transplant (SOT) recipients face an increased susceptibility to invasive fungal infection (IFI) due to filamentous fungi. Post-transplant invasive aspergillosis (IA) and mucormycosis are related to exceedingly high mortality rates and graft loss risk, and its management involve a unique range of clinical challenges.
    Areas covered: First, the current treatment recommendations for IA and mucormycosis among SOT recipients are critically reviewed, including the supporting evidence. Next, we discussed particular concerns in this patient population, such as drug-drug interactions (DDIs) between triazoles and post-transplant immunosuppression or treatment-related toxicity. The role for immunomodulatory and host-targeted therapies is also considered, as well as the theoretical impact of the intrinsic antifungal activity of calcineurin inhibitors. Finally, a personal opinion is made on future directions in the pharmacological approach to post-transplant IFI.
    Expert opinion: Despite relevant advances in the treatment of mold IFIs in the SOT setting, such as the incorporation of isavuconazole (with lower incidence of DDIs and better tolerability than voriconazole), there remains a large room for improvement in areas such as the position of combination therapy or the optimal strategy for the reduction of baseline immunosuppression. Importantly, future studies should define the specific contribution of newer antifungal agents and classes.
    MeSH term(s) Humans ; Antifungal Agents/therapeutic use ; Antifungal Agents/adverse effects ; Invasive Fungal Infections/drug therapy ; Organ Transplantation/adverse effects ; Drug Interactions ; Mucormycosis/drug therapy ; Aspergillosis/drug therapy ; Transplant Recipients ; Immunosuppressive Agents/adverse effects ; Immunosuppressive Agents/therapeutic use ; Animals
    Chemical Substances Antifungal Agents ; Immunosuppressive Agents
    Language English
    Publishing date 2024-03-11
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2001535-5
    ISSN 1744-7666 ; 1465-6566
    ISSN (online) 1744-7666
    ISSN 1465-6566
    DOI 10.1080/14656566.2024.2326507
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  3. Article ; Online: Reply.

    Gil Mosquera, Manuel / Fernández-Ruiz, Mario

    Medicina clinica (English ed.)

    2023  Volume 160, Issue 9, Page(s) 417–418

    Language English
    Publishing date 2023-04-20
    Publishing country Spain
    Document type Journal Article
    ISSN 2387-0206
    ISSN (online) 2387-0206
    DOI 10.1016/j.medcle.2022.12.008
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  4. Article ; Online: Reply.

    Gil Mosquera, Manuel / Fernández-Ruiz, Mario

    Medicina clinica

    2023  Volume 160, Issue 9, Page(s) 417–418

    Title translation Respuesta.
    Language Spanish
    Publishing date 2023-01-23
    Publishing country Spain
    Document type Letter ; Comment
    ZDB-ID 411607-0
    ISSN 1578-8989 ; 0025-7753
    ISSN (online) 1578-8989
    ISSN 0025-7753
    DOI 10.1016/j.medcli.2022.12.013
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  5. Article ; Online: Which trial do we need? Elective early surgical treatment of left-sided infective endocarditis.

    Fernández-Ruiz, Mario / Aguado, José María

    Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases

    2023  Volume 29, Issue 9, Page(s) 1103–1106

    MeSH term(s) Humans ; Endocarditis/surgery ; Endocarditis/microbiology ; Endocarditis, Bacterial/drug therapy ; Endocarditis, Bacterial/surgery ; Endocarditis, Bacterial/microbiology
    Language English
    Publishing date 2023-04-13
    Publishing country England
    Document type Journal Article
    ZDB-ID 1328418-6
    ISSN 1469-0691 ; 1470-9465 ; 1198-743X
    ISSN (online) 1469-0691
    ISSN 1470-9465 ; 1198-743X
    DOI 10.1016/j.cmi.2023.04.010
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    Zs.A 4541: Show issues Location:
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  6. Article ; Online: Torque Teno virus load as a surrogate marker for the net state of immunosuppression: The beneficial side of the virome.

    Fernández-Ruiz, Mario

    American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons

    2020  Volume 20, Issue 8, Page(s) 1963–1964

    MeSH term(s) Biomarkers ; Graft Rejection ; Humans ; Infections ; Kidney Transplantation ; Prospective Studies ; Risk Assessment ; Torque teno virus
    Chemical Substances Biomarkers
    Language English
    Publishing date 2020-04-12
    Publishing country United States
    Document type Editorial ; Research Support, Non-U.S. Gov't ; Comment
    ZDB-ID 2060594-8
    ISSN 1600-6143 ; 1600-6135
    ISSN (online) 1600-6143
    ISSN 1600-6135
    DOI 10.1111/ajt.15872
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    Zs.A 5542: Show issues Location:
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  7. Article ; Online: Is there a real risk of bacterial infection in patients receiving targeted and biological therapies?

    Noreña, Ivan / Fernández-Ruiz, Mario / Aguado, José María

    Enfermedades infecciosas y microbiologia clinica (English ed.)

    2022  Volume 40, Issue 5, Page(s) 266–272

    Abstract: Over the past decades, the advent of targeted and biological therapies has revolutionized the management of cancer and autoimmune, hematological and inflammatory conditions. Although a large amount of information is now available on the risk of ... ...

    Abstract Over the past decades, the advent of targeted and biological therapies has revolutionized the management of cancer and autoimmune, hematological and inflammatory conditions. Although a large amount of information is now available on the risk of opportunistic infections associated with some of these agents, the evidence regarding the susceptibility to bacterial infections is more limited. Biological agents have been shown to entail a variable risk of bacterial infections in pivotal randomized clinical trials and post-marketing studies. Recommendations on risk minimization strategies and therapeutic interventions are therefore scarce and often based on expert opinion, with only a few clear statements for some particular agents (i.e. meningococcal vaccination for patients receiving eculizumab). In the present review the available information regarding the incidence of and risk factors for bacterial infection associated with the use of different groups of biological agents is summarized according to their mechanisms of action, and recommendations based on this evidence are provided. Additional information coming from clinical research and real-world studies is required to address unmet questions in this emerging field.
    MeSH term(s) Bacterial Infections/drug therapy ; Bacterial Infections/epidemiology ; Bacterial Infections/etiology ; Biological Factors ; Biological Therapy/adverse effects ; Humans ; Incidence ; Opportunistic Infections/epidemiology ; Opportunistic Infections/etiology
    Chemical Substances Biological Factors
    Language English
    Publishing date 2022-05-14
    Publishing country Spain
    Document type Journal Article ; Review
    ISSN 2529-993X
    ISSN (online) 2529-993X
    DOI 10.1016/j.eimce.2020.10.014
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  8. Article ; Online: Bacteremia due to Leuconostoc species: A 13-year single-center case series.

    Caso, José María / Recio, Raúl / Ruiz-Ruigómez, María / Orellana, María Ángeles / Fernández-Ruiz, Mario

    Enfermedades infecciosas y microbiologia clinica (English ed.)

    2023  Volume 42, Issue 3, Page(s) 149–151

    Abstract: Introduction: Leuconostoc spp. are facultatively anaerobic Gram-positive cocci involved in cases of hospital-acquired bacteremia, mainly in immunocompromised hosts. The available data is scarce due to its uncommon presentation.: Methods: We describe ... ...

    Abstract Introduction: Leuconostoc spp. are facultatively anaerobic Gram-positive cocci involved in cases of hospital-acquired bacteremia, mainly in immunocompromised hosts. The available data is scarce due to its uncommon presentation.
    Methods: We describe all the episodes of Leuconostoc spp. bacteremia in a third level hospital in a 13-year period (2008-2021).
    Results: Four cases of clinically relevant bacteremia were detected. All cases were categorized as catheter-related. The following risk factors were found: previous glycopeptide therapy (75%), use of parenteral nutrition (100%) and cancer (75%). All isolates showed susceptibility to beta-lactams. Catheter removal was performed and wide spectrum antimicrobials were administered, with clinical response in all cases except one.
    Discussion: Apart from cancer and glycopeptide exposure, disruption of skin barrier and gastrointestinal conditions were identified as risk factors, as it was concordantly underlined in other case series. Susceptibility to beta-lactams is usually maintained. Catheter removal and administration of an active antibacterial therapy seem to be the best approach for Leuconostoc spp. catheter-related bacteremia.
    MeSH term(s) Humans ; Bacteremia/microbiology ; beta-Lactams/pharmacology ; Catheters, Indwelling/microbiology ; Glycopeptides/adverse effects ; Gram-Positive Bacterial Infections/diagnosis ; Gram-Positive Bacterial Infections/drug therapy ; Gram-Positive Bacterial Infections/etiology ; Leuconostoc ; Neoplasms/complications
    Chemical Substances beta-Lactams ; Glycopeptides
    Language English
    Publishing date 2023-04-21
    Publishing country Spain
    Document type Case Reports ; Journal Article
    ISSN 2529-993X
    ISSN (online) 2529-993X
    DOI 10.1016/j.eimce.2023.01.007
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  9. Article ; Online: Cytomegalovirus Cell-Mediated Immunity: Ready for Routine Use?

    Bestard, Oriol / Kaminski, Hannah / Couzi, Lionel / Fernández-Ruiz, Mario / Manuel, Oriol

    Transplant international : official journal of the European Society for Organ Transplantation

    2023  Volume 36, Page(s) 11963

    Abstract: Utilizing assays that assess specific T-cell-mediated immunity against cytomegalovirus (CMV) holds the potential to enhance personalized strategies aimed at preventing and treating CMV in organ transplantation. This includes improved risk stratification ... ...

    Abstract Utilizing assays that assess specific T-cell-mediated immunity against cytomegalovirus (CMV) holds the potential to enhance personalized strategies aimed at preventing and treating CMV in organ transplantation. This includes improved risk stratification during transplantation compared to relying solely on CMV serostatus, as well as determining the optimal duration of antiviral prophylaxis, deciding on antiviral therapy when asymptomatic replication occurs, and estimating the risk of recurrence. In this review, we initially provide an overlook of the current concepts into the immune control of CMV after transplantation. We then summarize the existent literature on the clinical experience of the use of immune monitoring in organ transplantation, with a particular interest on the outcomes of interventional trials. Current evidence indicates that cell-mediated immune assays are helpful in identifying patients at low risk for replication for whom preventive measures against CMV can be safely withheld. As more data accumulates from these and other clinical scenarios, it is foreseeable that these assays will likely become part of the routine clinical practice in organ transplantation.
    MeSH term(s) Humans ; Cytomegalovirus ; Cytomegalovirus Infections/drug therapy ; Antiviral Agents/therapeutic use ; Immunity, Cellular ; Organ Transplantation
    Chemical Substances Antiviral Agents
    Language English
    Publishing date 2023-11-07
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 639435-8
    ISSN 1432-2277 ; 0934-0874
    ISSN (online) 1432-2277
    ISSN 0934-0874
    DOI 10.3389/ti.2023.11963
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    Zs.A 2358: Show issues Location:
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  10. Article ; Online: Viruses, friends, and foes: The case of Torque Teno Virus and the net state of immunosuppression.

    Redondo, Natalia / Navarro, David / Aguado, José María / Fernández-Ruiz, Mario

    Transplant infectious disease : an official journal of the Transplantation Society

    2022  Volume 24, Issue 2, Page(s) e13778

    Abstract: New reliable biomarkers are needed to improve individual risk assessment for post-transplant infection, acute graft rejection and other immune-related complications after solid organ transplantation (SOT) and allogeneic hematopoietic stem cell ... ...

    Abstract New reliable biomarkers are needed to improve individual risk assessment for post-transplant infection, acute graft rejection and other immune-related complications after solid organ transplantation (SOT) and allogeneic hematopoietic stem cell transplantation (allo-HSCT). One promising strategy relies on the monitoring of replication kinetics of virome components as functional surrogate for the net state of immunosuppression. Torque Teno Virus (TTV) is a small, non-enveloped, circular, single-stranded DNA anellovirus with no attributable pathological effects. A major component of the human blood virome, TTV exhibits various features that facilitate its application as immune biomarker: high prevalence rates, nearly ubiquitous distribution, stable viral loads with little intra-individual variability, insensitivity to antiviral drugs, and availability of commercial PCR assays for DNA quantification. The present review summarizes the available studies supporting the use of post-transplant TTV viremia to predict patient and graft outcomes after SOT and allo-HSCT. Taken together, this evidence suggests that high or increasing TTV DNA levels precede the occurrence of infectious complications in the SOT setting, whereas low or decreasing viral loads are associated with the development of acute rejection. The interpretation in allo-HSCT recipients is further complicated by complex interplay with the underlying disease, conditioning regimen, and timing of recovery of lymphocyte counts, although TTV kinetics may act as a marker of immunological reconstitution at the early post-transplant period. The standardization of PCR methods and reporting units for TTV DNAemia and the results from ongoing interventional trials evaluating a TTV load-guided strategy to adjust immunosuppressive therapy are achievements expected in the coming years.
    MeSH term(s) DNA, Viral ; Friends ; Graft vs Host Disease ; Hematopoietic Stem Cell Transplantation ; Humans ; Immunosuppression Therapy/adverse effects ; Torque teno virus/genetics ; Viral Load
    Chemical Substances DNA, Viral
    Language English
    Publishing date 2022-01-31
    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.13778
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