Article
Immunology
Ana D. Vega, Lilian M. Abbo
Summary: This review summarizes the clinical outcomes of using rapid diagnostic tests (RDTs) in solid organ transplant (SOT) patients and discusses the potential benefits and drawbacks of these technologies. The integration of RDTs with proactive antimicrobial stewardship programs (ASPs) in SOT patients leads to faster species identification and susceptibility results, shorter time-to-optimal therapy, decreased hospital length-of-stay and costs, and decreased mortality. However, there are also drawbacks such as overdiagnosis and failure to identify important pathogens. Future studies should focus on optimizing the use of RDTs in conjunction with traditional microbiology methods for SOT patients.
TRANSPLANT INFECTIOUS DISEASE
(2022)
Article
Emergency Medicine
Alec Wesolowski, Jessica L. Miller, Maureen Shields, Jennifer Dela-Pena
Summary: This study compares the use of antibiotics and antiviral drugs before and after the implementation of rapid influenza PCR in the emergency department (ED). The results show that the use of rapid influenza PCR reduces the use of antibiotics and optimizes antiviral therapy for patients with influenza, especially those at higher risk of complications.
AMERICAN JOURNAL OF EMERGENCY MEDICINE
(2023)
Review
Immunology
Sherry A. Dunbar, Christopher Gardner, Shubhagata Das
Summary: This article describes the application of two rapid, molecular bloodstream infection panels that can identify the most common pathogens and associated genetic determinants of antibiotic resistance, providing clinicians with faster information for treatment. Molecular testing methods reduce the turnaround time for diagnosing bloodstream pathogens to a few hours, helping to initiate timely and effective treatment.
FRONTIERS IN CELLULAR AND INFECTION MICROBIOLOGY
(2022)
Article
Immunology
Ana Paula Matos Porto, Bruno de Melo Tavares, Denise Brandao de Assis, Elisa Teixeira Mendes, Evelyne Santana Girao, Lauro Vieira Perdigao Neto, Maria Alice Pimentel Falcao, Maura Salaroli de Oliveira, Maristela Pinheiro Freire, Thais Guimaraes, Tiago Arantes, Anna Sara Levin, Silvia Figueiredo Costa
Summary: The incidence of multidrug resistant organisms infections among solid organ transplant patients is very high in Brazil, with carbapenem-resistant Gram-negative bacteria and vancomycin-resistant Enterococcus being the most common MDROs. Implementation of antimicrobial stewardship programmes in Brazilian hospitals for SOT recipients faces barriers such as lack of electronic medical records, national guidelines specific to SOT recipients, recommendations on surveillance culture, availability of rapid diagnostic tests, and insufficient pharmacist and clinician time allocated to ASP activities.
TRANSPLANT INFECTIOUS DISEASE
(2022)
Review
Infectious Diseases
Hannah Imlay, Nicholas C. Laundy, Graeme N. Forrest, Monica A. Slavin
Summary: A growing number of studies have shown that shorter courses of antibiotics can achieve similar outcomes for bacterial infections. However, immunocompromised patients, who could benefit from shorter antibiotic courses, are often excluded from these studies.
CLINICAL MICROBIOLOGY AND INFECTION
(2023)
Article
Microbiology
Brian R. Lee, Anjana Sasidharan, Chris J. Harrison, Rangaraj Selvarangan
Summary: The study found that conducting CSF RT-PCR testing for enterovirus and parechovirus can significantly reduce the length of hospitalization for children, decreasing the likelihood of antibiotic usage. This helps to improve the quality of care for pediatric patients.
JOURNAL OF CLINICAL MICROBIOLOGY
(2021)
Article
Immunology
Evan D. Robinson, Allison M. Stilwell, April E. Attai, Lindsay E. Donohue, Megan D. Shah, Brandon K. Hill, Zachary S. Elliott, Melinda Poulter, Frankie Brewster, Heather L. Cox, Amy J. Mathers
Summary: This study found that implementation of a phenotypic RDT + ASP intervention can reduce the time to antimicrobial susceptibility testing and institutional-preferred antimicrobial therapy for patients with Gram-negative bacilli bloodstream infections. It also showed a decrease in the use of broad-spectrum agents and an increase in narrow-spectrum beta-lactams. Although discrepant RDT results occurred, there were no differences in clinical outcomes observed.
CLINICAL INFECTIOUS DISEASES
(2021)
Article
Immunology
Julia A. Bielicki, Oriol Manuel
Summary: In Switzerland, antimicrobial stewardship programs in solid-organ transplant recipients rely more on transplant infectious disease consultations than structured institutional interventions. However, the close collaboration between TID specialists and transplant physicians, the limited number of centers involved in transplant recipient care, and the development of the Swiss Transplant Cohort Study present opportunities for a successful ASP implementation in Switzerland.
TRANSPLANT INFECTIOUS DISEASE
(2022)
Article
Immunology
Saraswathi E. Murthy, Emmanuel Q. Wey
Summary: This article discusses the current practice of antimicrobial stewardship (AMS) in solid organ transplant (SOT) units in the United Kingdom and explores future improvements. While there is a standardized approach to AMS in the National Health Service (NHS), there is a need for SOT-specific AMS approaches and more data on antimicrobial resistance rates. Further research is needed to investigate optimal antimicrobial prophylaxis regimens for each solid organ group.
TRANSPLANT INFECTIOUS DISEASE
(2023)
Article
Infectious Diseases
Kyle D. Hueth, Andrea M. Prinzi, Tristan T. Timbrook
Summary: Diagnostic stewardship aims to improve the effectiveness of diagnostic testing through collaborative activities, with a focus on long-term measurement of diagnostic effectiveness.
Review
Pharmacology & Pharmacy
Jonathan S. Lapin, Richard D. Smith, Krutika M. Hornback, J. Kristie Johnson, Kimberly C. Claeys
Summary: Antimicrobial stewardship (AMS) programs have rapidly adopted novel molecular rapid diagnostic technologies (mRDTs) to improve antimicrobial management for bloodstream infections (BSIs). Most literature demonstrating the clinical and economic benefits of mRDTs for BSI is in the presence of active AMS intervention. Leveraging mRDTs to improve antimicrobial therapy for BSI is increasingly integral to AMS program activities.
Article
Immunology
Zoe Raglow, Sonali D. Advani, Samuel L. Aitken, Payal K. Patel
Summary: Data on antimicrobial stewardship metrics for SOT recipients are limited, and specific interventions and considerations are needed to address the distinct needs of these patients.
TRANSPLANT INFECTIOUS DISEASE
(2022)
Article
Immunology
Jonathan Hand, Hannah Imlay
Summary: This article reviews the challenges, metrics, and opportunities for antimicrobial stewardship in immunocompromised patients, highlighting the need for future development in this field.
INFECTIOUS DISEASE CLINICS OF NORTH AMERICA
(2023)
Article
Immunology
Sage B. Greenlee, Tommy J. Parraga Acosta, Charles T. Makowski, Rachel M. Kenney, Mayur Ramesh, Jonathan D. Williams, George J. Alangaden
Summary: This study describes the inpatient antimicrobial use among solid organ transplant recipients within 12 months after transplant. The results show variations in medication use and infection occurrence among different organ transplant recipients. Further studies are needed to better understand the treatment patterns in this complex patient population.
TRANSPLANT INFECTIOUS DISEASE
(2022)
Article
Immunology
Kathryn Sine, Haley Appaneal, David Dosa, Kerry L. LaPlante
Summary: This article proposes a tailored and sustainable approach to antimicrobial stewardship in primary care settings using telehealth. The use of telehealth presents unique challenges for antimicrobial stewardship, such as limited physical examination and changes to the patient-provider relationship. With the increased use of telehealth due to the COVID-19 pandemic, there is a need for innovative antimicrobial stewardship strategies.
CLINICAL INFECTIOUS DISEASES
(2022)
Article
Immunology
Jonathan Hand
INFECTIOUS DISEASE CLINICS OF NORTH AMERICA
(2018)
Letter
Infectious Diseases
S. Travis King, Jonathan Hand, Kayla R. Stover, Christopher M. Bland
JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY
(2019)
Article
Surgery
Rebecca Pellett Madan, Jonathan Hand
CLINICAL TRANSPLANTATION
(2019)
Editorial Material
Gastroenterology & Hepatology
Jonathan Hand, Shirish Huprikar
LIVER TRANSPLANTATION
(2019)
Letter
Surgery
Christine M. Durand, William Werbel, Brianna Doby, Diane Brown, Niraj M. Desai, Maricar Malinis, Jennifer Price, Peter Chin-Hong, Shikha Mehta, Rachel Friedman-Moraco, Nicole A. Turgeon, Alexander Gilbert, Michele I. Morris, Valentina Stosor, Nahel Elias, Saima Aslam, Carlos A. Q. Santos, Jonathan M. Hand, Jennifer Husson, Timothy L. Pruett, Avinash Agarwal, Oluwafisayo Adebiyi, Marcus Pereira, Catherine B. Small, Senu Apewokin, Dong Heun Lee, Ghady Haidar, Emily Blumberg, Sapna A. Mehta, Shirish Huprikar, Sander S. Florman, Andrew D. Redd, Aaron A. R. Tobian, Dorry L. Segev
AMERICAN JOURNAL OF TRANSPLANTATION
(2020)
Article
Gastroenterology & Hepatology
Humberto Bohorquez, Emily Bugeaud, Natalie Bzowej, Jennifer Scheuermann, Jonathan Hand, David Bruce, Ian Carmody, Ari Cohen, Shobha Joshi, John Seal, Dennis Sonnier, George Therapondos, Nigel Girgrah, Stephanie Anders, George E. Loss
Summary: The study findings suggest that liver transplantation using hepatitis C virus (HCV)-viremic organs into HCV-aviremic recipients followed by direct-acting antiviral (DAA) therapy results in clinical outcomes comparable to those achieved with HCV-aviremic allografts.
LIVER TRANSPLANTATION
(2021)
Article
Surgery
Miranda So, Jonathan Hand, Graeme Forrest, Stephanie M. Pouch, Helen Te, Monica Ardura, Rachel M. Bartash, Darshana M. Dadhania, Jeffrey Edelman, Dilek Ince, Margaret R. Jorgenson, Sarah Kabbani, Erika D. Lease, Deborah Levine, Linda Ohler, Gopi Patel, Jennifer Pisano, Michael L. Spinner, Lilian Abbo, Elizabeth C. Verna, Shahid Husain
Summary: Antimicrobial stewardship programs have significantly improved antibiotic, antifungal, and antiviral use in clinical settings, but there is currently a lack of specific requirements for solid organ transplant recipients. The wide variability in susceptibility to infection among transplant patients make it challenging to implement a one-size-fits-all stewardship approach in this population.
AMERICAN JOURNAL OF TRANSPLANTATION
(2022)
Editorial Material
Immunology
Graeme N. Forrest, Miranda So, Jonathan Hand, Stephanie Pouch, Shahid Husain
TRANSPLANT INFECTIOUS DISEASE
(2022)
Article
Immunology
Rachel Sigler, Darcy Wooten, Rebecca N. Kumar, Jonathan Hand, Nicholas Marschalk, Roderick Go, Katya Prakash, Erica Stohs, Joanna Schaenman, Nancy Law
Summary: The study created a simulation curriculum to evaluate the skill of infectious disease trainees in assessing organ suitability for transplantation based on infection risk. The results showed that the curriculum was effective in teaching and preparing trainees for clinical practice.
TRANSPLANT INFECTIOUS DISEASE
(2023)
Meeting Abstract
Surgery
Emily Bugeaud, Jonathan Hand, Humberto Bohorquez, David Bruce, Ian Carmody, Ari Cohen, John Seal, Dennis Sonnier, George Loss
AMERICAN JOURNAL OF TRANSPLANTATION
(2020)
Meeting Abstract
Surgery
M. So, J. Hand, M. Richmond, A. Morris, S. Husain
AMERICAN JOURNAL OF TRANSPLANTATION
(2019)
Meeting Abstract
Surgery
E. M. Bugeaud, N. Bzowej, J. Hand, J. Scheuermann, H. Bohorquez, C. Brown, D. Bruce, I. Carmody, A. Cohen, S. Joshi, N. Latt, J. Seal, D. Sonnier, G. Therapondos, G. Tyson, N. Girgrah, G. Loss
AMERICAN JOURNAL OF TRANSPLANTATION
(2019)
Meeting Abstract
Surgery
Emily Bugeaud, Natalie Bzowej, Jennifer Scheuermann, Humberto Bohorquez, Cristal Brown, David Bruce, Ian Carmody, Ari Cohen, Jonathan Hand, Shobha Joshi, Nyan Latt, John Seal, Dennis Sonnier, George Therapondos, Gia Tyson, Nigel Girgrah, George Loss
AMERICAN JOURNAL OF TRANSPLANTATION
(2019)
Article
Health Care Sciences & Services
Richard Milani, Jonathan K. Wilt, Jonathan Entwisle, Jonathan Hand, Pedro Cazabon, Jefferson G. Bohan