Gabriel Paykin, Sara Vogrin, Peter Shuttleworth, Andrew Gador-Whyte, Sarah Garner, Janine Trevillyan, Eric Wong, Olivia Smibert
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引用次数: 0
Abstract
Background: Identifying patients with latent tuberculosis infection (LTBI) is challenging. This is particularly true amongst immunocompromised hosts, in whom the diagnostic accuracy of available tests is limited. The authors evaluated the impact of routine pretransplant review by a transplant infectious diseases (TID) physician on LTBI screening in allogeneic hematopoietic stem cell transplant (alloHSCT) recipients.
Methods: Adult patients who received an alloHSCT between January 2018 and December 2022 were eligible for inclusion. Data were retrospectively extracted from patient records. Participants were dichotomized into those that had a routine pretransplant review with a TID physician and who that did not.
Results: Of the 116 participants included, 61.2% had a documented TID review. This intervention was associated with more frequent initiation of LTBI treatment (8.5% vs. 0.0%) and a tendency for LTBI treatment to be initiated in the absence of immunodiagnostic criteria (7.1% vs. 0.0%). A case of LTBI reactivation occurred in each group.
Conclusion: Routine pretransplant review by TID physicians improved the recognition of risk factors for LTBI and increased the initiation of LTBI treatment in patients with a high pretest probability of LTBI. Further research is needed to evaluate the utility of routine pretransplant TID review and to determine the optimal strategy for preventing LTBI reactivation amongst alloHSCT recipients in low-endemic settings.
期刊介绍：
Transplant Infectious Disease has been established as a forum for presenting the most current information on the prevention and treatment of infection complicating organ and bone marrow transplantation. The point of view of the journal is that infection and allograft rejection (or graft-versus-host disease) are closely intertwined, and that advances in one area will have immediate consequences on the other. The interaction of the transplant recipient with potential microbial invaders, the impact of immunosuppressive strategies on this interaction, and the effects of cytokines, growth factors, and chemokines liberated during the course of infections, rejection, or graft-versus-host disease are central to the interests and mission of this journal.
Transplant Infectious Disease is aimed at disseminating the latest information relevant to the infectious disease complications of transplantation to clinicians and scientists involved in bone marrow, kidney, liver, heart, lung, intestinal, and pancreatic transplantation. The infectious disease consequences and concerns regarding innovative transplant strategies, from novel immunosuppressive agents to xenotransplantation, are very much a concern of this journal. In addition, this journal feels a particular responsibility to inform primary care practitioners in the community, who increasingly are sharing the responsibility for the care of these patients, of the special considerations regarding the prevention and treatment of infection in transplant recipients. As exemplified by the international editorial board, articles are sought throughout the world that address both general issues and those of a more restricted geographic import.
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