A 5-Year Prospective Multicenter Evaluation of Influenza Infection in Transplant Recipients
Background: Seasonal influenza infection may cause significant morbidity and mortality in transplant recipients. The purpose of this study was to assess the epidemiology of symptomatic influenza infection posttransplant and determine risk factors for severe disease.
Methods: Twenty centers in the United States, Canada, and Spain prospectively enrolled solid organ transplant (SOT) or hematopoietic stem cell transplant (HSCT) recipients with microbiologically confirmed influenza over 5 consecutive years (2010-2015). Demographics, microbiology data, and outcomes were collected. Serial nasopharyngeal swabs were collected at diagnosis and upto 28 days, and quantitative polymerase chain reaction for influenza A was performed.
Results: We enrolled 616 patients with confirmed influenza (477 SOT; 139 HSCT). Pneumonia at presentation was in 134 of 606 (22.1%) patients. Antiviral therapy was given to 94.1% for a median of 5 days (range, 1-42 days); 66.5% patients were hospitalized and 11.0% required intensive care unit (ICU) care. The receipt of vaccine in the same influenza season was associated with a decrease in disease severity as determined by the presence of pneumonia (odds ratio [OR], 0.34 [95% confidence interval {CI}, .21-.55], P < .001) and ICU admission (OR, 0.49 [95% CI, .26-.90], P = .023). Similarly, early antiviral treatment (within 48 hours) was associated with improved outcomes. In patients with influenza A, pneumonia, ICU admission, and not being immunized were also associated with higher viral loads at presentation (P = .018, P = .008, and P = .024, respectively).
Conclusions: Annual influenza vaccination and early antiviral therapy are associated with a significant reduction in influenza-associated morbidity, and should be emphasized as strategies to improve outcomes of transplant recipients.
| Errataetall: |
CommentIn: Clin Infect Dis. 2018 Oct 15;67(9):1330-1332. - PMID 29635545 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2018 |
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| Erschienen: |
2018 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:67 |
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| Enthalten in: |
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America - 67(2018), 9 vom: 15. Okt., Seite 1322-1329 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Kumar, Deepali [VerfasserIn] |
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| Links: |
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| Themen: |
Antiviral Agents |
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| Anmerkungen: |
Date Completed 31.10.2019 Date Revised 01.11.2019 published: Print CommentIn: Clin Infect Dis. 2018 Oct 15;67(9):1330-1332. - PMID 29635545 Citation Status MEDLINE |
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| doi: |
10.1093/cid/ciy294 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM282842012 |
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| 100 | 1 | |a Kumar, Deepali |e verfasserin |4 aut | |
| 245 | 1 | 2 | |a A 5-Year Prospective Multicenter Evaluation of Influenza Infection in Transplant Recipients |
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| 500 | |a Date Revised 01.11.2019 | ||
| 500 | |a published: Print | ||
| 500 | |a CommentIn: Clin Infect Dis. 2018 Oct 15;67(9):1330-1332. - PMID 29635545 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Background: Seasonal influenza infection may cause significant morbidity and mortality in transplant recipients. The purpose of this study was to assess the epidemiology of symptomatic influenza infection posttransplant and determine risk factors for severe disease | ||
| 520 | |a Methods: Twenty centers in the United States, Canada, and Spain prospectively enrolled solid organ transplant (SOT) or hematopoietic stem cell transplant (HSCT) recipients with microbiologically confirmed influenza over 5 consecutive years (2010-2015). Demographics, microbiology data, and outcomes were collected. Serial nasopharyngeal swabs were collected at diagnosis and upto 28 days, and quantitative polymerase chain reaction for influenza A was performed | ||
| 520 | |a Results: We enrolled 616 patients with confirmed influenza (477 SOT; 139 HSCT). Pneumonia at presentation was in 134 of 606 (22.1%) patients. Antiviral therapy was given to 94.1% for a median of 5 days (range, 1-42 days); 66.5% patients were hospitalized and 11.0% required intensive care unit (ICU) care. The receipt of vaccine in the same influenza season was associated with a decrease in disease severity as determined by the presence of pneumonia (odds ratio [OR], 0.34 [95% confidence interval {CI}, .21-.55], P < .001) and ICU admission (OR, 0.49 [95% CI, .26-.90], P = .023). Similarly, early antiviral treatment (within 48 hours) was associated with improved outcomes. In patients with influenza A, pneumonia, ICU admission, and not being immunized were also associated with higher viral loads at presentation (P = .018, P = .008, and P = .024, respectively) | ||
| 520 | |a Conclusions: Annual influenza vaccination and early antiviral therapy are associated with a significant reduction in influenza-associated morbidity, and should be emphasized as strategies to improve outcomes of transplant recipients | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 7 | |a Antiviral Agents |2 NLM | |
| 650 | 7 | |a Influenza Vaccines |2 NLM | |
| 700 | 1 | |a Ferreira, Victor H |e verfasserin |4 aut | |
| 700 | 1 | |a Blumberg, Emily |e verfasserin |4 aut | |
| 700 | 1 | |a Silveira, Fernanda |e verfasserin |4 aut | |
| 700 | 1 | |a Cordero, Elisa |e verfasserin |4 aut | |
| 700 | 1 | |a Perez-Romero, Pilar |e verfasserin |4 aut | |
| 700 | 1 | |a Aydillo, Teresa |e verfasserin |4 aut | |
| 700 | 1 | |a Danziger-Isakov, Lara |e verfasserin |4 aut | |
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| 700 | 1 | |a Sharma, Tanvi S |e verfasserin |4 aut | |
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