tetano
Editor, Senior Moderator
Transplantation. 2010 Oct 1. [Epub ahead of print]
Pandemic Influenza A/H1N1 Virus Infection in Solid Organ Transplant Recipients: A Multicenter Study.
Smud A, Nagel CB, Madsen E, Rial MD, Barc?n LA, Gomez AA, Martinoia AG, Bangher MC, Altclas JD, Salgueira CC, Temporiti E, Bonvehi PE, Enriquez N, Efron ED, Bibolini JE, Lattes R.
1Infectious Disease Section, Internal Medicine, Hospital Italiano, Buenos Aires, Argentina. 2Department of Epidemiology and Infectious Diseases, Hospital Universitario de la Fundaci?n Favaloro, Buenos Aires, Argentina. 3Kidney Transplant Unit, Instituto de Nefrolog?a Nephrology, Buenos Aires, Argentina. 4Infectious Disease Section, Clinica de Nefrologia, Urologia y Enfermedades Cardiovasculares, Santa Fe, Argentina. 5Kidney Transplant Unit - HIGA San Mart?n, CUCAIBA, La Plata, Buenos Aires, Argentina. 6Infectious Disease Unit, Instituto de Cardiolog?a de Corrientes J F Cabral, Corrientes, Argentina. 7Infectious Disease and Infection Control Unit, Sanatorio Trinidad Mitre, Buenos Aires, Argentina. 8Infectious Disease Section, Department of Internal Medicine, CEMIC (Centro de Educaci?n M?dica e Investigaciones Cl?nicas), Buenos Aires, Argentina. 9Infectious Disease Unit - Hospital Brit?nico, Buenos Aires, Argentina. 10Infectious Disease and Infection Control Unit, Department of Clinical Management, Hospital de Alta Complejidad Presidente Juan D Per?n, Formosa, Argentina. 11Infectious Disease Unit, Department of Transplantation, Instituto de Nefrolog?a Nephrology, Buenos Aires, Argentina.
Abstract
BACKGROUND.: The 2009 novel influenza A/H1N1 virus pandemic did not spare solid organ transplant (SOT) recipients. We aimed to describe the behavior of pandemic influenza infection in a group of SOT recipients in Argentina. METHODS.: Data from 10 transplant (Tx) centers were retrospectively collected for SOT that presented with a respiratory illness compatible with pandemic influenza A infection, between May and September 2009. Cases were defined as suspected, probable, or confirmed according to diagnostic method. RESULTS.: Seventy-seven cases were included. No significant differences in presenting symptoms, pulmonary infiltrates, and graft involvement were found among 35 suspected, 19 probable, and 23 confirmed cases. The 33 ambulatory cases had significantly more sore throat and headache when compared with 34 cases admitted to medical ward (MW) and 10 admitted to intensive care unit (ICU), 9 of whom required ventilatory support. MW and ICU cases had significantly more dyspnea, hypoxemia, pulmonary infiltrates, and graft dysfunction. Time from onset of symptoms to first visit and to treatment was significantly longer in MW and ICU cases (P=0.008). Coinfections were found in six cases. Most cases received oseltamivir for 5 to 10 days. Six patients (7.8%) died from viral infection at a median of 15 days from admission. No differences in outcome were seen related to the transplanted organ, the immunosuppressive regimen, time from Tx, or confirmation of diagnosis. CONCLUSIONS.: Mortality is higher in Tx recipients than in the general population. Poor outcome seems to be related to a delay in the beginning of treatment.
PMID: 20921933 [PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/20921933
Pandemic Influenza A/H1N1 Virus Infection in Solid Organ Transplant Recipients: A Multicenter Study.
Smud A, Nagel CB, Madsen E, Rial MD, Barc?n LA, Gomez AA, Martinoia AG, Bangher MC, Altclas JD, Salgueira CC, Temporiti E, Bonvehi PE, Enriquez N, Efron ED, Bibolini JE, Lattes R.
1Infectious Disease Section, Internal Medicine, Hospital Italiano, Buenos Aires, Argentina. 2Department of Epidemiology and Infectious Diseases, Hospital Universitario de la Fundaci?n Favaloro, Buenos Aires, Argentina. 3Kidney Transplant Unit, Instituto de Nefrolog?a Nephrology, Buenos Aires, Argentina. 4Infectious Disease Section, Clinica de Nefrologia, Urologia y Enfermedades Cardiovasculares, Santa Fe, Argentina. 5Kidney Transplant Unit - HIGA San Mart?n, CUCAIBA, La Plata, Buenos Aires, Argentina. 6Infectious Disease Unit, Instituto de Cardiolog?a de Corrientes J F Cabral, Corrientes, Argentina. 7Infectious Disease and Infection Control Unit, Sanatorio Trinidad Mitre, Buenos Aires, Argentina. 8Infectious Disease Section, Department of Internal Medicine, CEMIC (Centro de Educaci?n M?dica e Investigaciones Cl?nicas), Buenos Aires, Argentina. 9Infectious Disease Unit - Hospital Brit?nico, Buenos Aires, Argentina. 10Infectious Disease and Infection Control Unit, Department of Clinical Management, Hospital de Alta Complejidad Presidente Juan D Per?n, Formosa, Argentina. 11Infectious Disease Unit, Department of Transplantation, Instituto de Nefrolog?a Nephrology, Buenos Aires, Argentina.
Abstract
BACKGROUND.: The 2009 novel influenza A/H1N1 virus pandemic did not spare solid organ transplant (SOT) recipients. We aimed to describe the behavior of pandemic influenza infection in a group of SOT recipients in Argentina. METHODS.: Data from 10 transplant (Tx) centers were retrospectively collected for SOT that presented with a respiratory illness compatible with pandemic influenza A infection, between May and September 2009. Cases were defined as suspected, probable, or confirmed according to diagnostic method. RESULTS.: Seventy-seven cases were included. No significant differences in presenting symptoms, pulmonary infiltrates, and graft involvement were found among 35 suspected, 19 probable, and 23 confirmed cases. The 33 ambulatory cases had significantly more sore throat and headache when compared with 34 cases admitted to medical ward (MW) and 10 admitted to intensive care unit (ICU), 9 of whom required ventilatory support. MW and ICU cases had significantly more dyspnea, hypoxemia, pulmonary infiltrates, and graft dysfunction. Time from onset of symptoms to first visit and to treatment was significantly longer in MW and ICU cases (P=0.008). Coinfections were found in six cases. Most cases received oseltamivir for 5 to 10 days. Six patients (7.8%) died from viral infection at a median of 15 days from admission. No differences in outcome were seen related to the transplanted organ, the immunosuppressive regimen, time from Tx, or confirmation of diagnosis. CONCLUSIONS.: Mortality is higher in Tx recipients than in the general population. Poor outcome seems to be related to a delay in the beginning of treatment.
PMID: 20921933 [PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/20921933