<i>Mycobacterium chelonae</i> necrotizing pneumonia after allogeneic hematopoietic stem cell transplant: report of clinical response to treatment with tigecycline

Peres, Edward; Khaled, Yasser; Krijanovski, Oleg I.; Mineishi, Shin; Levine, John E.; Kaul, Daniel; Riddell, James

doi:10.1111/j.1399-3062.2008.00351.x

Cited by 21 publications

(16 citation statements)

References 28 publications

(49 reference statements)

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“…Among three patients with M. abscessus infections and SOT, good clinical responses were seen with tigecycline-containing regimens including monotherapy in one case [15]. In a recent case report [16 ], a 34-year-old woman who underwent an antigenmatched allogenic-related SCT failed multidrug therapy but demonstrated some clinical improvement with four separate 6-week courses of tigecycline. However, despite these rare reports of improvement on tigecycline monotherapy, it should not be considered an appropriate treatment regimen.…”

Section: Treatment Of Nontuberculous Mycobacteria Infectionsmentioning

confidence: 93%

Nontuberculous mycobacterial disease in transplant recipients: early diagnosis and treatment

Daley

2009

Current Opinion in Organ Transplantation

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Recent studies have documented the protean nature of the clinical presentation of NTM infections in transplant recipients. These studies, as well as previously published reports, highlight the need for a high index of suspicion for clinicians when managing transplant patients with unexplained fever, cutaneous lesions, joint infections, or radiographic opacities. Early diagnosis of NTM infection and initiation of therapy are needed to prevent morbidity and mortality in this vulnerable population.

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Section: Treatment Of Nontuberculous Mycobacteria Infectionsmentioning

confidence: 93%

Nontuberculous mycobacterial disease in transplant recipients: early diagnosis and treatment

Daley

2009

Current Opinion in Organ Transplantation

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“…Pleuropulmonary infections in HSCT recipients are usually caused by slowly growing NTM species with MAC being the most frequently encountered species (5, 66, 69). Pulmonary infections account for about 30% of all infections caused by NTM in recipients of HSCT (5, 66).…”

Section: Pulmonary Infections Caused By Ntm In Hsct Recipientsmentioning

confidence: 99%

“…Pulmonary infections can be a complication of CVC-related NTM infections (8). They can present with lung nodules or necrotizing pneumonia (8, 69). Chest X-rays and CAT scans of lungs are essential diagnostically (4, 8, 65–67).…”

Section: Pulmonary Infections Caused By Ntm In Hsct Recipientsmentioning

confidence: 99%

“…However, additional therapies such as growth factors and non-steroidal anti-inflammatory drugs may be given to augment immunity of patients having NTM infections. Nevertheless, such additional therapies may not be effective (69). …”

Section: Treatment Of Ntm Infections In Recipients Of Hsctmentioning

confidence: 99%

“…Drug interactions between immunosuppressive agents such as cyclosporine-A and tacrolimus and various antimicrobials given to control NTM infections are real concerns as they have significant impact not only on control of the underlying infectious process but also on the outcome of HSCT (69, 74–76). …”

Section: Interactions Between Hsct Therapies and Antimicrobialsmentioning

confidence: 99%

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Infections Caused by Non-Tuberculous Mycobacteria in Recipients of Hematopoietic Stem Cell Transplantation

2014

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Non-tuberculous mycobacteria (NTM) are acid-fast bacteria that are ubiquitous in the environment and can colonize soil, dust particles, water sources, and food supplies. They are divided into rapidly growing mycobacteria such as Mycobacterium fortuitum, Mycobacterium chelonae, and Mycobacterium abscessus as well as slowly growing species such as Mycobacterium avium, Mycobacterium kansasii, and Mycobacterium marinum. About 160 different species, which can cause community acquired and health care-associated infections, have been identified. NTM are becoming increasingly recognized in recipients of hematopoietic stem cell transplantation (HSCT) with incidence rates ranging between 0.4 and 10%. These infections are 50–600 times commoner in transplant recipients than in the general population and the time of onset ranges from day 31 to day 1055 post-transplant. They have been reported following various forms of HSCT. Several risk factors predispose to NTM infections in recipients of stem cell transplantation and these are related to the underlying medical condition and its treatment, the pre-transplant conditioning therapies as well as the transplant procedure and its complications. Clinically, NTM may present with: unexplained fever, lymphadenopathy, osteomyelitis, soft tissue and skin infections, central venous catheter infections, bacteremia, lung, and gastrointestinal tract involvement. However, disseminated infections are commonly encountered in severely immunocompromised individuals and bloodstream infections are almost always associated with catheter-related infections. It is usually difficult to differentiate colonization from true infection, thus, the threshold for starting therapy remains undetermined. Respiratory specimens such as sputum, pleural fluid, and bronchoalveolar lavage in addition to cultures of blood, bone, skin, and soft tissues are essential diagnostically. Susceptibility testing of mycobacterial isolates is a basic component of optimal care. Currently, there are no guidelines for the treatment of NTM infections in recipients of stem cell transplantation, but such infections have been successfully treated with surgical debridement, removal of infected or colonized indwelling intravascular devices, and administration of various combinations of antimicrobials. Monotherapy can be associated with development of drug resistance due to new genetic mutation. The accepted duration of treatment is 9 months in allogeneic stem cell transplantation and 6 months in autologous setting. Unfortunately, eradication of NTM infections may be impossible and their treatment is often complicated by adverse effects and interactions with other transplant-related medication.

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New antimicrobial agents for the treatment of bacterial infections in cancer patients

Rolston

2009

Hematological Oncology

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Patients with cancer develop serious bacterial infections often, especially during periods of severe and prolonged neutropenia. Antibiotic usage for the prevention and treatment of bacterial infections in these high-risk patients leads to selection pressures resulting in the emergence and spread of resistant organisms. Many organisms acquire several resistance mechanisms, making them multi-drug-resistant (MDR) (defined as resistance to three or more different classes of antibiotics). These infections are associated with increased morbidity, mortality and costs. The development of novel antimicrobial agents with activity against pathogens that have become resistant to currently available agents is one strategy for combating resistant organisms. Several novel agents have either recently been approved, or are in various stages of development and are discussed in detail. It is unlikely that these agents will have a major impact on reducing the development and spread of MDR organisms. Consequently, the judicious use of currently available agents referred to as Antimicrobial Stewardship, and the development of and adherence to appropriate Infection Control policies and procedures are vital components in the management of these high-risk patients.

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Mycobacterium chelonae necrotizing pneumonia after allogeneic hematopoietic stem cell transplant: report of clinical response to treatment with tigecycline

Cited by 21 publications

References 28 publications

Nontuberculous mycobacterial disease in transplant recipients: early diagnosis and treatment

Nontuberculous mycobacterial disease in transplant recipients: early diagnosis and treatment

Infections Caused by Non-Tuberculous Mycobacteria in Recipients of Hematopoietic Stem Cell Transplantation

New antimicrobial agents for the treatment of bacterial infections in cancer patients

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