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Infections after Heart Transplantation
A. O. Doesch
Transplantationsmedizin , 2011,
Abstract: A main goal in the follow-up of patients after heart-transplantation (HTX) is the prevention and effective treatment of infections, one of the most common life threatening complications of long-term immunosuppressive therapy [1] (Figure 1). After solid organ transplantation a certain pattern of infections can be observed [1] (Figure 2). This helps developing a differential diagnosis in transplant recipients who present with infectious diseases and establishing effective preventive strategies. However, infections after heart transplantation should not only be recognized as an isolated problem. Especially regarding the impact on long term outcome negative effects of infections on the immune status of the recipient and the development of malignancies or cardiac transplant vasculopathy (TVP) have to be considered as well.
Interleukin-15: its role in microbial infections
Bannwart, C.F.;Nakaira, E.T.;Sartori, A.;Pera?oli, M.T.S.;
Journal of Venomous Animals and Toxins including Tropical Diseases , 2007, DOI: 10.1590/S1678-91992007000300002
Abstract: interleukin-15 (il-15) is a pleiotropic cytokine which regulates the proliferation, survival and the secretory activities of many distinct cell types in the body. this cytokine is produced by macrophages and many other cell types in response to infectious agents; it controls growth and differentiation of t and b lymphocytes, activation of natural killer (nk) and phagocytic cells, and contributes to the homeostasis of the immune system. the present review focuses on the biological and modulatory effects of il-15 in microbial infections and shows that this cytokine may play a role in the host defense against infections by inducing activation of effector cells from both innate and adaptive immune system.
Fungal infections in the immunocompromised host
Wanke, Bodo;Lazéra, Márcia dos Santos;Nucci, Marcio;
Memórias do Instituto Oswaldo Cruz , 2000, DOI: 10.1590/S0074-02762000000700025
Abstract: in recent years many remarkable changes occurred in our way of life, producing opportunities for microbes. all these changes are related to the recent emergence of previously unrecognized diseases, or the resurgence of diseases that, at least in developed countries, were thought to be under control. this concept is reviewed regarding fungal infections and their agents in the immunocompromised host. the changing pattern of these infections, the portals of entry of fungi into the human host, fungal pathogenicity and the main predisposing factors are analyzed. opportunistic fungal infections in cancer, organ transplant and acquired immunodeficiency syndrome patients are reviewed, specially candidiasis and aspergillosis.
Fungal infections in the immunocompromised host  [cached]
Wanke Bodo,Lazéra Márcia dos Santos,Nucci Marcio
Memórias do Instituto Oswaldo Cruz , 2000,
Abstract: In recent years many remarkable changes occurred in our way of life, producing opportunities for microbes. All these changes are related to the recent emergence of previously unrecognized diseases, or the resurgence of diseases that, at least in developed countries, were thought to be under control. This concept is reviewed regarding fungal infections and their agents in the immunocompromised host. The changing pattern of these infections, the portals of entry of fungi into the human host, fungal pathogenicity and the main predisposing factors are analyzed. Opportunistic fungal infections in cancer, organ transplant and acquired immunodeficiency syndrome patients are reviewed, specially candidiasis and aspergillosis.
Opportunistic infections following renal transplantation  [cached]
Rao K,Jha R,Narayan G,Sinha S
Indian Journal of Medical Microbiology , 2002,
Abstract: Opportunistic infection is common following renal transplantation. Prompt diagnosis and management can be life saving. Four different types of opportunistic respiratory infections diagnosed at our center during the period of January 1998 to December 2000 are discussed. Of the four cases one had Aspergillus, second had Sporothrix, third had Nocardia and fourth case Actinomyces species. Microbiologist has an important role to play by being aware of such opportunistic infections and helping the clinician to make early aetiological diagnosis.
Microbial flora in orodental infections  [cached]
Saini S,Aparna,Gupta N,Mahajan A
Indian Journal of Medical Microbiology , 2003,
Abstract: The present study was carried out to compare the normal aerobic and anaerobic bacterial oral flora with flora from deep seated dental caries, gingivitis and adult periodontitis. All the samples belonging to both the control and study groups yielded microbes. Aerobe / Anaerobe ratio was high in normal flora (1.48) as compared to dental caries (0.9), gingivitis (0.72) and periodontitis (0.56). Ninety seven percent of orodental infections were polymicrobial and three or more microbes were found in 84% cases of study group as compared to 28% in controls. Streptococcus mutans and anaerobic lactobacilli were common in dental caries, Actinomyces and Peptostreptococcus spp. in gingivitis, Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis in periodontitis.
Infections Caused by Stenotrophomonas maltophilia in Recipients of Hematopoietic Stem Cell Transplantation  [PDF]
Khalid Ahmed Al-Anazi,Asma M. Al-Jasser
Frontiers in Oncology , 2014, DOI: 10.3389/fonc.2014.00232
Abstract: Stenotrophomonas maltophilia (S. maltophilia) is a globally emerging Gram-negative bacillus that is widely spread in environment and hospital equipment. Recently, the incidence of infections caused by this organism has increased, particularly in patients with hematological malignancy and in recipients of hematopoietic stem cell transplantation (HSCT) having neutropenia, mucositis, diarrhea, central venous catheters or graft versus host disease and receiving intensive cytotoxic chemotherapy, immunosuppressive therapy, or broad-spectrum antibiotics. The spectrum of infections in HSCT recipients includes pneumonia, urinary tract and surgical site infection, peritonitis, bacteremia, septic shock, and infection of indwelling medical devices. The organism exhibits intrinsic resistance to many classes of antibiotics including carbapenems, aminoglycosides, most of the third-generation cephalosporins, and other β-lactams. Despite the increasingly reported drug resistance, trimethoprim-sulfamethoxazole is still the drug of choice. However, the organism is still susceptible to ticarcillin-clavulanic acid, tigecycline, fluoroquinolones, polymyxin-B, and rifampicin. Genetic factors play a significant role not only in evolution of drug resistance but also in virulence of the organism. The outcome of patients having S. maltophilia infections can be improved by: using various combinations of novel therapeutic agents and aerosolized aminoglycosides or colistin, prompt administration of in vitro active antibiotics, removal of possible sources of infection such as infected indwelling intravascular catheters, and application of strict infection control measures.
Clinical Relevance of Natural Killer Cells Following Hematopoietic Stem Cell Transplantation  [cached]
Jeanne M Palmer, Kamalakannan Rajasekaran, Monica S Thakar, Subramaniam Malarkannan
Journal of Cancer , 2013,
Abstract: Natural killer (NK) cells are one of the first cells to recover following allogeneic hematopoietic stem cell transplantation (HSCT), and are believed to play an important role in facilitating engraftment or preventing post-transplant infection and tumor recurrence. Recent studies have provided novel insights into the mechanisms by which NK cells mediate these highly clinically relevant immunological functions. In particular, the ability of NK cells to reduce the risk of graft versus host disease (GVHD) and increase the graft versus leukemia effect (GVL) in the setting of human leukocyte antigen (HLA)-haploidentical HSCT highlights their clinical potentials. NK cells also mediate anti-viral protection, in particular against cytomegalovirus (CMV), an infection that causes significant morbidity and mortality following transplant. Another crucial function of NK cells is providing protection against bacterial infections at the mucosal barriers. NK cells achieve this by promoting anti-microbial defenses and regeneration of epithelial cells. These recent exciting findings provide a strong basis for the formulation of novel NK cell-based immunotherapies. In this review, we summarize the recent advances related to the mechanisms, functions, and future clinical prospects of NK cells that can impact post-transplant outcomes.
Host defence peptides: antimicrobial and immunomodulatory activity and potential applications for tackling antibiotic-resistant infections
A Nijnik,REW Hancock
Emerging Health Threats Journal , 2009, DOI: 10.3134/ehtj.09.001
Abstract: The rapidly increasing incidence of multidrug-resistant infections and the alarmingly low rate of discovery of conventional antibiotics create an urgent need for alternative strategies to treat bacterial infections. Host defence peptides are short cationic molecules produced by the immune systems of most multicellular organisms; they are a class of compounds being actively researched. In this review, we provide an overview of the antimicrobial and immunomodulatory activities of natural host defence peptides, and discuss strategies for creating artificial derivatives with improved biological and pharmacological properties, issues of microbial resistance, and challenges associated with their adaptation for clinical use.
Human herpesvirus 6 infections after liver transplantation  [cached]
Rima Camille Abdel Massih, Raymund R Razonable
World Journal of Gastroenterology , 2009,
Abstract: Human herpesvirus 6 (HHV-6) infections occur in > 95% of humans. Primary infection, which occurs in early childhood as an asymptomatic illness or manifested clinically as roseola infantum, leads to a state of subclinical viral persistence and latency. Reactivation of latent HHV-6 is common after liver transplantation, possibly induced and facilitated by allograft rejection and immunosuppressive therapy. Since the vast majority of humans harbor the virus in a latent state, HHV-6 infections after liver transplantation are believed to be mostly due to endogenous reactivation or superinfection (reactivation in the transplanted organ). In a minority of cases, however, primary HHV-6 infection may occur when an HHV-6 negative individual receives a liver allograft from an HHV-6 positive donor. The vast majority of documented HHV-6 infections after liver transplantation are asymptomatic. In a minority of cases, HHV-6 has been implicated as a cause of febrile illness with rash and myelosuppression, hepatitis, pneumonitis, and encephalitis after liver transplantation. In addition, HHV-6 has been associated with a variety of indirect effects such as allograft rejection, and increased predisposition and severity of other infections including cytomegalovirus (CMV), hepatitis C virus, and opportunistic fungi. Because of the uncommon nature of the clinical illnesses directly attributed to HHV-6, there is currently no recommended HHV-6-specific approach to prevention. However, ganciclovir and valganciclovir, which are primarily intended for the prevention of CMV disease, are also active against HHV-6 and may prevent its reactivation after transplantation. The treatment of established HHV-6 disease is usually with intravenous ganciclovir, cidofovir, or foscarnet, complemented by reduction in the degree of immunosuppression. This article reviews the current advances in the pathogenesis, clinical diagnosis, and therapeutic modalities against HHV6 in the setting of liver transplantation.
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