RESUMO
BACKGROUND: Cytomegalovirus (CMV) induces multi-organ pathogenesis in hematopoietic stem cell transplant (HSCT) and kidney transplant (KT) recipients. Effective management involves systematic monitoring for CMV reactivation by quantitative real-time PCR, allowing timely preemptive intervention. However, the optimal blood compartment for CMV surveillance remains undetermined. OBJECTIVE: The aim of the study was to compare the quantification of CMV DNA in paired plasma and whole blood samples. STUDY DESIGN: From June and October 2022, we conducted a prospective study with 390 sets of paired plasma and whole blood specimens collected from 60 HSCT and 24 KT recipients. CMV DNA levels were compared between the cobas® CMV assay on the automated cobas® 6800 system for plasma and the reference assay, Abbott RealTime CMV assay on the m2000 RealTime platform for whole blood. RESULTS: The sensitivity and specificity of CMV quantification in plasma using the cobas® CMV assay were 90.0 % (95 %CI: 81.5 to 95.9) and 94.8 % (95 %CI: 91.8 to 96.8), respectively, compared to whole blood quantification with the Abbott assay. The overall agreement between these two strategies was 0.89 (95 %CI: 0.86-0.91). In samples with quantifiable results, a correlation was observed between the two methods (R2 = 0.62, 95 %CI: 0.65-0.87, p < 0.0001). CMV loads were significantly higher in whole blood, with a mean bias of 0.42 log10 IU/mL (95 %CI: -0.32-1.15). CONCLUSION: The cobas® CMV assay in plasma showed significant concordance with the Abbott RealTime CMV assay in whole blood, confirming the relevance of plasma samples for CMV monitoring in HSCT and KT recipients.
RESUMO
BACKGROUND: Pasteurella spp. can lead to fatal infections in humans. OBJECTIVE: To assess prognostic factors of invasive pasteurellosis. METHODS: We conducted a single retrospective cohort study of local versus invasive Pasteurella infections from January 1, 2005, to December 31, 2018, in the Amiens-Picardie University Hospital, France. RESULTS: Forty-five (20.9%) invasive pasteurellosis and 22 (10.2%) complicated local infections were reported among a total of 215 Pasteurella infections. The mortality rate among invasive infections was 22.2% (10/ 45) whereas no death was recorded in local infections group. Non-drug-induced prothrombin time test <70% of standard and platelet counts <100,000/mm3 were more frequent in non-survivors than in survivors (p=0.005 and p=0.019) in univariate analyses. A history of neoplasia (adjusted OR=13.62, p=0.020), an evidence of bacteremia (adjusted OR=20.68, p=0.025), and hemoglobin level <10 g/dL (adjusted OR=17.80, p=0.028) were identified as poor prognostic factors in multivariate analyses. CONCLUSION: Invasive pasteurellosis appears as a serious disease in vulnerable patients, particularly if bacteremia and/or coagulopathies occur.