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Intra-host diversity of drug-resistant cytomegalovirus: A case report of cytomegalovirus infection after allogeneic hematopoietic cell transplantation.
Jung, Ji-Yoon; Nho, Dukhee; Cho, Sung-Yeon; Lee, Dong-Gun; Choi, Su-Mi; Kim, Hee-Je; Kim, Myungshin; Oh, Eun-Jee.
Afiliação
  • Jung JY; Catholic Medical Center, The Catholic University of Korea, Seoul, South Korea.
  • Nho D; Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
  • Cho SY; Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, South Korea; Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul, South Korea; Catholic Hematology Hospital, Seoul St. Mary's Hospi
  • Lee DG; Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, South Korea; Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul, South Korea; Catholic Hematology Hospital, Seoul St. Mary's Hospi
  • Choi SM; Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, South Korea; Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
  • Kim HJ; Catholic Hematology Hospital, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
  • Kim M; Department of Laboratory Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
  • Oh EJ; Department of Laboratory Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
J Infect Chemother ; 28(10): 1415-1418, 2022 Oct.
Article em En | MEDLINE | ID: mdl-35810104
Cytomegalovirus (CMV) is a major infectious agent causing severe complications in allogeneic hematopoietic cell transplantation (HCT) recipients, thereby warranting the need for aggressive preemptive or targeted antiviral therapy. However, prolonged or repeated use of antiviral agents, such as ganciclovir (GCV), foscarnet (FOS), and cidofovir (CDV), can result in drug-resistant CMV infection, posing challenges to successful outcomes. Here, we report a case of a patient with acute myeloid leukemia and drug-resistant CMV infection who presented with persistent CMV DNAemia, colitis, pneumonia, and encephalitis. An intra-host diversity of UL97 and UL54 mutations were detected through the genotypic resistance testing conducted on two blood samples (D+199 and D+224) and a cerebrospinal fluid (CSF) specimen (D+260) collected from the patient. UL97 L595W/L595F and L595W mutations were detected in the blood and CSF samples, respectively, that conferred GCV resistance. UL54 F412L mutation detected in all three samples conferred GCV/CDV resistance. However, the V787L mutation of UL54, conferring GCV/FOS resistance, was observed only in the D+224 blood sample. Despite combination therapy with FOS and high dose GCV and adjunctive therapy with leflunomide, the patient died from CMV infection and multiple organ failure on D+279. Further data on resistant mutations and intra-host diversity of CMV should be accumulated to elucidate the antiviral resistance and related outcomes.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Infecções por Citomegalovirus / Transplante de Células-Tronco Hematopoéticas Idioma: En Revista: J Infect Chemother Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Coréia do Sul

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Infecções por Citomegalovirus / Transplante de Células-Tronco Hematopoéticas Idioma: En Revista: J Infect Chemother Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Coréia do Sul