Oral Valganciclovir as Preemptive Therapy for Cytomegalovirus Reactivation in Pediatric Hematopoietic Stem Cell Transplant Patients.

Cytomegalovirus (CMV) infection is one of the most common complications after allogeneic hematopoietic stem cell transplantations (HSCT). Valganciclovir (VGC) has increasingly been used as prophylaxis against CMV infection after solid organ transplantation, but data on the efficacy and safety of VGC in pediatric HSCT patients are limited. We present our experience with VGC following ganciclovir (GCV) as preemptive therapy in pediatric HSCT patients. A total of 46 patients (38% patients) were found to be positive for CMV reactivation. Patients were treated with GCV (group I, n: 22) or GCV followed by VGC (GCV+VGC, group II, n: 24). VGC was preferred in the treatment of outpatients, whereas inpatients were treated with GCV. There was no significant difference in CMV clearance (P=0.78), treatment duration (P=0.087), and second CMV infection (P=0.3) between the 2 groups. The length of hospital stay was 21 days in GCV group, 14 days in VGC following GCV group (P=0.07). There were no treatment-related side effect in both groups. In conclusion, oral administration of VGC as preemptive therapy was found to be safe and effective. It is also a more suitable application for pediatric patients instead of an intravenous route. It could reduce the duration of inpatient stay and cost of hospitalization.

[Investigation of some virulence factors of Trichosporon asahii strains isolated from the clinical samples of hospitalized patients]. / Hastanede yatan hastalarin klinik orneklerinden izole edilen Trichosporon asahii suslarinda bazi virulans faktörlerinin arastirilmasi.

In this study, acid proteinase, phospholipase and esterase activities, slime production and hydrophobic properties of a total of 48 Trichosporon asahii strains isolated from urine (43), peritoneal fluid (1), tongue swab sample (1), blood (1), nephrostomy (1) and one saprophyte strain from nail sample, were investigated. In none of the 48 strains, acid proteinase and phospholipase activities could be detected, while all were found to be esterase positive. In hydrocarbon assay performed with n-hexadecane, four strains exhibited moderate hydrophobicity, while 43 strains showed low level hydrophobicity and one strain was found to be negative. In the second procedure to measure hydrophobicity by using microspheres assay, the results were found to differ among the strains, with the lowest and the highest values between 53.2% and 92.7%. Establishing the production of slime, modified tube assay was performed. Ten strains were found to be moderate producers (++), 18 strains were weakly positive (+) and 20 strains were defined as non-slime producers. Since the current data on virulence factors of T. asahii is insufficient already, these results may contribute to the present data in the literature.