Publications by authors named "Zachary Yetmar"
Background: Multiple outpatient therapies have been developed for COVID-19 in high-risk individuals, but solid organ transplant (SOT) recipients were not well represented in controlled clinical trials. To date, few comparative studies have evaluated outcomes between outpatient therapies in this population.
Methods: We performed a retrospective cohort study using de-identified administrative claims data from OptumLabs Data Warehouse.
: is an uncommon pathogen that has been reported to infect musculoskeletal structures. However, studies are largely limited to case reports, and little is known regarding management and outcomes of these infections. : We performed a multicenter retrospective cohort study of adults with culture-confirmed musculoskeletal infections at three Mayo Clinic centers in Arizona, Florida, and Minnesota from November 2011 through April 2022.
View Article and Find Full Text PDFBackground: Nocardia often causes pulmonary infection among those with chronic pulmonary disease or immunocompromising conditions. Trimethoprim-sulfamethoxazole (TMP-SMX) is recommended as first-line treatment, though little data exists regarding outcomes of different dosing regimens.
Methods: We performed a multicenter retrospective cohort study of adult patients with non-disseminated pulmonary nocardiosis initially treated with TMP-SMX monotherapy.
Background: A multitude of factors are considered in an infectious disease (ID) training program's meticulous selection process of ID fellows but their correlation to pre and in-fellowship academic success as well as post-fellowship academic success and short-term outcomes is poorly understood. Our goal was to investigate factors associated with subsequent academic success in fellowship as well as post-fellowship short-term outcomes.
Methods: In 2022, we retrospectively analyzed deidentified academic records from 39 graduates of the Mayo Clinic Rochester ID Fellowship Program (1 July 2013- 30 June 2022).
Article Synopsis
- Nocardiosis mainly affects immunocompromised patients and can recur, leading to secondary prophylaxis for those at high risk, yet data on its recurrence and prophylaxis effectiveness is limited.
- A study examined 303 adults diagnosed with nocardiosis from Nov 2011 to Apr 2022, focusing on those who completed primary treatment and had follow-up, using propensity score matching to analyze secondary prophylaxis effects.
- Results showed a low recurrence rate (5%) with recurrences mostly occurring shortly after treatment or years later, but secondary prophylaxis did not significantly reduce recurrence risk, suggesting that long-term antibiotics may not be necessary for everyone.
Background: Surgical-site infections (SSIs) are common in liver transplant recipients. The optimal SSI antimicrobial prophylaxis agent and duration are not established. We aimed to explore risk factors for SSIs after transplant, with a particular interest in the impact of perioperative antibiotic regimen on the development of SSIs.
View Article and Find Full Text PDFThe role of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) convalescent plasma in the treatment of Coronavirus Disease 2019 (COVID-19) in immunosuppressed individuals remains controversial. We describe the course of COVID-19 in patients who had received anti-CD20 therapy within the 3 years prior to infection. We compared outcomes between those treated with and those not treated with high titer SARS-CoV2 convalescent plasma.
View Article and Find Full Text PDFIntroduction: Gram-negative bacillary bloodstream infection (GN-BSI) is a frequent clinical challenge among immunocompromised hosts and is associated with a high mortality. The utility of follow-up blood cultures (FUBCs) for GN-BSI in this population, particularly in the setting of neutropenia, is poorly defined.
Methods: We conducted a single-center, retrospective cohort study between the period of July 2018 and April 2022 to investigate the utility of FUBCs and delineate risk factors for positive cultures among neutropenic patients with monomicrobial GN-BSI.
Article Synopsis
- A multicenter study examined the effects of adjunctive glucocorticoid therapy (AGT) on all-cause ICU admission and death rates among solid organ transplant recipients (SOTRs) with Pneumocystis jirovecii pneumonia (PJP) across several countries.
- The study included 172 SOTRs with an average age of 60, and found ICU admission rates at 43.4% and death rates at 20.8%.
- Results showed that AGT did not significantly lower the risk of ICU admission, death, or improve respiratory function, indicating a need to reconsider its routine use in PJP treatment for SOTRs and call for further research.
Background: Whether trimethoprim-sulfamethoxazole (TMP-SMX) prophylaxis prevents nocardiosis in solid organ transplant (SOT) recipients is controversial.
Objectives: To assess the effect of TMP-SMX in the prevention of nocardiosis after SOT, its dose-response relationship, its effect on preventing disseminated nocardiosis, and the risk of TMP-SMX resistance in case of breakthrough infection.
Methods: A systematic review and individual patient data meta-analysis.
Cytomegalovirus (CMV) is a common cause of infection after transplantation, but few studies have evaluated its epidemiology, risk factors, and outcomes among pancreas transplant recipients. We performed a retrospective cohort study of adults who underwent pancreas transplantation from January 1, 2010, through December 31, 2020, at 3 sites in Arizona, Florida, and Minnesota. The primary outcome was clinically significant CMV infection (csCMVi), defined as CMV disease or infection requiring antiviral therapy.
View Article and Find Full Text PDFIntroduction: Cytomegalovirus (CMV) causes significant morbidity in solid organ transplant recipients (SOTR). Measuring cell-mediated immunity (CMI) may inform the risk of CMV infection after antiviral prophylaxis and predict relapse after CMV treatment.
Methods: We serially assessed CMV CMI using the QuantiFERON-CMV assay (QF-CMV; Qiagen, Germantown, MD) in two cohorts of SOTRs: during valganciclovir prophylaxis and during treatment of CMV viremia.
Article Synopsis
- - Majocchi's granuloma (MG) is a rare fungal infection predominantly affecting hair follicles, often linked to previous use of immunosuppressants and corticosteroids, with case data coming from past reports due to its uncommon nature.
- - A study analyzed 147 adult patients over 30 years, revealing a median patient age of 55.6 years, with most patients being male, and Trichophyton species identified as the primary cause of MG.
- - Treatment typically involved a median duration of 31.5 days, primarily using oral terbinafine, leading to a successful clinical resolution in 96.6% of patients, although accurate diagnosis usually requires histopathologic confirmation.
Background: BK polyomavirus (BKV) infection is a common complication of kidney transplantation. While BKV has been described in non-kidney transplant recipients, data are limited regarding its epidemiology and outcomes in pancreas transplant recipients.
Methods: We conducted a retrospective cohort study of adults who underwent pancreas transplantation from 2010-2020.
The prevalence of invasive candidiasis caused by non- has rapidly increased. () is an important pathogen associated with substantial mortality. Our study examined the antifungal temporal susceptibility of and cross-resistance/non-wild-type patterns with other azoles and echinocandins.
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- Nocardiosis primarily affects immunocompromised patients and those with chronic lung diseases, with mixed findings regarding the impact of disseminated infections on outcomes.
- In a study of 511 adults, 31.3% had advanced infections and 15.8% died within a year; advanced infections were linked to higher mortality rates, while disseminated infections were not.
- The research suggests that factors like the Charlson Comorbidity Index and specific infection sites are more important for predicting mortality than the mere presence of disseminated infections, highlighting the need for further studies focusing on these aspects.
Background: A multitude of factors are considered in an infectious diseases (ID) training program's meticulous selection process of ID fellows but their correlation to pre and in-fellowship academic success as well as post-fellowship academic success and short-term outcomes is poorly understood. Our goal was to investigate factors associated with subsequent academic success in fellowship as well as post-fellowship short-term outcomes.
Methods: In 2022, we retrospectively analyzed deidentified academic records from 39 graduates of the Mayo Clinic Rochester ID Fellowship Program (July 1, 2013- June 30, 2022).
Posaconazole therapeutic drug monitoring (TDM) is widely utilized to assess therapeutic efficacy and safety; however, clinical effects of very high serum concentrations are unknown. A retrospective review of 90 patients receiving posaconazole for treatment or prophylaxis of invasive fungal infections with serum concentrations ≥3000 ng/mL from 1/1/2019 to 4/30/2021 evaluated the incidence and type of adverse drug reactions (ADRs). Symptomatic ADRs were very common in patients with posaconazole concentrations of ≥5000 ng/mL and 3000-4999 ng/mL (80% vs.
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- Pancreatic fungal infection (PFI) is a serious complication for patients with necrotizing pancreatitis, and its occurrence has risen in the past decade; this study investigates its clinical characteristics and outcomes in relation to bacterial infections and cases without infections.
- The research analyzed 225 patients who underwent interventions for necrotizing pancreatitis from 2005 to 2021, finding that almost half had PFI, with the risk of developing it being linked to a history of pancreatitis.
- Despite the high incidence of PFI, the study concluded that there were no significant differences in in-hospital outcomes or one-year survival rates among patients with PFI, bacterial infections, or no infections at all.
Article Synopsis
- Microalgae can lead to infections in humans, primarily causing a condition called protothecosis, which often appears as olecranon bursitis or localized soft tissue infections.
- The disease is especially concerning for immunocompromised individuals, who can experience more severe, widespread infections.
- This report details the experiences of 7 patients with infections connected to this microalgae at a single medical institution.
Background: Specific pretransplant infections have been associated with poor posttransplant outcomes. However, the impact of pretransplant Nocardia isolation has not been studied.
Methods: We performed a retrospective study from three centers in Arizona, Florida, and Minnesota of patients with Nocardia infection or colonization who subsequently underwent solid organ or hematopoietic stem cell transplantation from November 2011 through April 2022.
The literature regarding Clostridioides difficile infection (CDI) in left ventricular assist devices (LVADs) patients is limited. Therefore, we aimed to characterize the clinical course, risk factors, management, and outcomes of LVAD patients who developed CDI. Adult patients who underwent LVAD placement during 2010-2022 and developed CDI were included.
View Article and Find Full Text PDFNeutralizing antispike monoclonal antibody (mAb) therapies were highly efficacious in preventing coronavirus disease 2019 (COVID-19) hospitalization. While severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants may harbor spike protein mutations conferring reduced in vitro susceptibility to these antibodies, the effect of these mutations on clinical outcomes is not well characterized. We conducted a case-control study of solid organ transplant recipients who received an antispike mAb for treatment of mild-to-moderate COVID-19 and had an available sample from initial COVID-19 diagnosis for genotypic sequencing.
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