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. 2024 Dec;26(6):e14382.
doi: 10.1111/tid.14382. Epub 2024 Sep 28.

Efficacy and safety of a preventive strategy against tuberculosis in liver transplantation recipients including the treatment of latent infection with moxifloxacin

Marina Fayos  1 , Jose Tiago Silva  1   2   3 , Mario Fernández-Ruiz  1   3   4 , Tamara Ruiz-Merlo  1 , Alessandro Visentin  5 , Carmelo Loinaz  6 , Alejandro Manrique-Municio  6 , José María Caso  1 , Jesús González-Olmedo  1 , Isabel Rodríguez-Góncer  1   4 , Francisco López-Medrano  1   3   4 , Carlos Lumbreras  3   7 , José María Aguado  1   3   4 , Rafael San-Juan  1   3   4
Affiliations

Efficacy and safety of a preventive strategy against tuberculosis in liver transplantation recipients including the treatment of latent infection with moxifloxacin

Marina Fayos et al. Transpl Infect Dis. 2024 Dec.

Abstract

Background: Preventive management of tuberculosis in liver transplantation (LT) is challenging due to difficulties in detecting and treating latent tuberculosis infection (LTBI). The aim of this study was to analyze the safety and efficacy of a screening strategy for LTBI with the inclusion of moxifloxacin as treatment.

Methods: We performed a retrospective single-center study of all LTs performed between 2016 and 2019 with a minimum 4-year follow-up and a standardized protocol for the evaluation of LTBI.

Results: Pretransplant LTBI screening was performed in 191/218 (87.6%) patients, and LTBI was diagnosed in 27.2% of them. Treatment for LTBI was administered to 71.2% of the patients and included moxifloxacin in 75.6% of the cases. After a median follow-up of 1628 days, no cases of active tuberculosis occurred among moxifloxacin-treated patients. The incidence of Clostridioides difficile (0.46 vs. 0.38 episodes/1000 transplant-days; p = .8) and multidrug-resistant gram-negative bacilli infection (0 vs. 0.7 episodes per 1000 transplant-days; p = .08) were not significantly higher in comparison to patients who did not receive moxifloxacin.

Conclusion: A preventive strategy based on systematic LTBI screening and moxifloxacin treatment before LT in positive cases appears safe and effective in preventing the development of tuberculosis in LT recipients. However, our findings are limited by a small sample size; thus, larger studies are required to validate our observations.

Keywords: Clostridioides difficile infection; antimicrobial prescription; latent tuberculosis infection; liver transplantation; moxifloxacin; multidrug‐resistant bacteria; tuberculosis.

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References

REFERENCES

    1. Meije Y, Piersimoni C, Torre‐Cisneros J, Dilektasli AG, Aguado JM; Hosts ESGoIiC. Mycobacterial infections in solid organ transplant recipients. Clin Microbiol Infect. 2014;20(Suppl 7):89‐101.
    1. Abad CLR, Razonable RR. Mycobacterium tuberculosis after solid organ transplantation: a review of more than 2000 cases. Clin Transplant. 2018;32(6):e13259.
    1. Epstein DJ, Subramanian AK. Prevention and management of tuberculosis in solid organ transplant recipients. Infect Dis Clin North Am. 2018;32(3):703‐718.
    1. Bosch A, Valour F, Dumitrescu O, et al. A practical approach to tuberculosis diagnosis and treatment in liver transplant recipients in a low‐prevalence area. Med Mal Infect. 2019;49(4):231‐240.
    1. Santoro‐Lopes G, Subramanian AK, Molina I, Aguado JM, Rabagliatti R, Len O. Tuberculosis recommendations for solid organ transplant recipients and donors. Transplantation. 2018;102(2S Suppl 2):S60‐S65.

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