{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T12:10:25Z","timestamp":1790511025880,"version":"4.1.0"},"reference-count":26,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2014,7,21]],"date-time":"2014-07-21T00:00:00Z","timestamp":1405900800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2014,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Allogeneic hematopoietic stem cell transplantation (allo<jats:styled-content style=\"fixed-case\">HSCT<\/jats:styled-content>) recipients are at high risk of invasive pneumococcal disease (<jats:styled-content style=\"fixed-case\">IPD<\/jats:styled-content>). We investigated the incidence and risk factors of <jats:styled-content style=\"fixed-case\">IPD<\/jats:styled-content> in allo<jats:styled-content style=\"fixed-case\">HSCT<\/jats:styled-content> recipients from 4 regional transplant centers over an 11\u2010year period. This study aimed to inform future improvements in post\u2010transplant care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a retrospective nested 1:2 case\u2013control study in patients aged \u226518\u00a0years who underwent allo<jats:styled-content style=\"fixed-case\">HSCT<\/jats:styled-content> between 2001 and 2011 in 4 major allogeneic transplant centers. Controls were matched with <jats:styled-content style=\"fixed-case\">IPD<\/jats:styled-content> cases on the basis of conditioning intensity and donor relationship (related or unrelated). Demographics and clinical characteristics of cases and controls were summarized. Univariate analysis of risk factors in matched case\u2013control sets, and multivariate conditional logistic regression to control for confounding, were performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In 23 allo<jats:styled-content style=\"fixed-case\">HSCT<\/jats:styled-content> recipients, 26 <jats:styled-content style=\"fixed-case\">IPD<\/jats:styled-content> episodes were identified. The cumulative incidence over 11\u00a0years was 2.3% (95% confidence interval [<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>] 1.45\u20133.15) and the incidence density 956 per 100,000 transplant years of follow\u2010up (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 580\u20131321). Multivariate risk factor analysis and backwards elimination showed a significant positive association between mycophenolate mofetil (<jats:styled-content style=\"fixed-case\">MMF<\/jats:styled-content>), hyposplenism\/asplenia, and <jats:styled-content style=\"fixed-case\">IPD<\/jats:styled-content>, whereas trimethoprim\u2010sulfamethoxazole (<jats:styled-content style=\"fixed-case\">TMP<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">SMX<\/jats:styled-content>) prophylaxis for <jats:italic><jats:styled-content style=\"fixed-case\">P<\/jats:styled-content>neumocystis jirovecii<\/jats:italic> pneumonia (<jats:styled-content style=\"fixed-case\">PJP<\/jats:styled-content>) was associated with lower odds of <jats:styled-content style=\"fixed-case\">IPD<\/jats:styled-content> cases. Of allo<jats:styled-content style=\"fixed-case\">HSCT<\/jats:styled-content> recipients with <jats:styled-content style=\"fixed-case\">IPD<\/jats:styled-content>, 38.5% required intensive care, and, of deaths documented in cases over the period of review, 30% were attributable to <jats:styled-content style=\"fixed-case\">IPD<\/jats:styled-content>. Serotypes causing <jats:styled-content style=\"fixed-case\">IPD<\/jats:styled-content> matched currently available vaccines in 15\/22 (68.1%) episodes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The incidence of <jats:styled-content style=\"fixed-case\">IPD<\/jats:styled-content> in allo<jats:styled-content style=\"fixed-case\">HSCT<\/jats:styled-content> recipients is an important cause of morbidity and mortality, with rates of disease being many fold higher than the general population. Patients with evidence of hyposplenism\/asplenia define a high\u2010risk group in the allo<jats:styled-content style=\"fixed-case\">HSCT<\/jats:styled-content> population for <jats:styled-content style=\"fixed-case\">IPD<\/jats:styled-content>, and the independent association with <jats:styled-content style=\"fixed-case\">IPD<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">MMF<\/jats:styled-content> in the adjusted model from this study requires further evaluation. The occurrence of post\u2010transplant <jats:styled-content style=\"fixed-case\">IPD<\/jats:styled-content> may be reduced by measures such as vaccination with both 13\u2010valent and 23\u2010valent pneumococcal vaccines. <jats:styled-content style=\"fixed-case\">TMP<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">SMX<\/jats:styled-content> prophylaxis for the prevention of <jats:styled-content style=\"fixed-case\">PJP<\/jats:styled-content> may offer incidental protection against <jats:styled-content style=\"fixed-case\">IPD<\/jats:styled-content> in allo<jats:styled-content style=\"fixed-case\">HSCT<\/jats:styled-content> recipients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tid.12268","type":"journal-article","created":{"date-parts":[[2014,7,21]],"date-time":"2014-07-21T06:02:51Z","timestamp":1405922571000},"page":"751-759","source":"Crossref","is-referenced-by-count":40,"title":["Invasive pneumococcal disease following adult allogeneic hematopoietic stem cell transplantation"],"prefix":"10.1111","volume":"16","author":[{"given":"A.","family":"Torda","sequence":"first","affiliation":[{"name":"Faculty of Medicine University of New South Wales Randwick New South Wales Australia"},{"name":"Department of Infectious Diseases Prince of Wales Hospital Randwick New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Q.","family":"Chong","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of New South Wales Randwick New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Microbiology Royal Prince Alfred Hospital Camperdown New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Chen","sequence":"additional","affiliation":[{"name":"Centre for Infectious Diseases and Microbiology Laboratory Services ICPMR \u2013 Pathology West The University of Sydney Westmead Hospital Westmead New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Dodds","sequence":"additional","affiliation":[{"name":"Department of Hematology St Vincent's Hospital Darlinghurst New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Greenwood","sequence":"additional","affiliation":[{"name":"Department of Hematology Royal North Shore Hospital St Leonards New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Larsen","sequence":"additional","affiliation":[{"name":"Department of Hematology Royal Prince Alfred Hospital Camperdown New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Gilroy","sequence":"additional","affiliation":[{"name":"St Vincent's Hospital Sydney and BMT Network Agency for Clinical Innovation (ACI) Darlinghurst New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,7,21]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2008.11.024"},{"key":"e_1_2_6_3_1","volume-title":"The Australian Immunisation Handbook (13th edition 20)","author":"Australian Government Department of Health and Ageing","year":"2008"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2141.2002.03457.x"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/md.0b013e31803eb176"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bmt.1705964"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V95.12.3683"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bmt.1704870"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1080\/146532401753156403"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cit816"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2009.06.019"},{"issue":"2","key":"e_1_2_6_12_1","first-page":"E151","article-title":"Invasive pneumococcal disease in Australia 2007 and 2008","volume":"36","author":"Barry C","year":"2012","journal-title":"Commun Dis Intell"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annepidem.2006.05.007"},{"issue":"1","key":"e_1_2_6_14_1","first-page":"26","article-title":"EpiReview: invasive pneumococcal disease, NSW, 2002","volume":"16","author":"Gilmour R","year":"2005","journal-title":"N S W Public Health Bull"},{"issue":"4","key":"e_1_2_6_15_1","first-page":"505","article-title":"Invasive pneumococcal disease in Australia, 2001","volume":"26","author":"Roche P","year":"2002","journal-title":"Commun Dis Intell Q Rep"},{"issue":"4","key":"e_1_2_6_16_1","first-page":"466","article-title":"Invasive pneumococcal disease in Australia, 2002","volume":"27","author":"Roche P","year":"2003","journal-title":"Commun Dis Intell Q Rep"},{"issue":"4","key":"e_1_2_6_17_1","first-page":"441","article-title":"Invasive pneumococcal disease in Australia, 2003","volume":"28","author":"Roche P","year":"2004","journal-title":"Commun Dis Intell Q Rep"},{"issue":"1","key":"e_1_2_6_18_1","first-page":"80","article-title":"Invasive pneumococcal disease in Australia, 2004","volume":"30","author":"Roche PW","year":"2006","journal-title":"Commun Dis Intell Q Rep"},{"issue":"1","key":"e_1_2_6_19_1","first-page":"86","article-title":"Invasive pneumococcal disease in Australia, 2005","volume":"31","author":"Roche P","year":"2007","journal-title":"Commun Dis Intell Q Rep"},{"issue":"1","key":"e_1_2_6_20_1","first-page":"18","article-title":"Invasive pneumococcal disease in Australia, 2006","volume":"32","author":"Roche PW","year":"2008","journal-title":"Commun Dis Intell Q Rep"},{"key":"e_1_2_6_21_1","unstructured":"GottliebT CollignonP RobsonJ PearsonJ BellJ on behalf of The Australian Group for Antimicrobial Resistance.Antimicrobial Susceptibility Report of Streptococcus pneumoniae Isolates from the Australian Group on Antimicrobial Resistance (AGAR) 2007 Surveillance Report 2007. Available athttp:\/\/www.agargroup.org\/files\/SPNE%2007%20report%20final.pdf"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268810000919"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.164.20.2206"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2012.02.017"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2009.263"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1086\/598324"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2008.06.012"}],"container-title":["Transplant Infectious Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Ftid.12268","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tid.12268","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T10:23:35Z","timestamp":1695551015000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/tid.12268"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,7,21]]},"references-count":26,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2014,10]]}},"alternative-id":["10.1111\/tid.12268"],"URL":"https:\/\/doi.org\/10.1111\/tid.12268","archive":["Portico"],"relation":{},"ISSN":["1398-2273","1399-3062"],"issn-type":[{"value":"1398-2273","type":"print"},{"value":"1399-3062","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,7,21]]}}}