Julien Coussement

Julien Coussement
Peter MacCallum Cancer Centre · Department of Infectious Diseases

MD PhD

About

54
Publications
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686
Citations

Publications

Publications (54)
Article
Full-text available
Background: Nocardiosis is a rare, life-threatening opportunistic infection, affecting 0.04% to 3.5% of patients after solid organ transplantation (SOT). The aim of this study was to identify risk factors for Nocardia infection after SOT and to describe the presentation of nocardiosis in these patients. Methods: We performed a retrospective case...
Article
Full-text available
Background Solid organ transplant (SOT) recipients are at risk of nocardiosis, a rare opportunistic bacterial infection, but prognosis and outcome of these patients are poorly defined. Our objectives were to identify factors associated with one-year mortality after nocardiosis and describe the outcome of patients receiving short-course antibiotics...
Article
Full-text available
Background. Urinary tract infection is the commonest infection among kidney transplant recipients. Many transplant physicians fear that host compromise will allow low-virulence strains to cause pyelonephritis in kidney transplant recipients, so often treat asymptomatic bacteriuria with antibiotics. Identification of the host/microbe factor(s) that...
Article
Full-text available
Objectives: Many transplant physicians screen for and treat asymptomatic bacteriuria (ASB) during post-kidney transplant surveillance. We investigated whether antibiotics are effective in reducing the occurrence of symptomatic urinary tract infection (UTI) in kidney transplant recipients with ASB. Methods: We performed this multicentre, randomis...
Article
Full-text available
Background Nocardiosis is a rare infection that is often difficult to treat and may be life-threatening. There is no consensus on its management. Objectives To provide the current evidence for the diagnosis and management of individuals with nocardiosis, and to propose a management approach for this uncommon infection. Sources We systematically s...
Article
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Background The characteristics and outcomes of adult patients with respiratory syncytial virus (RSV) infection who require intensive care unit (ICU) admission are poorly defined. Although several studies in adults with RSV infection have been published in recent years, they did not focus specifically on critically ill patients. Research question W...
Article
The objectives of this study were to assess the immunogenicity and safety of COVID-19 vaccines in patients with haematological malignancy. A systematic review and meta-analysis of clinical studies of immune responses to COVID-19 vaccination stratified by underlying malignancy and published from 1 January 2021 to 31 August 2021 was conducted using M...
Preprint
The objectives of this study were to assess the immunogenicity and safety of COVID-19 vaccines in patients with haematological malignancy. A systematic review and meta-analysis of clinical studies of immune responses to COVID-19 vaccination stratified by underlying malignancy and published from 1 January 2021 to 31 August 2021 was conducted using M...
Article
Background: Nocardiosis is rare after hematopoietic cell transplantation (HCT). Little is known regarding its presentation, management, and outcome in this population. Methods: In this retrospective international study, we reviewed nocardiosis episodes in HCT recipients (01.01.2000-31.12.2018; 135 transplant centers; 33 countries) and described...
Article
Full-text available
Purpose of review: Brain nocardiosis is a rare but severe infection mostly occurring among immunocompromised patients. In this review, we present recent data on this infection and address some of the common clinical dilemmas encountered in patients with brain nocardiosis. Recent findings: Strategies used to approach a patient with suspected brai...
Article
Full-text available
There are scarce data on the efficacy of ertapenem in the treatment of bacteremia due to ESBL-producing Enterobacterales (ESBL-E) in kidney transplant (KT) recipients. We evaluated the association between treatment with ertapenem or meropenem and clinical cure in KT recipients with non-severe bacteremic urinary tract infections (B-UTI) caused by ES...
Article
Background and objectives High-intensity chemotherapy and advances in novel immunotherapies have seen the emergence of cytomegalovirus (CMV) infections in cancer patients other than allogeneic haematopoietic cell transplantation (HCT). We therefore aimed to evaluate the epidemiology, clinical characteristics, and outcomes of CMV infection in this p...
Article
Full-text available
Background Little is known regarding the optimal management of nocardiosis among solid organ transplant (SOT) recipients. It is often suggested to avoid trimethoprim/sulfamethoxazole (TMP-SMX) monotherapy in heavily immunocompromised patients (such as SOT recipients) and/or in case of severe or disseminated nocardiosis. Our aim was to report our ex...
Article
Full-text available
Purpose of review: This review aims to summarize available guidelines as well as the emerging evidence for the prevention and treatment of invasive fungal diseases in high-risk haematology patients. Recent findings: Primary mould-active prophylaxis is the strategy used in many centres to manage the risk of invasive fungal disease in high-risk haem...
Article
Background Whether active therapy with β‐lactam/β‐lactamase inhibitors (BLBLI) is as affective as carbapenems for extended‐spectrum β‐lactamase‐producing Enterobacterales (ESBL‐E) bloodstream infection (BSI) secondary to urinary tract infection (UTI) in kidney transplant recipients (KTR) remains unclear. Methods We retrospectively evaluated 306 KT...
Article
Full-text available
Purpose of review. Urinary tract infection (UTI) is the most common infection in kidney transplant recipients (KTRs). Several elements increase the risk of UTI and/or modify its clinical presentation among KTRs (e.g., immunosuppressive therapy, kidney allograft denervation, and use of urinary catheters). Also, KTRs may have UTIs due to difficult-t...
Article
Nocardiosis is a rare but potentially severe bacterial opportunistic infection that may occur after solid organ transplantation (SOT), typically among thoracic transplant recipients and/or in recipients with a high degree of immunosuppression due to anti‐rejection therapy [1]. However, nocardiosis may also occur late after transplantation among min...
Article
Full-text available
Background: During routine post-kidney transplant care, most European transplant physicians screen patients for asymptomatic bacteriuria. The usefulness of this strategy is debated. To make screening cost-effective, asymptomatic bacteriuria should be prevalent enough to justify the expense, and antibiotics should improve patient outcomes significa...
Article
Background: Scedosporium species and Lomentospora prolificans (S/L) are the second most common causes of invasive mold infections following Aspergillus in lung-transplant recipients. Methods: We assessed the current practices on management of S/L colonization/infection of the lower respiratory tract before and after lung transplantation in a lar...
Article
Background: There is no consensus on the optimal management of immunosuppression during bacterial infections among solid organ transplant recipients. Methods: A multicenter, cross-sectional survey, of high-volume kidney and liver transplant centers across US and Europe. Structured questionnaires including six multiple choice questions concerning...
Article
Introduction La nocardiose est une infection opportuniste grave qui touche de 0,04 à 3,5 % des greffés d’organe solide. Le cotrimoxazole (CMZ) en monothérapie semble être une option thérapeutique intéressante, compte tenu de son large spectre anti-Nocardia et de sa bonne diffusion tissulaire. L’objectif de notre étude était de décrire l’expérience...
Article
Full-text available
Background Transplant recipients are at risk of pulmonary nocardiosis, a life-threatening opportunistic infection caused by Nocardia species. Given the limitations of conventional diagnostic techniques (i.e., microscopy and culture), a polymerase chain reaction (PCR)-based assay was developed to detect Nocardia spp. on clinical samples. While this...
Article
Full-text available
BACKGROUND: The incidence of nosocomial infections due to carbapenem-resistant Klebsiella pneumoniae is increasing worldwide. Whole genome sequencing (WGS) can help elucidate the transmission route of nosocomial pathogens. METHODS: We combined WGS and epidemiological data to analyze an outbreak of NDM-producing K. pneumoniae that occurred in two B...
Article
Full-text available
We read with interest the recent paper by Molina and coworkers, who studied the relationship between anti-Pneumocystis prophylaxis and Nocardia infections in allogeneic hematopoietic stem cell transplant recipients. The authors concluded that the use of atovaquone may be associated with an increased risk of Nocardia infection after allogeneic hemat...
Article
Full-text available
Background. Asymptomatic bacteriuria is frequent in kidney transplant recipients (KTRs). However, there is no consensus on diagnosis or management. We conducted a European survey to explore current practice related to the diagnosis and management of asymptomatic bacteriuria in adult KTRs. Methods. A panel of experts from the European Renal Associa...
Article
Full-text available
BACKGROUND. Asymptomatic bacteriuria, defined as bacteriuria without signs or symptoms of urinary tract infection (UTI), occurs in 17% to 51% of kidney transplant recipients and is thought to increase the risk for a subsequent UTI. No consensus exists on the role of antibiotics for asymptomatic bacteriuria in kidney transplantation. OBJECTIVES:...
Article
Full-text available
Purpose of review: Nocardia spp. is a gram-positive bacteria that may cause infections in humans. Nocardiosis has been described since the early years of transplantation. This review aims to provide an overview of present knowledge regarding posttransplant nocardiosis, with a focus on recent findings. Recent findings: Nocardiosis is not rare amo...
Article
Objectives To assess the risk factors for the development of late-onset invasive pulmonary aspergillosis (IPA) after kidney transplantation (KT). Methods We performed a multinational case-control study that retrospectively recruited 112 KT recipients diagnosed with IPA between 2000 and 2013. Controls were matched (1:1 ratio) by center and date of...
Article
Full-text available
Risk factors for invasive pulmonary aspergillosis (IPA) after kidney transplantation (KT) have been poorly explored. We performed a multinational case-control study that included 51 KT recipients diagnosed with early (first 180 post-transplant days) IPA in 19 institutions between 2000 and 2013. Controls recipients were matched (1:1 ratio) by center...
Article
Screening for and treating asymptomatic bacteriuria is an old habit in many kidney transplantation centers. This strategy is largely driven by theoretical concerns, including the fact that symptoms of urinary tract infection may be impeded by graft denervation, the alteration of inflammatory signs by immunosuppressive medications and fear that rapi...
Article
Full-text available
The prognostic factors and optimal therapy for invasive pulmonary aspergillosis (IPA) after kidney transplantation (KT) remain poorly studied. We included in this multinational retrospective study 112 recipients diagnosed with probable (75.0% of cases) or proven (25.0%) IPA between 2000 and 2013. The median interval from transplantation to diagnosi...
Article
Full-text available
Background Therapeutic drug monitoring of mycophenolic acid (MPA) is usually performed with a limited sampling strategy (LSS), which relies on a limited number of blood samples and subsequent extrapolation of the global exposure to MPA. LSS is usually performed successfully with mycophenolate mofetil (MMF), but data on enteric-coated mycophenolate...
Article
Cytomegalovirus (CMV) pneumonitis occurs frequently among solid organ transplant recipients and is classically associated with significant viral replication in both blood and bronchoalveolar lavage (BAL) samples. We present a case of a 64-year-old lung transplant recipient who presented with CMV pneumonitis that was diagnosed based on the associati...
Chapter
Even if heart transplantation is an undisputed source of medical progress, several complications still hamper the outcome of transplanted patients. Among them, infections are associated with significant morbidity, mortality, and economic burden. Depending on clinical and radiological signs and based on the time interval after transplantation, a bro...
Article
This is the protocol for a review and there is no abstract. The objectives are as follows: To assess the benefits and harms of treating asymptomatic bacteriuria in kidney transplant recipients with antimicrobial agents to prevent symptomatic UTI, all-cause mortality and the indirect effects of UTI (acute rejection, graft loss, worsening of graft f...
Article
This is the protocol for a review and there is no abstract. The objectives are as follows: To assess the benefits and harms of treating asymptomatic bacteriuria in kidney transplant recipients with antimicrobial agents to prevent symptomatic UTI, all-cause mortality and the indirect effects of UTI (acute rejection, graft loss, worsening of graft fu...
Conference Paper
Objectives: Nocardia spp. are ubiquitous aerobic actinomycetes. Solid organ transplant recipients are at risk for Nocardia infections [1]. Identifying risk factors is of major interest in such patients, as this opportunistic infection is a rare but life-threatening event [2]. Only one case-control study has explored the risk factors for nocardiosis...
Article
Hyponatremia occurring as a result of the syndrome of inappropriate antidiuretic hormone secretion (SIADH) is a common and potentially lethal complication in critically ill patients. Urea, by inducing renal water excretion and promoting sodium (Na) retention, has been well described as a treatment for chronic SIADH. However, there are limited data...

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