GrippeEspagneV1, Main, Exploration, bibRecord, 000082

A 5-Year Prospective Multicenter Evaluation of Influenza Infection in Transplant Recipients.

Identifieur interne : 000082 ( Main/Exploration ); précédent : 000081; suivant : 000083

A 5-Year Prospective Multicenter Evaluation of Influenza Infection in Transplant Recipients.

Auteurs : Deepali Kumar [Canada] ; Victor H. Ferreira [Canada] ; Emily Blumberg [États-Unis] ; Fernanda Silveira [États-Unis] ; Elisa Cordero [Espagne] ; Pilar Perez-Romero [Espagne] ; Teresa Aydillo [Espagne] ; Lara Danziger-Isakov [États-Unis] ; Ajit P. Limaye [États-Unis] ; Jordi Carratala [Espagne] ; Patricia Munoz [Espagne] ; Miguel Montejo [Espagne] ; Francisco Lopez-Medrano [Espagne] ; Maria Carmen Farinas [Espagne] ; Joan Gavalda [Espagne] ; Asuncion Moreno [Espagne] ; Marilyn Levi ; Jesus Fortun [Espagne] ; Julian Torre-Cisneros [Espagne] ; Janet A. Englund [États-Unis] ; Yoichiro Natori [Canada] ; Shahid Husain [Canada] ; Gail Reid [États-Unis] ; Tanvi S. Sharma [États-Unis] ; Atul Humar [Canada]

Source :

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America [ 1537-6591 ] ; 2018.

RBID : pubmed:29635437

Descripteurs français

KwdFr :
- Adolescent (MeSH), Adulte (MeSH), Adulte d'âge moyen (MeSH), Antiviraux (usage thérapeutique), Canada (épidémiologie), Enfant (MeSH), Enfant d'âge préscolaire (MeSH), Espagne (épidémiologie), Facteurs de risque (MeSH), Femelle (MeSH), Grippe humaine (traitement médicamenteux), Grippe humaine (épidémiologie), Hospitalisation (statistiques et données numériques), Humains (MeSH), Jeune adulte (MeSH), Mâle (MeSH), Nourrisson (MeSH), Receveurs de transplantation (MeSH), Sujet âgé (MeSH), Sujet âgé de 80 ans ou plus (MeSH), Vaccination (MeSH), Vaccins antigrippaux (usage thérapeutique), États-Unis (épidémiologie), Études prospectives (MeSH).
MESH :
- statistiques et données numériques : Hospitalisation.
- traitement médicamenteux : Grippe humaine.
- usage thérapeutique : Antiviraux, Vaccins antigrippaux.
- épidémiologie : Canada, Espagne, Grippe humaine, États-Unis.
- Adolescent, Adulte, Adulte d'âge moyen, Enfant, Enfant d'âge préscolaire, Facteurs de risque, Femelle, Humains, Jeune adulte, Mâle, Nourrisson, Receveurs de transplantation, Sujet âgé, Sujet âgé de 80 ans ou plus, Vaccination, Études prospectives.
Wicri :
- geographic : Canada, Espagne, États-Unis.

English descriptors

KwdEn :
- Adolescent (MeSH), Adult (MeSH), Aged (MeSH), Aged, 80 and over (MeSH), Antiviral Agents (therapeutic use), Canada (epidemiology), Child (MeSH), Child, Preschool (MeSH), Female (MeSH), Hospitalization (statistics & numerical data), Humans (MeSH), Infant (MeSH), Influenza Vaccines (therapeutic use), Influenza, Human (drug therapy), Influenza, Human (epidemiology), Male (MeSH), Middle Aged (MeSH), Prospective Studies (MeSH), Risk Factors (MeSH), Spain (epidemiology), Transplant Recipients (MeSH), United States (epidemiology), Vaccination (MeSH), Young Adult (MeSH).
MESH :
- chemical , therapeutic use : Antiviral Agents, Influenza Vaccines.
- geographic , epidemiology : Canada, Spain, United States.
- drug therapy : Influenza, Human.
- epidemiology : Influenza, Human.
- statistics & numerical data : Hospitalization.
- Adolescent, Adult, Aged, Aged, 80 and over, Child, Child, Preschool, Female, Humans, Infant, Male, Middle Aged, Prospective Studies, Risk Factors, Transplant Recipients, Vaccination, Young Adult.

Abstract

Background

Seasonal influenza infection may cause significant morbidity and mortality in transplant recipients. The purpose of this study was to assess the epidemiology of symptomatic influenza infection posttransplant and determine risk factors for severe disease.

Methods

Twenty centers in the United States, Canada, and Spain prospectively enrolled solid organ transplant (SOT) or hematopoietic stem cell transplant (HSCT) recipients with microbiologically confirmed inﬂuenza over 5 consecutive years (2010-2015). Demographics, microbiology data, and outcomes were collected. Serial nasopharyngeal swabs were collected at diagnosis and upto 28 days, and quantitative polymerase chain reaction for influenza A was performed.

Results

We enrolled 616 patients with confirmed influenza (477 SOT; 139 HSCT). Pneumonia at presentation was in 134 of 606 (22.1%) patients. Antiviral therapy was given to 94.1% for a median of 5 days (range, 1-42 days); 66.5% patients were hospitalized and 11.0% required intensive care unit (ICU) care. The receipt of vaccine in the same influenza season was associated with a decrease in disease severity as determined by the presence of pneumonia (odds ratio [OR], 0.34 [95% confidence interval {CI}, .21-.55], P < .001) and ICU admission (OR, 0.49 [95% CI, .26-.90], P = .023). Similarly, early antiviral treatment (within 48 hours) was associated with improved outcomes. In patients with influenza A, pneumonia, ICU admission, and not being immunized were also associated with higher viral loads at presentation (P = .018, P = .008, and P = .024, respectively).

Conclusions

Annual influenza vaccination and early antiviral therapy are associated with a significant reduction in influenza-associated morbidity, and should be emphasized as strategies to improve outcomes of transplant recipients.

DOI: 10.1093/cid/ciy294
PubMed: 29635437

Affiliations:

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Le document en format XML

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<author><name sortKey="Danziger Isakov, Lara" sort="Danziger Isakov, Lara" uniqKey="Danziger Isakov L" first="Lara" last="Danziger-Isakov">Lara Danziger-Isakov</name>
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<wicri:cityArea>Pediatric Infectious Diseases, Cincinnati Children's Hospital Medical Center</wicri:cityArea>
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<author><name sortKey="Limaye, Ajit P" sort="Limaye, Ajit P" uniqKey="Limaye A" first="Ajit P" last="Limaye">Ajit P. Limaye</name>
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<author><name sortKey="Carratala, Jordi" sort="Carratala, Jordi" uniqKey="Carratala J" first="Jordi" last="Carratala">Jordi Carratala</name>
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<author><name sortKey="Munoz, Patricia" sort="Munoz, Patricia" uniqKey="Munoz P" first="Patricia" last="Munoz">Patricia Munoz</name>
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<author><name sortKey="Montejo, Miguel" sort="Montejo, Miguel" uniqKey="Montejo M" first="Miguel" last="Montejo">Miguel Montejo</name>
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<author><name sortKey="Lopez Medrano, Francisco" sort="Lopez Medrano, Francisco" uniqKey="Lopez Medrano F" first="Francisco" last="Lopez-Medrano">Francisco Lopez-Medrano</name>
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<author><name sortKey="Farinas, Maria Carmen" sort="Farinas, Maria Carmen" uniqKey="Farinas M" first="Maria Carmen" last="Farinas">Maria Carmen Farinas</name>
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<author><name sortKey="Gavalda, Joan" sort="Gavalda, Joan" uniqKey="Gavalda J" first="Joan" last="Gavalda">Joan Gavalda</name>
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<wicri:regionArea>Hospital Vall d'Hebron</wicri:regionArea>
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<author><name sortKey="Moreno, Asuncion" sort="Moreno, Asuncion" uniqKey="Moreno A" first="Asuncion" last="Moreno">Asuncion Moreno</name>
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<author><name sortKey="Levi, Marilyn" sort="Levi, Marilyn" uniqKey="Levi M" first="Marilyn" last="Levi">Marilyn Levi</name>
<affiliation><nlm:affiliation>Division of Infectious Diseases, University of Colorado Hospital, Aurora.</nlm:affiliation>
<wicri:noCountry code="subField">Aurora</wicri:noCountry>
</affiliation>
</author>
<author><name sortKey="Fortun, Jesus" sort="Fortun, Jesus" uniqKey="Fortun J" first="Jesus" last="Fortun">Jesus Fortun</name>
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<country>Espagne</country>
<placeName><settlement type="city">Madrid</settlement>
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</placeName>
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<author><name sortKey="Torre Cisneros, Julian" sort="Torre Cisneros, Julian" uniqKey="Torre Cisneros J" first="Julian" last="Torre-Cisneros">Julian Torre-Cisneros</name>
<affiliation wicri:level="1"><nlm:affiliation>Hospital Universitario Reina Sofía, Cordoba, Spain.</nlm:affiliation>
<country xml:lang="fr">Espagne</country>
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<author><name sortKey="Englund, Janet A" sort="Englund, Janet A" uniqKey="Englund J" first="Janet A" last="Englund">Janet A. Englund</name>
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<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Washington (État)</region>
</placeName>
<wicri:cityArea>Pediatric Infectious Diseases, Seattle Children's Hospital</wicri:cityArea>
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</author>
<author><name sortKey="Natori, Yoichiro" sort="Natori, Yoichiro" uniqKey="Natori Y" first="Yoichiro" last="Natori">Yoichiro Natori</name>
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<country xml:lang="fr">Canada</country>
<wicri:regionArea>Transplant Infectious Diseases and Multi-Organ Transplant Program, University Health Network, Toronto, Ontario</wicri:regionArea>
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</affiliation>
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<author><name sortKey="Husain, Shahid" sort="Husain, Shahid" uniqKey="Husain S" first="Shahid" last="Husain">Shahid Husain</name>
<affiliation wicri:level="1"><nlm:affiliation>Transplant Infectious Diseases and Multi-Organ Transplant Program, University Health Network, Toronto, Ontario, Canada.</nlm:affiliation>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>Transplant Infectious Diseases and Multi-Organ Transplant Program, University Health Network, Toronto, Ontario</wicri:regionArea>
<wicri:noRegion>Ontario</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Reid, Gail" sort="Reid, Gail" uniqKey="Reid G" first="Gail" last="Reid">Gail Reid</name>
<affiliation wicri:level="2"><nlm:affiliation>Division of Infectious Diseases, Loyola University Medical Center, Chicago, Illinois.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Illinois</region>
</placeName>
<wicri:cityArea>Division of Infectious Diseases, Loyola University Medical Center, Chicago</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Sharma, Tanvi S" sort="Sharma, Tanvi S" uniqKey="Sharma T" first="Tanvi S" last="Sharma">Tanvi S. Sharma</name>
<affiliation wicri:level="2"><nlm:affiliation>Pediatric Infectious Diseases, Boston Children's Hospital, Massachusetts.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Massachusetts</region>
</placeName>
<wicri:cityArea>Pediatric Infectious Diseases, Boston Children's Hospital</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Humar, Atul" sort="Humar, Atul" uniqKey="Humar A" first="Atul" last="Humar">Atul Humar</name>
<affiliation wicri:level="1"><nlm:affiliation>Transplant Infectious Diseases and Multi-Organ Transplant Program, University Health Network, Toronto, Ontario, Canada.</nlm:affiliation>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>Transplant Infectious Diseases and Multi-Organ Transplant Program, University Health Network, Toronto, Ontario</wicri:regionArea>
<wicri:noRegion>Ontario</wicri:noRegion>
</affiliation>
</author>
</titleStmt>
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<sourceDesc><biblStruct><analytic><title xml:lang="en">A 5-Year Prospective Multicenter Evaluation of Influenza Infection in Transplant Recipients.</title>
<author><name sortKey="Kumar, Deepali" sort="Kumar, Deepali" uniqKey="Kumar D" first="Deepali" last="Kumar">Deepali Kumar</name>
<affiliation wicri:level="1"><nlm:affiliation>Transplant Infectious Diseases and Multi-Organ Transplant Program, University Health Network, Toronto, Ontario, Canada.</nlm:affiliation>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>Transplant Infectious Diseases and Multi-Organ Transplant Program, University Health Network, Toronto, Ontario</wicri:regionArea>
<wicri:noRegion>Ontario</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Ferreira, Victor H" sort="Ferreira, Victor H" uniqKey="Ferreira V" first="Victor H" last="Ferreira">Victor H. Ferreira</name>
<affiliation wicri:level="1"><nlm:affiliation>Transplant Infectious Diseases and Multi-Organ Transplant Program, University Health Network, Toronto, Ontario, Canada.</nlm:affiliation>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>Transplant Infectious Diseases and Multi-Organ Transplant Program, University Health Network, Toronto, Ontario</wicri:regionArea>
<wicri:noRegion>Ontario</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Blumberg, Emily" sort="Blumberg, Emily" uniqKey="Blumberg E" first="Emily" last="Blumberg">Emily Blumberg</name>
<affiliation wicri:level="3"><nlm:affiliation>Division of Infectious Diseases, University of Pennsylvania, Philadelphia.</nlm:affiliation>
<country>États-Unis</country>
<placeName><settlement type="city">Philadelphie</settlement>
<region type="state">Pennsylvanie</region>
</placeName>
<wicri:orgArea>Division of Infectious Diseases, University of Pennsylvania</wicri:orgArea>
</affiliation>
</author>
<author><name sortKey="Silveira, Fernanda" sort="Silveira, Fernanda" uniqKey="Silveira F" first="Fernanda" last="Silveira">Fernanda Silveira</name>
<affiliation wicri:level="2"><nlm:affiliation>Division of Infectious Diseases, University of Pittsburgh Medical Center, Pennsylvania.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Pennsylvanie</region>
</placeName>
<wicri:cityArea>Division of Infectious Diseases, University of Pittsburgh Medical Center</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Cordero, Elisa" sort="Cordero, Elisa" uniqKey="Cordero E" first="Elisa" last="Cordero">Elisa Cordero</name>
<affiliation wicri:level="1"><nlm:affiliation>Hospital Universitario Virgen del Rocío and Biomedicine Research Institute, Spanish Network for Research in Infectious Diseases (REIPI), Seville, Spain.</nlm:affiliation>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Hospital Universitario Virgen del Rocío and Biomedicine Research Institute, Spanish Network for Research in Infectious Diseases (REIPI), Seville</wicri:regionArea>
<wicri:noRegion>Seville</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Perez Romero, Pilar" sort="Perez Romero, Pilar" uniqKey="Perez Romero P" first="Pilar" last="Perez-Romero">Pilar Perez-Romero</name>
<affiliation wicri:level="1"><nlm:affiliation>Hospital Universitario Virgen del Rocío and Biomedicine Research Institute, Spanish Network for Research in Infectious Diseases (REIPI), Seville, Spain.</nlm:affiliation>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Hospital Universitario Virgen del Rocío and Biomedicine Research Institute, Spanish Network for Research in Infectious Diseases (REIPI), Seville</wicri:regionArea>
<wicri:noRegion>Seville</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Aydillo, Teresa" sort="Aydillo, Teresa" uniqKey="Aydillo T" first="Teresa" last="Aydillo">Teresa Aydillo</name>
<affiliation wicri:level="1"><nlm:affiliation>Hospital Universitario Virgen del Rocío and Biomedicine Research Institute, Spanish Network for Research in Infectious Diseases (REIPI), Seville, Spain.</nlm:affiliation>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Hospital Universitario Virgen del Rocío and Biomedicine Research Institute, Spanish Network for Research in Infectious Diseases (REIPI), Seville</wicri:regionArea>
<wicri:noRegion>Seville</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Danziger Isakov, Lara" sort="Danziger Isakov, Lara" uniqKey="Danziger Isakov L" first="Lara" last="Danziger-Isakov">Lara Danziger-Isakov</name>
<affiliation wicri:level="2"><nlm:affiliation>Pediatric Infectious Diseases, Cincinnati Children's Hospital Medical Center, Ohio.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Ohio</region>
</placeName>
<wicri:cityArea>Pediatric Infectious Diseases, Cincinnati Children's Hospital Medical Center</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Limaye, Ajit P" sort="Limaye, Ajit P" uniqKey="Limaye A" first="Ajit P" last="Limaye">Ajit P. Limaye</name>
<affiliation wicri:level="4"><nlm:affiliation>Division of Infectious Diseases, University of Washington, Seattle.</nlm:affiliation>
<orgName type="university">Université de Washington</orgName>
<country>États-Unis</country>
<placeName><settlement type="city">Seattle</settlement>
<region type="state">Washington (État)</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Carratala, Jordi" sort="Carratala, Jordi" uniqKey="Carratala J" first="Jordi" last="Carratala">Jordi Carratala</name>
<affiliation wicri:level="3"><nlm:affiliation>Hospital Universitario de Bellvitge, Barcelona, Spain.</nlm:affiliation>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Hospital Universitario de Bellvitge, Barcelona</wicri:regionArea>
<placeName><settlement type="city">Barcelone</settlement>
<region nuts="2" type="region">Catalogne</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Munoz, Patricia" sort="Munoz, Patricia" uniqKey="Munoz P" first="Patricia" last="Munoz">Patricia Munoz</name>
<affiliation wicri:level="3"><nlm:affiliation>Hospital General Universitario Gregorio Marañón, Madrid, Spain.</nlm:affiliation>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Hospital General Universitario Gregorio Marañón, Madrid</wicri:regionArea>
<placeName><settlement type="city">Madrid</settlement>
<region nuts="2" type="region">Communauté de Madrid</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Montejo, Miguel" sort="Montejo, Miguel" uniqKey="Montejo M" first="Miguel" last="Montejo">Miguel Montejo</name>
<affiliation wicri:level="1"><nlm:affiliation>Hospital Universitario de Cruces, Vizcaya, Spain.</nlm:affiliation>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Hospital Universitario de Cruces, Vizcaya</wicri:regionArea>
<wicri:noRegion>Vizcaya</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Lopez Medrano, Francisco" sort="Lopez Medrano, Francisco" uniqKey="Lopez Medrano F" first="Francisco" last="Lopez-Medrano">Francisco Lopez-Medrano</name>
<affiliation wicri:level="3"><nlm:affiliation>Hospital Universitario 12 de Octubre, Madrid, Spain.</nlm:affiliation>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Hospital Universitario 12 de Octubre, Madrid</wicri:regionArea>
<placeName><settlement type="city">Madrid</settlement>
<region nuts="2" type="region">Communauté de Madrid</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Farinas, Maria Carmen" sort="Farinas, Maria Carmen" uniqKey="Farinas M" first="Maria Carmen" last="Farinas">Maria Carmen Farinas</name>
<affiliation wicri:level="1"><nlm:affiliation>Hospital Universitario Marqués de Valdecilla, Cantabria, Spain.</nlm:affiliation>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Hospital Universitario Marqués de Valdecilla, Cantabria</wicri:regionArea>
<wicri:noRegion>Cantabria</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Gavalda, Joan" sort="Gavalda, Joan" uniqKey="Gavalda J" first="Joan" last="Gavalda">Joan Gavalda</name>
<affiliation wicri:level="1"><nlm:affiliation>Hospital Vall d'Hebron, Spain.</nlm:affiliation>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Hospital Vall d'Hebron</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Moreno, Asuncion" sort="Moreno, Asuncion" uniqKey="Moreno A" first="Asuncion" last="Moreno">Asuncion Moreno</name>
<affiliation wicri:level="3"><nlm:affiliation>Hospital Clinic, Barcelona, Spain.</nlm:affiliation>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Hospital Clinic, Barcelona</wicri:regionArea>
<placeName><settlement type="city">Barcelone</settlement>
<region nuts="2" type="region">Catalogne</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Levi, Marilyn" sort="Levi, Marilyn" uniqKey="Levi M" first="Marilyn" last="Levi">Marilyn Levi</name>
<affiliation><nlm:affiliation>Division of Infectious Diseases, University of Colorado Hospital, Aurora.</nlm:affiliation>
<wicri:noCountry code="subField">Aurora</wicri:noCountry>
</affiliation>
</author>
<author><name sortKey="Fortun, Jesus" sort="Fortun, Jesus" uniqKey="Fortun J" first="Jesus" last="Fortun">Jesus Fortun</name>
<affiliation wicri:level="3"><nlm:affiliation>Hospital Universitario Ramón y Cajal, Madrid.</nlm:affiliation>
<country>Espagne</country>
<placeName><settlement type="city">Madrid</settlement>
<region nuts="2" type="region">Communauté de Madrid</region>
</placeName>
<wicri:orgArea>Hospital Universitario Ramón y Cajal</wicri:orgArea>
</affiliation>
</author>
<author><name sortKey="Torre Cisneros, Julian" sort="Torre Cisneros, Julian" uniqKey="Torre Cisneros J" first="Julian" last="Torre-Cisneros">Julian Torre-Cisneros</name>
<affiliation wicri:level="1"><nlm:affiliation>Hospital Universitario Reina Sofía, Cordoba, Spain.</nlm:affiliation>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Hospital Universitario Reina Sofía, Cordoba</wicri:regionArea>
<wicri:noRegion>Cordoba</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Englund, Janet A" sort="Englund, Janet A" uniqKey="Englund J" first="Janet A" last="Englund">Janet A. Englund</name>
<affiliation wicri:level="2"><nlm:affiliation>Pediatric Infectious Diseases, Seattle Children's Hospital, Washington.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Washington (État)</region>
</placeName>
<wicri:cityArea>Pediatric Infectious Diseases, Seattle Children's Hospital</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Natori, Yoichiro" sort="Natori, Yoichiro" uniqKey="Natori Y" first="Yoichiro" last="Natori">Yoichiro Natori</name>
<affiliation wicri:level="1"><nlm:affiliation>Transplant Infectious Diseases and Multi-Organ Transplant Program, University Health Network, Toronto, Ontario, Canada.</nlm:affiliation>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>Transplant Infectious Diseases and Multi-Organ Transplant Program, University Health Network, Toronto, Ontario</wicri:regionArea>
<wicri:noRegion>Ontario</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Husain, Shahid" sort="Husain, Shahid" uniqKey="Husain S" first="Shahid" last="Husain">Shahid Husain</name>
<affiliation wicri:level="1"><nlm:affiliation>Transplant Infectious Diseases and Multi-Organ Transplant Program, University Health Network, Toronto, Ontario, Canada.</nlm:affiliation>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>Transplant Infectious Diseases and Multi-Organ Transplant Program, University Health Network, Toronto, Ontario</wicri:regionArea>
<wicri:noRegion>Ontario</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Reid, Gail" sort="Reid, Gail" uniqKey="Reid G" first="Gail" last="Reid">Gail Reid</name>
<affiliation wicri:level="2"><nlm:affiliation>Division of Infectious Diseases, Loyola University Medical Center, Chicago, Illinois.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Illinois</region>
</placeName>
<wicri:cityArea>Division of Infectious Diseases, Loyola University Medical Center, Chicago</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Sharma, Tanvi S" sort="Sharma, Tanvi S" uniqKey="Sharma T" first="Tanvi S" last="Sharma">Tanvi S. Sharma</name>
<affiliation wicri:level="2"><nlm:affiliation>Pediatric Infectious Diseases, Boston Children's Hospital, Massachusetts.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Massachusetts</region>
</placeName>
<wicri:cityArea>Pediatric Infectious Diseases, Boston Children's Hospital</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Humar, Atul" sort="Humar, Atul" uniqKey="Humar A" first="Atul" last="Humar">Atul Humar</name>
<affiliation wicri:level="1"><nlm:affiliation>Transplant Infectious Diseases and Multi-Organ Transplant Program, University Health Network, Toronto, Ontario, Canada.</nlm:affiliation>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>Transplant Infectious Diseases and Multi-Organ Transplant Program, University Health Network, Toronto, Ontario</wicri:regionArea>
<wicri:noRegion>Ontario</wicri:noRegion>
</affiliation>
</author>
</analytic>
<series><title level="j">Clinical infectious diseases : an official publication of the Infectious Diseases Society of America</title>
<idno type="eISSN">1537-6591</idno>
<imprint><date when="2018" type="published">2018</date>
</imprint>
</series>
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</fileDesc>
<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent (MeSH)</term>
<term>Adult (MeSH)</term>
<term>Aged (MeSH)</term>
<term>Aged, 80 and over (MeSH)</term>
<term>Antiviral Agents (therapeutic use)</term>
<term>Canada (epidemiology)</term>
<term>Child (MeSH)</term>
<term>Child, Preschool (MeSH)</term>
<term>Female (MeSH)</term>
<term>Hospitalization (statistics & numerical data)</term>
<term>Humans (MeSH)</term>
<term>Infant (MeSH)</term>
<term>Influenza Vaccines (therapeutic use)</term>
<term>Influenza, Human (drug therapy)</term>
<term>Influenza, Human (epidemiology)</term>
<term>Male (MeSH)</term>
<term>Middle Aged (MeSH)</term>
<term>Prospective Studies (MeSH)</term>
<term>Risk Factors (MeSH)</term>
<term>Spain (epidemiology)</term>
<term>Transplant Recipients (MeSH)</term>
<term>United States (epidemiology)</term>
<term>Vaccination (MeSH)</term>
<term>Young Adult (MeSH)</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr"><term>Adolescent (MeSH)</term>
<term>Adulte (MeSH)</term>
<term>Adulte d'âge moyen (MeSH)</term>
<term>Antiviraux (usage thérapeutique)</term>
<term>Canada (épidémiologie)</term>
<term>Enfant (MeSH)</term>
<term>Enfant d'âge préscolaire (MeSH)</term>
<term>Espagne (épidémiologie)</term>
<term>Facteurs de risque (MeSH)</term>
<term>Femelle (MeSH)</term>
<term>Grippe humaine (traitement médicamenteux)</term>
<term>Grippe humaine (épidémiologie)</term>
<term>Hospitalisation (statistiques et données numériques)</term>
<term>Humains (MeSH)</term>
<term>Jeune adulte (MeSH)</term>
<term>Mâle (MeSH)</term>
<term>Nourrisson (MeSH)</term>
<term>Receveurs de transplantation (MeSH)</term>
<term>Sujet âgé (MeSH)</term>
<term>Sujet âgé de 80 ans ou plus (MeSH)</term>
<term>Vaccination (MeSH)</term>
<term>Vaccins antigrippaux (usage thérapeutique)</term>
<term>États-Unis (épidémiologie)</term>
<term>Études prospectives (MeSH)</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Antiviral Agents</term>
<term>Influenza Vaccines</term>
</keywords>
<keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>Canada</term>
<term>Spain</term>
<term>United States</term>
</keywords>
<keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Influenza, Human</term>
</keywords>
<keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Influenza, Human</term>
</keywords>
<keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Hospitalization</term>
</keywords>
<keywords scheme="MESH" qualifier="statistiques et données numériques" xml:lang="fr"><term>Hospitalisation</term>
</keywords>
<keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Grippe humaine</term>
</keywords>
<keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Antiviraux</term>
<term>Vaccins antigrippaux</term>
</keywords>
<keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Canada</term>
<term>Espagne</term>
<term>Grippe humaine</term>
<term>États-Unis</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Adolescent</term>
<term>Adult</term>
<term>Aged</term>
<term>Aged, 80 and over</term>
<term>Child</term>
<term>Child, Preschool</term>
<term>Female</term>
<term>Humans</term>
<term>Infant</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Prospective Studies</term>
<term>Risk Factors</term>
<term>Transplant Recipients</term>
<term>Vaccination</term>
<term>Young Adult</term>
</keywords>
<keywords scheme="MESH" xml:lang="fr"><term>Adolescent</term>
<term>Adulte</term>
<term>Adulte d'âge moyen</term>
<term>Enfant</term>
<term>Enfant d'âge préscolaire</term>
<term>Facteurs de risque</term>
<term>Femelle</term>
<term>Humains</term>
<term>Jeune adulte</term>
<term>Mâle</term>
<term>Nourrisson</term>
<term>Receveurs de transplantation</term>
<term>Sujet âgé</term>
<term>Sujet âgé de 80 ans ou plus</term>
<term>Vaccination</term>
<term>Études prospectives</term>
</keywords>
<keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Canada</term>
<term>Espagne</term>
<term>États-Unis</term>
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<front><div type="abstract" xml:lang="en"><p><b>Background</b>
</p>
<p>Seasonal influenza infection may cause significant morbidity and mortality in transplant recipients. The purpose of this study was to assess the epidemiology of symptomatic influenza infection posttransplant and determine risk factors for severe disease.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>Methods</b>
</p>
<p>Twenty centers in the United States, Canada, and Spain prospectively enrolled solid organ transplant (SOT) or hematopoietic stem cell transplant (HSCT) recipients with microbiologically confirmed inﬂuenza over 5 consecutive years (2010-2015). Demographics, microbiology data, and outcomes were collected. Serial nasopharyngeal swabs were collected at diagnosis and upto 28 days, and quantitative polymerase chain reaction for influenza A was performed.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>Results</b>
</p>
<p>We enrolled 616 patients with confirmed influenza (477 SOT; 139 HSCT). Pneumonia at presentation was in 134 of 606 (22.1%) patients. Antiviral therapy was given to 94.1% for a median of 5 days (range, 1-42 days); 66.5% patients were hospitalized and 11.0% required intensive care unit (ICU) care. The receipt of vaccine in the same influenza season was associated with a decrease in disease severity as determined by the presence of pneumonia (odds ratio [OR], 0.34 [95% confidence interval {CI}, .21-.55], P < .001) and ICU admission (OR, 0.49 [95% CI, .26-.90], P = .023). Similarly, early antiviral treatment (within 48 hours) was associated with improved outcomes. In patients with influenza A, pneumonia, ICU admission, and not being immunized were also associated with higher viral loads at presentation (P = .018, P = .008, and P = .024, respectively).</p>
</div>
<div type="abstract" xml:lang="en"><p><b>Conclusions</b>
</p>
<p>Annual influenza vaccination and early antiviral therapy are associated with a significant reduction in influenza-associated morbidity, and should be emphasized as strategies to improve outcomes of transplant recipients.</p>
</div>
</front>
</TEI>
<pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">29635437</PMID>
<DateCompleted><Year>2019</Year>
<Month>10</Month>
<Day>31</Day>
</DateCompleted>
<DateRevised><Year>2019</Year>
<Month>11</Month>
<Day>01</Day>
</DateRevised>
<Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1537-6591</ISSN>
<JournalIssue CitedMedium="Internet"><Volume>67</Volume>
<Issue>9</Issue>
<PubDate><Year>2018</Year>
<Month>10</Month>
<Day>15</Day>
</PubDate>
</JournalIssue>
<Title>Clinical infectious diseases : an official publication of the Infectious Diseases Society of America</Title>
<ISOAbbreviation>Clin. Infect. Dis.</ISOAbbreviation>
</Journal>
<ArticleTitle>A 5-Year Prospective Multicenter Evaluation of Influenza Infection in Transplant Recipients.</ArticleTitle>
<Pagination><MedlinePgn>1322-1329</MedlinePgn>
</Pagination>
<ELocationID EIdType="doi" ValidYN="Y">10.1093/cid/ciy294</ELocationID>
<Abstract><AbstractText Label="Background">Seasonal influenza infection may cause significant morbidity and mortality in transplant recipients. The purpose of this study was to assess the epidemiology of symptomatic influenza infection posttransplant and determine risk factors for severe disease.</AbstractText>
<AbstractText Label="Methods">Twenty centers in the United States, Canada, and Spain prospectively enrolled solid organ transplant (SOT) or hematopoietic stem cell transplant (HSCT) recipients with microbiologically confirmed inﬂuenza over 5 consecutive years (2010-2015). Demographics, microbiology data, and outcomes were collected. Serial nasopharyngeal swabs were collected at diagnosis and upto 28 days, and quantitative polymerase chain reaction for influenza A was performed.</AbstractText>
<AbstractText Label="Results">We enrolled 616 patients with confirmed influenza (477 SOT; 139 HSCT). Pneumonia at presentation was in 134 of 606 (22.1%) patients. Antiviral therapy was given to 94.1% for a median of 5 days (range, 1-42 days); 66.5% patients were hospitalized and 11.0% required intensive care unit (ICU) care. The receipt of vaccine in the same influenza season was associated with a decrease in disease severity as determined by the presence of pneumonia (odds ratio [OR], 0.34 [95% confidence interval {CI}, .21-.55], P < .001) and ICU admission (OR, 0.49 [95% CI, .26-.90], P = .023). Similarly, early antiviral treatment (within 48 hours) was associated with improved outcomes. In patients with influenza A, pneumonia, ICU admission, and not being immunized were also associated with higher viral loads at presentation (P = .018, P = .008, and P = .024, respectively).</AbstractText>
<AbstractText Label="Conclusions">Annual influenza vaccination and early antiviral therapy are associated with a significant reduction in influenza-associated morbidity, and should be emphasized as strategies to improve outcomes of transplant recipients.</AbstractText>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Kumar</LastName>
<ForeName>Deepali</ForeName>
<Initials>D</Initials>
<AffiliationInfo><Affiliation>Transplant Infectious Diseases and Multi-Organ Transplant Program, University Health Network, Toronto, Ontario, Canada.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Ferreira</LastName>
<ForeName>Victor H</ForeName>
<Initials>VH</Initials>
<AffiliationInfo><Affiliation>Transplant Infectious Diseases and Multi-Organ Transplant Program, University Health Network, Toronto, Ontario, Canada.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Blumberg</LastName>
<ForeName>Emily</ForeName>
<Initials>E</Initials>
<AffiliationInfo><Affiliation>Division of Infectious Diseases, University of Pennsylvania, Philadelphia.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Silveira</LastName>
<ForeName>Fernanda</ForeName>
<Initials>F</Initials>
<AffiliationInfo><Affiliation>Division of Infectious Diseases, University of Pittsburgh Medical Center, Pennsylvania.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Cordero</LastName>
<ForeName>Elisa</ForeName>
<Initials>E</Initials>
<AffiliationInfo><Affiliation>Hospital Universitario Virgen del Rocío and Biomedicine Research Institute, Spanish Network for Research in Infectious Diseases (REIPI), Seville, Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Perez-Romero</LastName>
<ForeName>Pilar</ForeName>
<Initials>P</Initials>
<AffiliationInfo><Affiliation>Hospital Universitario Virgen del Rocío and Biomedicine Research Institute, Spanish Network for Research in Infectious Diseases (REIPI), Seville, Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Aydillo</LastName>
<ForeName>Teresa</ForeName>
<Initials>T</Initials>
<AffiliationInfo><Affiliation>Hospital Universitario Virgen del Rocío and Biomedicine Research Institute, Spanish Network for Research in Infectious Diseases (REIPI), Seville, Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Danziger-Isakov</LastName>
<ForeName>Lara</ForeName>
<Initials>L</Initials>
<AffiliationInfo><Affiliation>Pediatric Infectious Diseases, Cincinnati Children's Hospital Medical Center, Ohio.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Limaye</LastName>
<ForeName>Ajit P</ForeName>
<Initials>AP</Initials>
<AffiliationInfo><Affiliation>Division of Infectious Diseases, University of Washington, Seattle.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Carratala</LastName>
<ForeName>Jordi</ForeName>
<Initials>J</Initials>
<AffiliationInfo><Affiliation>Hospital Universitario de Bellvitge, Barcelona, Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Munoz</LastName>
<ForeName>Patricia</ForeName>
<Initials>P</Initials>
<AffiliationInfo><Affiliation>Hospital General Universitario Gregorio Marañón, Madrid, Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Montejo</LastName>
<ForeName>Miguel</ForeName>
<Initials>M</Initials>
<AffiliationInfo><Affiliation>Hospital Universitario de Cruces, Vizcaya, Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Lopez-Medrano</LastName>
<ForeName>Francisco</ForeName>
<Initials>F</Initials>
<AffiliationInfo><Affiliation>Hospital Universitario 12 de Octubre, Madrid, Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Farinas</LastName>
<ForeName>Maria Carmen</ForeName>
<Initials>MC</Initials>
<AffiliationInfo><Affiliation>Hospital Universitario Marqués de Valdecilla, Cantabria, Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Gavalda</LastName>
<ForeName>Joan</ForeName>
<Initials>J</Initials>
<AffiliationInfo><Affiliation>Hospital Vall d'Hebron, Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Moreno</LastName>
<ForeName>Asuncion</ForeName>
<Initials>A</Initials>
<AffiliationInfo><Affiliation>Hospital Clinic, Barcelona, Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Levi</LastName>
<ForeName>Marilyn</ForeName>
<Initials>M</Initials>
<AffiliationInfo><Affiliation>Division of Infectious Diseases, University of Colorado Hospital, Aurora.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Fortun</LastName>
<ForeName>Jesus</ForeName>
<Initials>J</Initials>
<AffiliationInfo><Affiliation>Hospital Universitario Ramón y Cajal, Madrid.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Torre-Cisneros</LastName>
<ForeName>Julian</ForeName>
<Initials>J</Initials>
<AffiliationInfo><Affiliation>Hospital Universitario Reina Sofía, Cordoba, Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Englund</LastName>
<ForeName>Janet A</ForeName>
<Initials>JA</Initials>
<AffiliationInfo><Affiliation>Pediatric Infectious Diseases, Seattle Children's Hospital, Washington.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Natori</LastName>
<ForeName>Yoichiro</ForeName>
<Initials>Y</Initials>
<AffiliationInfo><Affiliation>Transplant Infectious Diseases and Multi-Organ Transplant Program, University Health Network, Toronto, Ontario, Canada.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Husain</LastName>
<ForeName>Shahid</ForeName>
<Initials>S</Initials>
<AffiliationInfo><Affiliation>Transplant Infectious Diseases and Multi-Organ Transplant Program, University Health Network, Toronto, Ontario, Canada.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Reid</LastName>
<ForeName>Gail</ForeName>
<Initials>G</Initials>
<AffiliationInfo><Affiliation>Division of Infectious Diseases, Loyola University Medical Center, Chicago, Illinois.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Sharma</LastName>
<ForeName>Tanvi S</ForeName>
<Initials>TS</Initials>
<AffiliationInfo><Affiliation>Pediatric Infectious Diseases, Boston Children's Hospital, Massachusetts.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Humar</LastName>
<ForeName>Atul</ForeName>
<Initials>A</Initials>
<AffiliationInfo><Affiliation>Transplant Infectious Diseases and Multi-Organ Transplant Program, University Health Network, Toronto, Ontario, Canada.</Affiliation>
</AffiliationInfo>
</Author>
</AuthorList>
<Language>eng</Language>
<PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType>
<PublicationType UI="D016448">Multicenter Study</PublicationType>
<PublicationType UI="D064888">Observational Study</PublicationType>
<PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType>
</PublicationTypeList>
</Article>
<MedlineJournalInfo><Country>United States</Country>
<MedlineTA>Clin Infect Dis</MedlineTA>
<NlmUniqueID>9203213</NlmUniqueID>
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<CommentsCorrectionsList><CommentsCorrections RefType="CommentIn"><RefSource>Clin Infect Dis. 2018 Oct 15;67(9):1330-1332</RefSource>
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<CommentsCorrections RefType="CommentIn"><RefSource>Clin Infect Dis. 2019 Nov 13;69(11):2037</RefSource>
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<CommentsCorrections RefType="CommentIn"><RefSource>Clin Infect Dis. 2019 Nov 13;69(11):2037-2038</RefSource>
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<QualifierName UI="Q000188" MajorTopicYN="N">drug therapy</QualifierName>
<QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName>
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<MeshHeading><DescriptorName UI="D013030" MajorTopicYN="N" Type="Geographic">Spain</DescriptorName>
<QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D066027" MajorTopicYN="Y">Transplant Recipients</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D014481" MajorTopicYN="N" Type="Geographic">United States</DescriptorName>
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</MeshHeading>
<MeshHeading><DescriptorName UI="D014611" MajorTopicYN="N">Vaccination</DescriptorName>
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<MeshHeading><DescriptorName UI="D055815" MajorTopicYN="N">Young Adult</DescriptorName>
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<Month>12</Month>
<Day>21</Day>
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<PubMedPubDate PubStatus="accepted"><Year>2018</Year>
<Month>04</Month>
<Day>06</Day>
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<Month>4</Month>
<Day>11</Day>
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<PubMedPubDate PubStatus="medline"><Year>2019</Year>
<Month>11</Month>
<Day>2</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
<PubMedPubDate PubStatus="entrez"><Year>2018</Year>
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<Hour>6</Hour>
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<li>Communauté de Madrid</li>
<li>Illinois</li>
<li>Massachusetts</li>
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<li>Madrid</li>
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<li>Seattle</li>
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<orgName><li>Université de Washington</li>
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<country name="États-Unis"><region name="Pennsylvanie"><name sortKey="Blumberg, Emily" sort="Blumberg, Emily" uniqKey="Blumberg E" first="Emily" last="Blumberg">Emily Blumberg</name>
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<name sortKey="Silveira, Fernanda" sort="Silveira, Fernanda" uniqKey="Silveira F" first="Fernanda" last="Silveira">Fernanda Silveira</name>
</country>
<country name="Espagne"><noRegion><name sortKey="Cordero, Elisa" sort="Cordero, Elisa" uniqKey="Cordero E" first="Elisa" last="Cordero">Elisa Cordero</name>
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<name sortKey="Carratala, Jordi" sort="Carratala, Jordi" uniqKey="Carratala J" first="Jordi" last="Carratala">Jordi Carratala</name>
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<name sortKey="Fortun, Jesus" sort="Fortun, Jesus" uniqKey="Fortun J" first="Jesus" last="Fortun">Jesus Fortun</name>
<name sortKey="Gavalda, Joan" sort="Gavalda, Joan" uniqKey="Gavalda J" first="Joan" last="Gavalda">Joan Gavalda</name>
<name sortKey="Lopez Medrano, Francisco" sort="Lopez Medrano, Francisco" uniqKey="Lopez Medrano F" first="Francisco" last="Lopez-Medrano">Francisco Lopez-Medrano</name>
<name sortKey="Montejo, Miguel" sort="Montejo, Miguel" uniqKey="Montejo M" first="Miguel" last="Montejo">Miguel Montejo</name>
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A 5-Year Prospective Multicenter Evaluation of Influenza Infection in Transplant Recipients.

A 5-Year Prospective Multicenter Evaluation of Influenza Infection in Transplant Recipients.

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