bluuebunny/crossref_metadata_2025_split huggingface dataset:
P-34. Patients’ Survey of Human Papilloma Virus Vaccination among Systemic Lupus Erythematosus Patients in Japan after Suspension of Proactive Recommendation
Authors: Kurita Takashi , Yamamoto Akio , Hosoya Tadashi , Tsuchida Marina , Yasuda Shinsuke , Gu Yoshiaki 
Published: January 2025

Abstract

Background
Systemic lupus erythematosus (SLE) patients are known to have a high incidence of cervical cancer. The main reason for this is considered to reflect the high rate of Human papilloma virus (HPV) infection and inadequate HPV clearance due to immunosuppressive status. Japan has been facing a problem of low HPV vaccination rates due to the suspension of proactive recommendations for routine HPV vaccination for more than eight years because of the negative media campaign. The objective of this study is to identify the factors that inhibit HPV vaccination among SLE patients to develop strategies for improving HPV vaccination rate.
Figure
Sources of medical information for HPV vaccinated and unvaccinated participants. We asked which informational tools participants use to gather medical information. The most trusted sources are indicated by dark bars; others are indicated by light bars.
* indicates significant differences between HPV vaccinated and unvaccinated participants (p&lt;0.05, chi-square test). (a): Answers by HPV vaccinated participants. (b): Answers by HPV unvaccinated participants.
HPV, Human papilloma virus; SNS, Social networking service; TV, Television

Methods
We conducted a questionnaire survey of female SLE patients aged 18-45 years attending our hospital to analyze factors related to HPV vaccination.

Results
We obtained responses of 83 participants. Only 5 (6.0%) were received HPV vaccination, 15 (18.1%) were uncertain of their vaccine history, and 27 (32.5%) had never even heard of HPV vaccination. The reasons for unvaccinated against HPV were "don't know" with 24 participants, "missed opportunity" with 15, and "troublesome, somehow" with 8. The most trusted source of medical information for the unvaccinated was their physician (47, 60.3%) (Figure). Among the unvaccinated, those who wished to be vaccinated in the future were positively correlated with “trust of vaccine benefit” (r=0.515. p=0.014) and “accurate knowledge about HPV vaccine” (r=0.614, p=0.002), and negatively correlated with “negative attitudes toward vaccination and vaccine policy” (r=-0.562, p=0.007).

Conclusion
HPV vaccination rate among SLE patients in Japan was extremely low. The main reason was lack of knowledge. The most effective solution is considered to provide accurate information and adequate recommendations of HPV vaccination by attending physicians.

Disclosures
Yoshiaki Gu, MD, PhD, MPH, MSD K.K.: Grant/Research Support
P-2285. Factors Associated with Chagas Reactivation After Heart Transplantation: Retrospective Analysis at a Large Volume Academic Transplant Center
Authors: Beaird Omer E , Multani Ashrit , Gaynor Pryce , Yanagimoto-Ogawa Lauren , Fraschilla Stephanie , King Maya , Smith Jonathan G , Nsair Ali , Carlson Margrit , Kubak Bernard M , Schaenman Joanna M 
Published: January 2025

Abstract

Background
Chagas cardiomyopathy (CC), caused by Trypanosoma cruzi, is a common indication for orthotopic heart transplantation (OHT) for patients born in Latin America, however post-transplant Chagas reactivation (CR) is common, occurring in ∼60% of cases. Serial T. cruzi PCR monitoring post-OHT with pre-emptive therapy is the current standard for managing post-transplant CR in part due to poor tolerability of benznidazole and nifurtimox. While this approach is often effective, poor accessibility can create delays in treatment, leading to adverse outcomes. We examined patients with CC who underwent OHT to evaluate factors associated with CR.

Methods
We conducted a retrospective review of all patients with CC who underwent OHT at our center between January 2011 – May 2024, reviewing demographics, pre-transplant desensitization, induction and maintenance immunosuppression, rejection history, and presence or absence of azole prophylaxis.

Results
24 patients with confirmed CC were identified, whose characteristics are listed in Table 1. CR occurred in 5 (20.8%) patients, of whom 2 developed clinical manifestations. Asymptomatic CR occurred in 1/20 patients (5%) on azole prophylaxis, whereas 4/4 (100%) patients not on azole prophylaxis had CR (p&lt; 0.001). Age, sex, induction immunosuppression, and treatment for rejection were not significantly associated with CR. Comparison of patients with and without CR is shown in Table 2.

Conclusion
The rate of CR in our cohort was lower than expected based on published data. This may be related to the use of azole prophylaxis which we frequently use for prevention of coccidioidomycosis. Azoles have varying in vitro and in vivo antitrypanosomal activity. In randomized clinical trials (RCTs), posaconazole demonstrated ability to suppress molecular detection of T. cruzi. Our findings suggest that azole prophylaxis, including fluconazole, may have a protective effect against CR. Considering favorable cost and tolerability of fluconazole as compared to benznidazole and nifurtimox, these findings could have significant implications for post-transplant management of CC. Given the small number of patients with CR in our cohort, larger studies including RCTs are needed to validate this observation.

Disclosures
Joanna M. Schaenman, MD, PhD, FAST, Eurofins Viracor: Honoraria|F2G: Grant/Research Support|MedCure: Advisor/Consultant|Moderna: Clinical trial support to institution|OneLegacy: Advisor/Consultant
P-37. Factors Associated with Healthcare Professionals’ RSV Older Adult Vaccination Knowledge and Practices During the First Season of Vaccine Availability in the United States
Authors: La Elizabeth M , Sweeney Carolyn , Singer David , Davenport Eric , Calhoun Sarah , Harmelink Andrea 
Published: January 2025

Abstract

Background
In 2023, respiratory syncytial virus (RSV) vaccines were approved by the United States (US) Food and Drug Administration (FDA) for adults aged ≥60 years and recommended by the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices (ACIP) using shared clinical decision-making (SCDM). This study evaluated healthcare professional (HCP) characteristics associated with RSV vaccination knowledge and practices.

Methods
A cross-sectional online survey targeting approximately 600 HCPs was conducted in November 2023 to assess HCP knowledge, attitudes, and practices related to older adult RSV vaccination. Three logistic regression models used these survey data to explore HCP characteristics associated with RSV vaccination knowledge and practices (e.g., likelihood of knowing FDA indication and ACIP recommendation). The models included HCP type as a covariate a priori, with other covariates determined using backwards selection with a prespecified stay criterion (P &lt; 0.1).

Results
The survey was completed by 603 HCPs (Table 1). HCPs had higher odds of being knowledgeable about the FDA indication and ACIP recommendation for older adult RSV vaccination if their workplace stocked RSV vaccine(s); odds were lower if HCPs were least familiar with RSV disease or had a higher percentage of non-White adult patients (Table 2). Odds of initiating RSV vaccination conversations with ≤5% of older adult patients were higher among HCPs who were less familiar with RSV disease, felt less confident in SCDM conversations, and perceived RSV protection to be less important than other respiratory infections (Table 3). Being less familiar with RSV disease was also associated with higher odds of not recommending/administering RSV vaccines to any older adults in the past 3 months (Table 4).

Conclusion
HCP familiarity with older adult RSV disease was associated with RSV vaccination knowledge and practices, highlighting the importance of continued RSV disease awareness efforts. Results can be used to tailor these efforts towards HCPs with potential vaccination knowledge and practice gaps to help ensure equitable RSV vaccination access across older adults.
FUNDING: GSK (study identifier: VEO-000726)

Disclosures
Elizabeth M. La, PhD, GSK: employee|GSK: Stocks/Bonds (Private Company) David Singer, PharmD, MS, GSK: employee|GSK: Stocks/Bonds (Public Company) Eric Davenport, MStat, MEcon, GSK: study funding Andrea Harmelink, PhD, FNP, GSK: Stocks/Bonds (Public Company)
P-2288. Antibiotic Use and Infectious Complications in Hematological Patients Undergoing CAR T-Cell Therapy
Authors: Puerta-Alcalde Pedro , Calbacho Maria , Bailen Rebeca , Martin Ana Africa , Garcia Inmaculada , Puertas Borja , Vilalta Anna , Montoro Mercedes , Anguera Sergi , Ortiz Valentin , Fernandez-Larrea Carlos , Soriano Alex , Garcia-Vidal Carolina 
Published: January 2025

Abstract

Background
Patients undergoing chimeric antigen receptor (CAR) T-cell therapy face significant infection risks. Current data on the frequency and nature of these infections remain limited.
Table 1

Methods
Prospective multicenter cohort including all consecutive patients treated with CD19 or BCMA CAR T-cell therapy from January 2022 to February 2024 in three university hospitals in Spain. All participants provided informed consent and were monitored for 90 days post-treatment.
Table 1 (continued)

Results
A total of 210 patients were enrolled. Demographics, comorbidities, and specific therapy details are outlined in Table 1. Overall, 71% of patients experienced fever at a median of 2 days (IQR 1-3) after CAR T-cell infusion. Antibiotics were administered to 79.3% of patients for a median duration of 7 days (IQR 4-11) with meropenem (57.6%) and piperacillin-tazobactam (40.5%) being the most frequently used. Bacteremia was evidenced in 17 (8.1%) patients, with 6 (2.9%) patients experiencing multiple episodes. The median onset of first bacteremia was 27 days (IQR 16.5-36), with 14/17 (82.3%) episodes occurring over 2 weeks after CAR T-cell infusion. Predominant pathogens were P. aeruginosa (5, 2.4%), coagulase-negative staphylococci (5, 2.4%), and E. coli (4, 1.9%). Clostridioides difficile infection occurred in 7 (3.3%) patients. Viral infections were reported in 37 (17.6%) patients, primarily due to SARS-CoV-2 (22, 10.5%) and Influenza (6, 2.9%), while fungal infections were noted in 10 (4.8%) patients (4 aspergillosis, 3 candidemia, 1 mucormycosis, 1 other mold, and 1 possible fungal infection). ICU admission was required for 38 (18.1%) patients, with infections prompting 6 of these cases. The 90-day mortality rate stood at 6.2%, with 61.5% of these deaths attributed to infections. Patients suffering any infection (bacterial, viral, or fungal) had significantly higher 90-day mortality (17.2% vs 2.0%, p &lt; 0.001). Table 2 shows the different 90-day mortality rates regarding the type of infection.

Conclusion
Antibiotic use is prevalent immediately following CAR T-cell infusion, despite a low initial bacterial infection rate. Nonetheless, infections within the first 90 days post-CAR-T infusion are common and correlate with worse outcomes.

Disclosures
All Authors: No reported disclosures
P-2294. Listeriosis in cancer patients: Uncommon and protean
Authors: Snellings Robin , Matsuo Takahiro , Wurster Sebastian , Jiang Ying , Tarrand Jeffery , Cho Sung-Yeon , Kontoyiannis Dimitrios P 
Published: January 2025

Abstract

Background
Historically cancer patients (pts) are considered to be at an increased risk of Listeria monocytogenes infection (listeriosis, LT), especially those with ongoing chemotherapy or receipt of glucocorticoids (GCs). However, the features of this uncommon infection have not been described in contemporary cohorts of cancer pts.

Methods
We performed a 12-year retrospective chart review of cancer pts with LT as confirmed by positive culture from blood or other sterile clinical samples at MD Anderson Cancer Center (2011-2023).

Results
We identified 20 cancer pts with LT. Twelve (60%) had an underlying hematologic malignancy (Figure 1). Lymphopenia &lt; 1000/µL (17, 85%, severe &lt; 200/µL in 20%) and monocytopenia &lt; 1000/µL (18, 90%, severe &lt; 200/µL in 35%) were common at diagnosis, as well as chemotherapy (13, 65%) and GC use (11, 55%) within 30 days prior to LT diagnosis. Most (15 pts) were &lt; 65 years old. Fever was seen in 10 pts. Vomiting/diarrhea were common (50%), while 45% of pts had headache or altered mental status. LT most often presented with bacteremia (17, 85%) and gastroenteritis (9, 45%) (Figure 2). 7/9 pts with gastroenteritis were bacteremic. Central nervous system (CNS) manifestations (meningitis, brain abscess) were documented in 2 pts who had a lumbar puncture. Focal non-CNS infections were seen in 30% of pts in unusual sites: cellulitis, abscess, endocarditis, cholangitis, urinary tract infection, and peritonitis. Of interest, 11pts (55%) had low SOFA score at presentation and were given antibiotics only after blood cultures were positive for Listeria. In fact, most pts (17, 85%) either did not receive empiric (n=11) or had inappropriate empiric antibiotics (n=6) until LT diagnosis. The 30-day mortality from LT diagnosis was 25% and correlated with high SOFA score ≥ 5 (5/8 pts, P = 0.0005). Delayed appropriate antibiotics were not significantly associated with increased 30-day mortality in this small cohort (Table 1).

Conclusion
Although uncommon, LT in cancer pts has pleotropic manifestations and variable morbidity, from non-bacteremic gastroenteritis to septicemia, CNS and non-CNS focal infections. Consider LT in ill cancer pts with lymphopenia/monocytopenia and recent chemotherapy or GCs, especially if they have GI symptoms, even in the absence of fever or CNS involvement.

Disclosures
Sebastian Wurster, MD, MSc, Astellas Pharma: Grant/Research Support|Gilead Sciences: Grant/Research Support Dimitrios P. Kontoyiannis, MD, AbbVie: Advisor/Consultant|Astellas Pharma: Advisor/Consultant|Astellas Pharma: Grant/Research Support|Astellas Pharma: Honoraria|Cidara Therapeutics: Advisor/Consultant|Gilead Sciences: Advisor/Consultant|Gilead Sciences: Grant/Research Support|Gilead Sciences: Honoraria|Knight: Advisor/Consultant|Merck: Advisor/Consultant|Scynexis: Advisor/Consultant
P-2296. Risk Factors for Invasive Aspergillus Infections among Lung Transplant Recipients in the Era of COVID-19 Pandemic
Authors: Moffitt Thomas , Nandavaram Sravanthi , Soria Jaime , Myint Thein 
Published: January 2025

Abstract

Background
Invasive aspergillus infection is a major cause of mortality among lung transplant recipients (LTRs). The trends of aspergillus infection appear to be increasing after COVID pandemic.

Methods
A retrospective chart review of all LRTs who developed aspergillus infections was performed at our transplant center from January 2019 to July 2023. Proven aspergillus infection is defined as a positive culture or pathology with abnormal imaging, whereas probable aspergillus infection is an elevated aspergillus antigen with abnormal imaging.

Results
One hundred and thirty-four patients who underwent lung transplantation between January 2019 and July 2023 were followed through December 2023. 21.6% (29/134) and 12.7% (17/134) patients developed proven and probable aspergillus infections, respectively. Although the incidence of proven aspergillus infection has been stable in 2022, the incidence of probable aspergillus infection has increased significantly from 3.6% (1/28) in 2019 to 29% (9/31) (p&lt; 0.01) (Figure 1).
From Jan 2020- July 2023 data analysis, COVID-19 infection was found in 46.2% (18/39) of LTRs diagnosed with aspergillus infection and 45.2% (28/62) of LTRs without diagnosis of aspergillus infection (P=0.92). Of 46 LTRs with COVID-19 infection, 6 (13%) had secondary aspergillus infection.
The clinical characteristics of LTRs with and without invasive aspergillus infection from 2021 to 2023 are shown in Table 1. The risk factors for aspergillus infection include single lung transplant recipients and airway stenosis in multivariate analysis (Table 2). The use of voriconazole was significant for a risk factor in bivariate analysis but not significant in multivariate analysis. Voriconazole prophylaxis was placed for high-risk patients for aspergillus infection.
Inpatient all-cause mortality was 22.86 % in the patients with invasive aspergillus infections compared to 17.54% in LTRs without aspergillosis (p=0.593)
Table 2: Risk factors for Aspergillus infection among lung transplant recipients

Conclusion
The trends of invasive aspergillus infection in LTRs increased from 25% in 2019 to 54.8% in 2022. COVID-19 infection contributed to a slight increase the incidence of aspergillus infection. The risk factors for invasive aspergillosis include single lung transplant recipients and airway stenosis.

Disclosures
All Authors: No reported disclosures
P-2307. Premature Discontinuation of Trimethoprim-Sulfamethoxazole Prophylaxis in Abdominal Transplant Recipients: A Deeper Dive
Authors: Tinkham Tyler T , Ilges Dan , Hudson Madeline R , Votruba Cassandra D , Corey Rebecca , Beemiller McKenna J , Potter Justin M , Gonzalez Alan , Rastegar Ashkan , Lizaola-Mayo Blanca , Kodali Lavanya , Vikram Holenarasipur R 
Published: January 2025

Abstract

Background
Trimethoprim-sulfamethoxazole (TS) prophylaxis can prevent Pneumocystis jirovecii (PCP) and other opportunistic infections (OIs), such as intestinal protozoa, Toxoplasma, Listeria, and Nocardia. We sought to assess the frequency, causative factors, and impact of early TS discontinuation in abdominal SOT recipients.

Methods
This is a single-center, retrospective cohort study of adult abdominal SOT recipients at Mayo Clinic Arizona between 1/1/2021 and 6/30/2023. Objectives included the rate and reasons behind early TS discontinuation and whether TS prophylaxis was reinitiated. Early discontinuation was defined as cessation of TS prophylaxis within 6 months post-transplant for ≥7 days. Secondary outcomes included median duration of therapy, alternative prophylactic agent utilized, and incidence of TS preventable OI. Patients were excluded if they had no TS ordered, died &lt;180 days from transplant, or received a thoracic organ transplant.

Results
942 abdominal SOT recipients were identified. Thus far 171 liver, 11 Kidney, and 29 liver/kidney have been reviewed and included in the current analysis. TS was discontinued early in 60 (28%) patients. Predominant reasons for discontinuation were hyperkalemia (45%), cytopenias (17%), and acute kidney injury (15%). Allergy was the indication for discontinuation in 1 patient. Median duration of TS before discontinuation was 39 days (IQR 66). TS was not resumed in 78% of cases. The predominant reason for non-resumption was alternative prophylaxis with no clear intent to rechallenge TS (70%). The main discontinuation reason had resolved in 70% that stopped due to cytopenias, 67% that stopped due to liver injury, and 96% that stopped due to hyperkalemia. Alternative prophylaxis included pentamidine (50%), dapsone (32%), atovaquone (5%), none (13%). No patients developed PCP or other TS preventable OI during 9-month follow-up post-SOT.

Conclusion
TS is discontinued prematurely in a significant number of SOT recipients and is often not resumed despite resolution of the offending cause. Given its proven track record in preventing several OIs in SOT recipients, providers should document reason(s) for TS discontinuation and consider resumption of TS after reasons for discontinuation resolve.

Disclosures
All Authors: No reported disclosures
P-2317. Risk Factors Associated with post-Hematopoietic Stem Cell Transplant Mortality: Two-Year Cohort in a Public Hospital in Perú
Authors: Agramonte Mario Jeisson , Moscol-Chavez Karol , Aranda-Gomero Lourdes , Wong-Chang Alfredo , Vilcarromero Stalin , Copaja-Corzo Cesar 
Published: January 2025

Abstract

Background
In Latin America, Hematopoietic Stem Cell Transplants have experienced significant growth in recent years, both in terms of quantity and quality. Specialized hospitals and high-level medical centers have been established in several countries, including Perú, to carry out these procedures.
The availability of compatible donors, the experience of the medical team, the condition of the recipient, the stage of the disease, the resources available for monitoring and surveillance of transplant complications are some of the factors involved in the success of the transplant.
This study aims to describe the characteristics and factors associated with mortality in hematopoietic transplant recipients in patients post hematopoietic stem cell transplant attended at a hospital in Peru
sociodemographic characteristics

Methods
Retrospective cohort study, conducted at a hospital in Peru between April and May 2024. We included all patients who underwent hematopoietic stem cell transplant between 2017 and 2022. We evaluated death at one hundred days of follow-up and at two years.
Survival at 100 days post transplant

Results
We evaluated 342 medical records, median age 23 years, 53.5% were women. The most common diagnosis for the transplant was leukemia 83.6%. Mortality in the first 100 days post TPH was 8.2%, and at two years was 30.4%. In the multivariate model and at one hundred days, sepsis HRa: 24.72 (7.95 to 76.85) was associated with death and engraftment to survival HRa: 0.26 (0.07 to 0.93). Regarding mortality at two years, haploidentical transplant HRa:1.92 (1.20 to 3.08), sepsis HRa: 5.36 (2.98 to 9.63), and disease relapse HRa: 4.32 (2.80 to 6.66) were associated with death and engraftment to survival HRa: 0.12 (0.06 to 0.25).
2-year post-transplant survival

Conclusion
Sepsis was the primary risk factor associated with death in the first one hundred days post-transplant. At two years of follow-up, disease relapse and sepsis were the risk factors for death. Hematopoietic stem cell transplant in Peru is performed in few specialized centers and this initial report identifies the need for further interventions to reduce the risk of infection.

Disclosures
All Authors: No reported disclosures