942. Pulmonary Infections in Intestinal Transplant Recipients with Preexisting Pulmonary Nodules

Abstract Background Pulmonary nodules in asymptomatic patients could represent latent pulmonary infections. Intestinal transplant (ITx) recipients with preexisting pulmonary nodules might be at higher risk for pulmonary infections. However, data is lacking. Methods This retrospective study included adult patients that underwent intestinal transplantation (ITx) from 5/2016 to 5/2020. Chest computed tomography (CT) scans performed within 12 months prior of ITx were obtained to evaluate for preexisting pulmonary nodules. Screening for endemic mycoses, Aspergillus, Cryptococcus and latent tuberculosis infection (LTBI) performed within 12 months prior ITx was obtained. We assessed for worsening pulmonary nodules, and fungal and mycobacterial infections during the 1st year post-transplant. Survival at one year post-transplant was also assessed. Results Forty-three patients underwent ITx. Twenty-three (53%) were Female. Median age was 46 years (range: 18-67). Chest CT scans were performed in 36(84%) patients prior to ITx. Preexisting pulmonary nodules were found in 30 (83%) of the patients. All were asymptomatic. Nodules were not calcified in 10 (33%) patients, calcified in 4 (13%), some calcified and some not calcified in 4 (13%) and unclear in 12 (40%). All the patients screened negative for fungi [Coccidioides antibody (Ab) was done in 15 (50%) patients, Blastomyces Ab and Histoplasma Ab in 7 (23%) each, Histoplasma urine antigen (Ag) and Aspergillus serum galactomannan in 3 (10%) each, and Cryptococcus serum Ag in 10 (33%) patients]. QuantiFERON-TB (QFT) was negative in 35 (81%) patients, positive in 2 (5%) and indeterminate in 6 patients (14%). QFT-Gold In-Tube was replaced to QFT-Plus in 3/2019. Post-transplant worsening of pulmonary nodules was noted in 12 (40%) patients and bronchoscopy was performed in six of them. Note that only 1 (3%) of the patients that had pre-existing pulmonary nodules developed a pulmonary infection (invasive pulmonary aspergillosis diagnosed 33 days after ITx). Our cohort survival at one year post-transplant was 79%. Conclusion Preexisting pulmonary nodules was common in our ITx cohort. However, only one case of pulmonary infection was noted among those who had preexisting pulmonary nodules. Clinical monitoring is essential. Disclosures All Authors: No reported disclosures

Background.Pulmonary nodules in asymptomatic patients could represent latent pulmonary infections.Intestinal transplant (ITx) recipients with preexisting pulmonary nodules might be at higher risk for pulmonary infections.However, data is lacking.
Methods.This retrospective study included adult patients that underwent intestinal transplantation (ITx) from 5/2016 to 5/2020.Chest computed tomography (CT) scans performed within 12 months prior of ITx were obtained to evaluate for preexisting pulmonary nodules.Screening for endemic mycoses, Aspergillus, Cryptococcus and latent tuberculosis infection (LTBI) performed within 12 months prior ITx was obtained.We assessed for worsening pulmonary nodules, and fungal and mycobacterial infections during the 1 st year post-transplant.Survival at one year post-transplant was also assessed.
Conclusion.Preexisting pulmonary nodules was common in our ITx cohort.However, only one case of pulmonary infection was noted among those who had preexisting pulmonary nodules.Clinical monitoring is essential.
Disclosures Background.Actinomyces are human commensals with significant pathogenic potential.The aim of this study was to determine the epidemiology of Actinomycosis in a tertiary care cancer center and identify species most commonly associated with invasive disease.
Methods.We retrospectively reviewed all patients referred to our institution with suspected or documented solid or hematological malignancies and positive cultures for Actinomyces species from July 2007 to June 2020 (13 years).Species identification was performed by VITEK ® automated system (bioMerieux Inc.).Probable invasive actinomycosis was defined as cases with consistent clinical presentation, suggestive radiographic findings, and a positive culture from a nonsterile site, but lack of histopathological confirmation.Proven invasive actinomycosis was defined as the presence of consistent clinical symptoms, suggestive radiographic findings, a positive culture and histopathological confirmation, or cultures from sterile site without histopathological confirmation.Contaminants were considered positive cultures from sterile or non-sterile site without evidence of disease.
Conclusion.The majority of positive cultures for Actinomyces species were considered contaminants.In our cohort Invasive actinomycosis affected mainly patients with solid tumors.Abdominopelvic was the most common site of invasive disease.Species most commonly associated with invasive actinomycosis were A. odontolyticus followed by A. meyeri with A. israelii isolated less frequently.
Disclosures Background.Cytomegalovirus (CMV) infection continues to cause morbidity in kidney transplant recipients, despite prophylaxis and pre-emptive therapy.Predictors

. All Authors: No reported disclosures 944. CMV Peak Viral Load, Recurrence, Duration, and Outcomes in Kidney
Johns Hopkins University, Baltimore, Maryland; 3 Seoul Medical Center, Seoul, Seoul-t'ukpyolsi, Republic of Korea; 4 Johns Hopkins School of Medicine, Baltimore, Maryland; 5 Johns Hopkins University School of Medicine, Baltimore, MD; 6 Merck and Co., Inc, North wales, Pennsylvania; 7 John Hopkins, Bethesda, Maryland Session: P-53.Infections in Immunocompromised Individuals