Review Of Literature And Prevention Strategies For Donor-derived Coccidioidomycosis After Organ Transplantation: An Essay.

At the end of this course, students should be able to:

• Discuss, apply, understand and adapt the necessity for and value of research for clinical practice and professional dev
• Discuss, apply, understand and adapt all structures of medical investigational studies along with the concepts and theory in evidence- based medicine and its clinical usefulness and applications.
• Understand, apply and adapt analysis techniques for reviewing medical investigational studies.
• Discuss ethical, practical, and personal values related to research and institutional review board concerns.
• Describe and correlate different research methodologies and recognize the different types of studies typically done for theses. Write a methodology so that the elements for replication are easily unders
• Understand and analyze the different types of data collection techniques.
• Understand the logic needed to and the presentation of a research questions. Understanding the logic and theoretical basis for a hypothesis, ask appropriate questions, and explain them logically.
• Understand how to state proofs in a thesis, and explain results.
• Design a literature review and an IRB propos

Question

In the U.S population, infectious diseases are common but if it is occurring post-transplant, then it becomes quite difficult to cope up with (Fishman, 2017). Transmission of unwanted coccidioidomycosis disease through organ transplantation has become one of the common but dangerous concerns in medical practice. Coccidioidomycosis is an infection, caused by the dimorphic fungi of the Coccidioides species. It is a pulmonary disease, responsible for the lower respiratory infection. It has been found in a study that in United States an unexpected morbidity as well as mortality occurs after organ transplantation due to the infection of coccidioidomycosis (Freedman, Jackson, McCotter & Benedict, 2018). In this regard, it is highly essential to find the prevention strategy to resist the occurrence of the disease after organ transplantation. The following paper will describe how the infectious disease is associated with organ transplantation and how people are getting affected. It will also depict some strategies to prevent donor-derived coccidioidomycosis. It will implement a research method and analyze the research findings thoroughly to get the answer of the main research question. Finally, the paper will summarize the main points to get a clear conclusion.    

There is an absence of studies that described proper ways or strategies to prevent the disease after the transplantation of organ among patients. Even, exactly when the infection spreads among the organ receiver is also not absolutely clear.

The purpose of this study is to review the current literature on coccidioidomycosis and how it affects people during the period of post-transplantation of organs. This study is also focused to explore the preventive strategies of the disease after organ transplantation. In this way, the study will try to sort out the problems associated with it.

The limitations of the study include the fact that the literature review as been done only on the published literatures and the language has also been limited in English. It is also difficult to measure all the relevant literatures objectively.

It is being assumed that the literature will be objective and the literature published will be focusing on the fact of the main topic. It will present a brief detail about the infectious disease coccidioidomycosis and its effects on the people along the prevention strategies (Schuster et al., 2017).

PDDTE- Potential donor-derived transmission events (Zwang et al., 2016).

OPTN- Organ procurement and transplantation network (Nelson et al., 2016).

The main research questions can be formed as how coccidioidomycosis is associated with organ transplantation and what are the prevention strategies.

Coccidioidomycosis is an infectious disease which has become a concern for the healthcare practitioners as it transfers to the patients of organ transplant from the donors. The mortality rate due to the donor derived coccidioidomycosis is quite noticeable and in most of the cases, it involves donor from OPTN region 5, which is an area that includes Arizona, Utah, Nevada, California, and New Mexico (Galgiani et al., 2016).

A thorough research of relevant journals in English language, in the PubMed, Medline and scholarly articles produced the result that case reports have been found from the year 1950 about the donor-derived coccidioidomycosis (Laws et al., 2018).

Learning Objectives

Various studies and literatures suggest a rapidly increasing incidence of coccidioidomycosis within the endemic region and report also states that the mortality is as high as 72% in the transplant population. The studies found that at least two cases of coccidioidomycosis are associated with the organ transplantation among 5 recipients (v et al., 2014). Even, it poses a serious risk among the transplant recipients and in some cases it leads to the death of the patient also.

Some previous studies disclosed the fact that coccidioidomycosis is associated with organ transplantation patients but there were limited resources stating the prevention strategies of the disease. Studies also revealed that group meetings held during 1980-2015, describing the possible outbreaks of coccidioidomycosis after organ transplant but the exact prevention strategies are limited (Kirchner & Pruett, 2016).

A screening or test has been added before the organ transplantation in order to avoid the disease on the recipient patient.

The researchers are in constant progress to find that people of endemic areas are more likely to suffer from coccidioidomycosis after organ transplantation and it is one of the significant causes of morbidity and mortality among the patients.

How the occurrence of coccidioidomycosis among the patients of organ transplantation is not cleared in the literatures.

It was really difficult to measure the actual preventive strategies or way outs of coccidioidomycosis and finding the exact time when the disease occurs after organ transplantation is also difficult to evaluate.

While handling the medical records ethical issues might arise from the patients’ sides which can have severe affect on the research findings. 

1. This project is also focussed to find out the preventive strategies of coccidioidomycosis after organ transplantation which was related to the theoretical issues of the literatures found.
2. Many previous studies were also unable to find the same and thus they are related to this project.
3. In the theoretical framework, this study is going to analyze reports on the issue and it will also produce the result of the research question.
4. The theories found from the literature review are not enriched with the prevention strategies of the disease.

The main aim of the study is to find out the clear answer of the research questions which are related to the topic coccidioidomycosis.

In order to complete the study, a retrospective cross-sectional study has been designed. We will be obtaining previous reports and information on the disease coccidioidomycosis.

All the reports will be thoroughly reviewed and data will be collected. Again, the reports of the patients of coccidioidomycosis will be collected from the hospitals to find out the causes behind it. Review of the reports will help in identifying if coccidioidomycosis is associated with organ transplantation or not.

A sequential data analysis method will be used in order to find the result of the research question. Generally, sequential analysis method is used when the sample size is not known and in this case, the data will be collected from the reports and literatures and from the hospital records, in which the sample size will not be known at the beginning (Kusne et al., 2016).

From the sequential data analysis, the result will be found.

The result will clearly represent how coccidioidomycosis is associated with organ transplantation and what strategies the medical practitioners follow in order to prevent them.

Apart from that it will additionally found that in which areas, the occurrence of coccidioidomycosis is comparatively high.

The result will be effective enough in producing the association of coccidioidomycosis with the organ transplantation but it might fail to provide a clear idea about the strategies of prevention of such disease as there are limited numbers of resources found in this regard.

In my field of study, the research implications will help to identify the issue and it will also help me to find preventive strategies while handling such patients. There might be ethical issues while obtaining the medical records of the patients from hospitals, and in that case, informed consent will be taken.

A future research is also required to identify the exact strategy of prevention of such infectious disease after organ transplantation.

References

Fishman, J. A. "Infection in organ transplantation." American Journal of Transplantation 17.4 (2017): 856-879.

Freedman, M., Jackson, B. R., McCotter, O., & Benedict, K. (2018). Coccidioidomycosis Outbreaks, United States and Worldwide, 1940–2015. Emerging infectious diseases, 24(3), 417.

Galgiani, J. N., Ampel, N. M., Blair, J. E., Catanzaro, A., Geertsma, F., Hoover, S. E., ... & Meyerson, S. L. (2016). 2016 Infectious Diseases Society of America (IDSA) clinical practice guideline for the treatment of coccidioidomycosis. Clinical Infectious Diseases, 63(6), e112-e146.

Kauffman, C. A., Freifeld, A. G., Andes, D. R., Baddley, J. W., Herwaldt, L., Walker, R. C., ... & Knapp, K. M. (2014). Endemic fungal infections in solid organ and hematopoietic cell transplant recipients enrolled in the Transplant?Associated Infection Surveillance Network (TRANSNET). Transplant Infectious Disease, 16(2), 213-224.

Kirchner, V. A., & Pruett, T. L. (2016). Receiving the unwanted gift: Infection transmission through organ transplantation. Surgical infections, 17(3), 318-322.

Kusne, S., Taranto, S., Covington, S., Kaul, D. R., Blumberg, E. A., Wolfe, C., & Green, M. (2016). Coccidioidomycosis transmission through organ transplantation: a report of the OPTN Ad Hoc Disease Transmission Advisory Committee. American Journal of Transplantation, 16(12), 3562-3567.

Laws, R. L., Cooksey, G. S., Jain, S., Wilken, J., McNary, J., Moreno, E., ... & Materna, B. (2018). Coccidioidomycosis Outbreak Among Workers Constructing a Solar Power Farm—Monterey County, California, 2016–2017. Morbidity and Mortality Weekly Report, 67(33), 931.

Len, O., Garzoni, C., Lumbreras, C., Molina, I., Meije, Y., Pahissa, A., ... & ESCMID Study Group of Infection in Compromised Hosts (ESGICH). (2014). Recommendations for screening of donor and recipient prior to solid organ transplantation and to minimize transmission of donor–derived infections. Clinical Microbiology and Infection, 20, 10-18.

Naeem, F., Mhaissen, M. N., McCarty, J., & Rongkavilit, C. (2017, October). Disseminated Coccidioidomycosis Among Children in Central California: A Retrospective Review. In Open forum infectious diseases (Vol. 4, No. suppl_1, pp. S82-S82). US: Oxford University Press.

Nelson, J. K., Giraldeau, G., Montoya, J. G., Deresinski, S., Ho, D. Y., & Pham, M. (2016, May). Donor-derived Coccidioides immitis endocarditis and disseminated infection in the setting of solid organ transplantation. In Open forum infectious diseases (Vol. 3, No. 3). Oxford University Press.

Schuster, M. G., Cleveland, A. A., Dubberke, E. R., Kauffman, C. A., Avery, R. K., Husain, S., ... & Murphy, K. (2017, March). Infections in hematopoietic cell transplant recipients: results from the organ transplant infection project, a multicenter, prospective, cohort study. In Open forum infectious diseases(Vol. 4, No. 2, p. ofx050). US: Oxford University Press.

Zwang, N. A., Shetty, A., Sustento?Reodica, N., Gordon, E. J., Leventhal, J., Gallon, L., & Friedewald, J. J. (2016). APOL1?Associated End?Stage Renal Disease in a Living Kidney Transplant Donor. American Journal of Transplantation, 16(12), 3568-3572.