Preventing Coccidioidomycosis in Organ Transplantation

This study explores the association of coccidioidomycosis with organ transplantation and prevention strategies. A literature review and cross-sectional retrospective study were conducted, with sequential data analysis used to analyze the results. Limited resources were found for prevention strategies, indicating a need for further research.

Clever one or two word title
Touro College
School of Health Science
Masters Thesis
Name of Thesis
Author: Your name goes here.
1

Clever one or two word title
Contents
Chapter One.....................................................................................................................................3
Introduction to the Study.............................................................................................................3
Statement of the Problems...........................................................................................................3
Purpose of the Study....................................................................................................................4
Limitations...................................................................................................................................4
Assumptions of the Study............................................................................................................4
Definitions of Terms....................................................................................................................4
Research Question(s)and/or Hypothesis......................................................................................4
Chapter Two....................................................................................................................................5
Review of the Literature..............................................................................................................5
First mention in literature quoting old literature like historical...................................................5
First discussed in the research literature......................................................................................5
History of work in the area..........................................................................................................6
Variations on Techniques............................................................................................................6
Clinical.....................................................................................................................................6
Only research...........................................................................................................................6
Theoretical issues in each area covered...................................................................................6
Difficulty in evaluating issues.................................................................................................6
Instrumental issues...................................................................................................................7
Relationship of your project to the above................................................................................7
Summary......................................................................................................................................7
2

Clever one or two word title
Chapter Three..................................................................................................................................9
Method.........................................................................................................................................9
Subjects....................................................................................................................................9
What instruments will you be using.......................................................................................9
Procedure................................................................................................................................9
Proposed Statistical Analysis.....................................................................................................10
Chapter Four..................................................................................................................................11
Results........................................................................................................................................11
Descriptives...........................................................................................................................11
From the sequential data analysis, the result will be found.......................................................11
Research Questions................................................................................................................11
The result will clearly represent how coccidioidomycosis is associated with organ
transplantation and what strategies the medical practitioners follow in order to prevent them.
...................................................................................................................................................11
Additional Findings..............................................................................................................11
Chapter Five...................................................................................................................................12
Discussion..................................................................................................................................12
Fate of research questions......................................................................................................12
Implications for your field of study.......................................................................................12
Implications for future research activities include what you would do differently...............12
Summary....................................................................................................................................13
References......................................................................................................................................14
3

Clever one or two word title
Chapter One
Introduction to the Study
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.
Statement of the Problems
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.
4

Clever one or two word title
Purpose of the Study
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.
Limitations
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.
Assumptions of the Study
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).
Definitions of Terms
PDDTE- Potential donor-derived transmission events (Zwang et al., 2016).
OPTN- Organ procurement and transplantation network (Nelson et al., 2016).
Research Question(s)and/or Hypothesis
5

Clever one or two word title
The main research questions can be formed as how coccidioidomycosis is associated with
organ transplantation and what are the prevention strategies.
6

Clever one or two word
title
Chapter Two
Review of the Literature
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).
First mention in literature quoting old literature like historical
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).
First discussed in the research literature
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
7

Clever one or two word
title
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.
History of work in the area
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).
Variations on Techniques
Clinical
A screening or test has been added before the organ transplantation in order to
avoid the disease on the recipient patient.
Only research
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.
Theoretical issues in each area covered
8

Clever one or two word
title
How the occurrence of coccidioidomycosis among the patients of organ
transplantation is not cleared in the literatures.
Difficulty in evaluating issues
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.
Instrumental issues
While handling the medical records ethical issues might arise from the patients’
sides which can have severe affect on the research findings.
Relationship of your project to the above
a. 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.
b. Many previous studies were also unable to find the same and thus they
are related to this project.
c. 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.
d. The theories found from the literature review are not enriched with the
prevention strategies of the disease.
9

Clever one or two word
title
Summary
Coccidioidomycosis is a common issue of medical field which is found in the
patients of organ transplantation and various deaths have occurred due to this reason.
This infectious disease mostly attacks the patients of endemic regions. Various literatures
and studies are there on this issue since 1950 and most of them produced the fact that in
kidney transplantation, liver transplantation and other organ transplantation, the risk is
high. Sometimes, donor-derived coccidioidomycosis becomes life-threatening to the
patients (Len et al., 2014). The rest of this paper is going to find out the answer of the
research questions stated at the beginning of the paper. The research question is, how
coccidioidomycosis is associated with organ transplantation and what are the strategies to
prevent them (Naeem, Mhaissen, McCarty & Rongkavilit, 2017).
10

Clever one or two word
title
Chapter Three
Method
Subjects
The main aim of the study is to find out the clear answer of the research questions
which are related to the topic coccidioidomycosis.
What instruments will you be using
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.
Procedure
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.
11

Clever one or two word
title
Proposed Statistical Analysis
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).
12

Clever one or two word
title
Chapter Four
Results
Descriptives
From the sequential data analysis, the result will be found.
Research Questions
The result will clearly represent how coccidioidomycosis is associated with organ
transplantation and what strategies the medical practitioners follow in order to prevent
them.
Additional Findings
Apart from that it will additionally found that in which areas, the occurrence of
coccidioidomycosis is comparatively high.
13

Clever one or two word
title
Chapter Five
Discussion
Fate of research questions
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.
Implications for your field of study
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.
Implications for future research activities include what you would do
differently
A future research is also required to identify the exact strategy of prevention of
such infectious disease after organ transplantation.
14

Clever one or two word
title
Summary
Coccidioidomycosis is one of the leading causes of deaths and increased mortality
rates among the patients of organ transplantation and it is one of the common issues of
medical field. The main aim of the research paper was to identify how
coccidioidomycosis is associated with the patients of organ transplantation and what are
the strategies to prevent that. After a thorough literature review, a cross-sectional
retrospective study will be organized with the previous reports and medical records of the
patients. Finally, after the collection of the data, a sequential statistical data analysis
method will be used to analyze the collected data. It is assumed the result will produce a
clear idea about the association of coccidioidomycosis with the patients of organ
transplantation. However, in order to find the strategies of prevention, further study is
required because of limited number of resources in this regard.
15

Clever one or two word
title
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,
16

Clever one or two word
title
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
17

Clever one or two word
title
Living Kidney Transplant Donor. American Journal of Transplantation, 16(12),
3568-3572.
18