title: Management of multidrug-resistant CMV infection in immunocompromised patients: case report of a heart-transplant recipient and review of the literature.
abstract: Cytomegalovirus (CMV) remains a leading cause of morbidity after solid organ transplantation. The efficiency of antivirals for the treatment of CMV infections may be hampered because of the emergence of CMV resistance to antivirals. The development of CMV multidrug resistance, which remains uncommon but does occur, constitutes a clinically challenging complication and may contribute to difficult therapeutic management and adverse clinical outcome. We report here the observation of the emergence of a multidrug-resistant CMV infection in a heart-transplant recipient and review the literature on similar cases to identify the potential strategies for the successful management of CMV multidrug resistance among immunocompromised patients.
authors.affiliation: INSERM UMR S996 and AP-HP, Hôpitaux Universitaires Paris-Sud, Service de Virologie, Villejuif, France.
authors.forename: Claire
authors.initials: C
authors.lastname: Deback
authors.forename: Sonia
authors.initials: S
authors.lastname: Burrel
authors.forename: Shaïda
authors.initials: S
authors.lastname: Varnous
authors.forename: Guislaine
authors.initials: G
authors.lastname: Carcelain
authors.forename: Françoise
authors.initials: F
authors.lastname: Conan
authors.forename: Zaïna
authors.initials: Z
authors.lastname: Aït-Arkoub
authors.forename: Brigitte
authors.initials: B
authors.lastname: Autran
authors.forename: Iradj
authors.initials: I
authors.lastname: Gandjbakhch
authors.forename: Henri
authors.initials: H
authors.lastname: Agut
authors.forename: David
authors.initials: D
authors.lastname: Boutolleau
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D016572:Cyclosporine / Q000627:therapeutic use; D003587:Cytomegalovirus / Q000187:drug effects* / Q000502:physiology; D003586:Cytomegalovirus Infections / Q000188:drug therapy* / Q000209:etiology / Q000276:immunology* / Q000821:virology; D019468:Disease Management; D024882:Drug Resistance, Viral; D000068338:Everolimus / Q000627:therapeutic use; D005260:Female; D017245:Foscarnet / Q000627:therapeutic use; D015774:Ganciclovir / Q000031:analogs & derivatives / Q000627:therapeutic use; D016027:Heart Transplantation / Q000009:adverse effects*; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007223:Infant; D008297:Male; D008875:Middle Aged; D000077562:Valganciclovir; D019562:Viral Load / Q000187:drug effects
chemical_list: D000305:Adrenal Cortex Hormones; D000998:Antiviral Agents; D007166:Immunosuppressive Agents; D017245:Foscarnet; D016572:Cyclosporine; D000068338:Everolimus; D000077562:Valganciclovir; D015774:Ganciclovir