2744. A 5-Year Single-Center Review of Strongyloides Seropositivity in Kidney Transplant Candidates in Rural Central Texas

Abstract

Background

The American Society of Transplantation recommends screening for Strongyloides stercoralis for people from or with extended travel to endemic areas including tropical regions of Southeast Asia and the Appalachian region of the United States. Asymptomatic carriers without risk factors can potentially be missed during screening assessments. Consequently, they can develop deadly hyperinfection and disseminated disease with immunosuppressive therapy. The aim of this study is to identify demographics and characteristics among our population of Strongyloides-infected kidney transplant candidates in rural Central Texas.

Methods

This study is a single-center, retrospective chart review of patients aged 18 or older who underwent evaluation for kidney transplant at our institution in rural Central Texas between January 1, 2018 and December 31, 2022 and tested equivocal or positive for serum Strongyloides IgG antibody.

Results

Out of the 1653 patients who underwent Strongyloides screening during their evaluation for kidney transplant within the study period, 182 (11.0%) returned as either equivocal or positive. Demographics of this Strongyloides-infected population are noted in table 1. 86.3% of these patients were born in the United States or Canada, 6.6% from Mexico, and 3.3% from Asia. 33.0% reported no international travel outside the United States (table 1). Comorbidities and symptoms of our population are listed in table 2. 83.5% were asymptomatic. Laboratory data and other risk factors for Strongyloides infection are noted in table 3. Only 6.0% had eosinophilia at time of diagnosis (considered as greater than 0.00 - 0.76 10*9/L). None of our population tested positive for human T-lymphotrophic virus (HTLV-1). Out of the 69 patients who were asked, 71.0% reported a history of walking outside barefoot.

Demographic information and international travel outside the United States

Patient comorbidities and symptoms

Laboratory data and other risk factors

Conclusion

Importantly, 11.0% of our population were found to have an equivocal or positive Strongyloides serology. Of those, 33.0% had no apparent risk factors for Strongyloides infection including international travel, suggesting local acquisition of the infection in rural Central Texas. More research is needed to identify unique risk factors for this population including environmental studies of this underserved population.

Disclosures

All Authors: No reported disclosures