Tuberc Respir Dis.  2013 Feb;74(2):63-69.

Late Respiratory Infection after Lung Transplantation

• Kim SY
• Shin JA
• Cho EN
• Byun MK
• Kim HJ
• Ahn CM
• Haam SJ
• Lee DY
• Paik HC
• Chang YS

Abstract

BACKGROUND
Aiming to improve outcome of lung transplantation (LTx) patients, we reviewed risk factors and treatment practices for the LTx recipients who experienced respiratory infection in the late post-LTx period (>1 month after LTx).
METHODS
We analyzed the clinical data of 48 recipients and donors from 61 LTx, who experienced late respiratory infections. Late respiratory infections were classified according to the etiology, time of occurrence, and frequency of donor-to-host transmission or colonization of the recipient prior to transplantation.
RESULTS
During the period of observation, 42 episodes of respiratory infections occurred. The organisms most frequently involved were gram (-) bacteria: Acinetobacter baumannii (n=13, 31.0%), Pseudomonas aeruginosa (n=7, 16.7%), and Klebsiella pneumoniae (n=4, 10.0%). Among the 42 episodes recorded, 14 occurred in the late post-LTx period. These were bacterial (n=6, 42.9%), fungal (n=2, 14.3%), viral (n=4, 28.5%), and mycobacterial (n=2, 14.3%) infections. Of 6 bacterial infections, 2 were from multidrug-resistant (MDR) A. baumannii and one from each of MDR P. aeruginosa, extended spectrum beta-lactamase (+) K. pneumoniae, methicillin-resistant Staphylococcus aureus and Streptococcus pneumoniae. Infection-related death occurred in 6 of the 14 episodes (43%).
CONCLUSION
Although the frequency of respiratory infection decreased sharply in the late post-LTx period, respiratory infection was still a major cause of mortality. Gram (-) MDR bacteria were the agents most commonly identified in these infections.

Keyword

Lung Transplantation; Respiratory Tract Infections

MeSH Terms

Acinetobacter baumannii
Bacteria
Bacterial Infections
beta-Lactamases
Colon
Humans
Klebsiella pneumoniae
Lung
Lung Transplantation
Methicillin-Resistant Staphylococcus aureus
Pneumonia
Pseudomonas aeruginosa
Respiratory Tract Infections
Risk Factors
Streptococcus pneumoniae
Tissue Donors
beta-Lactamases

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