Late Respiratory Infection after Lung Transplantation

• Published in: Tuberculosis and respiratory diseases Vol. 74; no. 2; pp. 63 - 69
• Main Authors: Kim, Sang Young, Shin, Jung Ar, Cho, Eun Na, Byun, Min Kwang, Kim, Hyung Jung, Ahn, Chul Min, Haam, Suk Jin, Lee, Doo Yun, Paik, Hyo Chae, Chang, Yoon Soo
• Format: Journal Article
• Language: English; Korean
• Published: Korea (South) 대한결핵 및 호흡기학회 01.02.2013; The Korean Academy of Tuberculosis and Respiratory Diseases; 대한결핵및호흡기학회
• Subjects: Lung Transplantation; Original; Respiratory Tract Infections; 내과학; Lung Transplantation; Respiratory Tract Infections
• ISSN: 1738-3536; 2005-6184
• DOI: 10.4046/trd.2013.74.2.63

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 β-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.