BACKGROUND: Thoracic transplant recipients appear to be at high risk for post-operative infections. Therefore, we investigated the incidence and risk factors of post-operative nosocomial infections (NIs) in lung and heart transplant recipients. METHODS: From January 2002 to December 2003, a cohort of 208 consecutive thoracic transplant recipients (137 lung transplants [LTx], 51 heart transplants [HTx] and 20 combined transplants [CLTx]) were analyzed for post-operative infections and in-hospital mortality. NIs were determined according to CDC definitions. Uni- and multivariate risk factor analyses were performed. RESULTS: Of the 157 NIs, 59 were pneumonia (37.6%), 34 primary sepsis (21.6%), 34 urinary tract (21.6%) and 30 surgical site (19.1%). Despite a total NI incidence of 75.5%, more importantly 56.3% of all patients remained free from any infection. CLTx patients had a higher risk of developing NIs (odds ratio [OR] 4.97; 95% confidence interval [CI] 1.74 to 15.34). Risk factors for NIs were volume reduction procedures in LTx (OR 2.6; 95% CI 1.13 to 6.30) and re-do Tx (OR 5.25; 95% CI 1.41 to 26.8). In LTx patients, pre-operative colonization with gram-negative rods was found to be a risk factor for post-transplant pneumonia (OR 3.7; 95% CI 1.19 to 11.37). Presence of NI (OR 2.53; 95% CI 1.07 to 6.25) was a risk factor for mortality, as was cystic fibrosis (OR 3.20; 95% CI 1.27 to 7.92) and ventilation prior to transplantation (OR 4.00; 95% CI 1.28 to 12.09). CONCLUSION: The mortality risk associated with NIs requires close infection surveillance for developing specific preventive anti-infection strategies.
BACKGROUND: Thoracic transplant recipients appear to be at high risk for post-operative infections. Therefore, we investigated the incidence and risk factors of post-operative nosocomial infections (NIs) in lung and heart transplant recipients. METHODS: From January 2002 to December 2003, a cohort of 208 consecutive thoracic transplant recipients (137 lung transplants [LTx], 51 heart transplants [HTx] and 20 combined transplants [CLTx]) were analyzed for post-operative infections and in-hospital mortality. NIs were determined according to CDC definitions. Uni- and multivariate risk factor analyses were performed. RESULTS: Of the 157 NIs, 59 were pneumonia (37.6%), 34 primary sepsis (21.6%), 34 urinary tract (21.6%) and 30 surgical site (19.1%). Despite a total NI incidence of 75.5%, more importantly 56.3% of all patients remained free from any infection. CLTx patients had a higher risk of developing NIs (odds ratio [OR] 4.97; 95% confidence interval [CI] 1.74 to 15.34). Risk factors for NIs were volume reduction procedures in LTx (OR 2.6; 95% CI 1.13 to 6.30) and re-do Tx (OR 5.25; 95% CI 1.41 to 26.8). In LTxpatients, pre-operative colonization with gram-negative rods was found to be a risk factor for post-transplant pneumonia (OR 3.7; 95% CI 1.19 to 11.37). Presence of NI (OR 2.53; 95% CI 1.07 to 6.25) was a risk factor for mortality, as was cystic fibrosis (OR 3.20; 95% CI 1.27 to 7.92) and ventilation prior to transplantation (OR 4.00; 95% CI 1.28 to 12.09). CONCLUSION: The mortality risk associated with NIs requires close infection surveillance for developing specific preventive anti-infection strategies.
Authors: N Martins; I S Martins; W V de Freitas; J A de Matos; A C G Magalhães; V B C Girão; R C S Dias; T C de Souza; F L P C Pellegrino; L D Costa; C H R Boasquevisque; S A Nouér; L W Riley; G Santoro-Lopes; B M Moreira Journal: Transpl Infect Dis Date: 2011-12-14 Impact factor: 2.228
Authors: Takeshi Nakajima; Vyachesav Palchevsky; David L Perkins; John A Belperio; Patricia W Finn Journal: Semin Immunopathol Date: 2011-01-27 Impact factor: 9.623
Authors: Shahid Husain; Martha L Mooney; Lara Danziger-Isakov; Frauke Mattner; Nina Singh; Robin Avery; Michael Ison; Atul Humar; Robert F Padera; Leo P Lawler; Andy Fisher; Richard J Drew; Kate F Gould; Amparo Sole; Sean Studer; Patricia Munoz; Lianne G Singer; Margaret Hannan Journal: J Heart Lung Transplant Date: 2011-04 Impact factor: 10.247