Federico Palacio1, Luis F Reyes2, Deborah J Levine3, Juan F Sanchez4, Luis F Angel5, Juan F Fernandez5, Stephanie M Levine6, Jordi Rello7, Ali Abedi5, Marcos I Restrepo8. 1. South Texas Veterans Health Care System, San Antonio, TX; University of Texas Health Science Center at San Antonio, San Antonio, TX. 2. University of Texas Health Science Center at San Antonio, San Antonio, TX; Universidad de La Sabana, Bogota, Colombia. 3. South Texas Veterans Health Care System, San Antonio, TX; University of Texas Health Science Center at San Antonio, San Antonio, TX; University of Texas Health Science Center at San Antonio, San Antonio, TX. 4. Scott and White Health Care System, Temple, TX. 5. University of Texas Health Science Center at San Antonio, San Antonio, TX. 6. South Texas Veterans Health Care System, San Antonio, TX. 7. Hospital Universitari Vall d'Hebron, Vall d'Hebron Institute of Research, CIBERES, Universitat Autonoma de Barcelona, Barcelona, Spain). 8. South Texas Veterans Health Care System, San Antonio, TX; University of Texas Health Science Center at San Antonio, San Antonio, TX. Electronic address: restrepom@uthscsa.edu.
Abstract
BACKGROUND: Limited data are available regarding the etiologic impact of health care-associated pneumonia (HCAP) in lung transplant recipients. Therefore, our aim was to evaluate the microbiologic differences between HCAP and hospital-acquired pneumonia (HAP)/ventilator-associated pneumonia (VAP) in lung transplant recipients with a radiographically confirmed diagnosis of pneumonia. METHODS: We performed a retrospective cohort study of lung transplant recipients with pneumonia at one transplant center over a 7-year period. Eligible patients included lung transplant recipients who developed a first episode of radiographically confirmed pneumonia ≥ 48 h following transplantation. HCAP, HAP, and VAP were classified according to the American Thoracic Society/Infectious Diseases Society of America 2005 guidelines. χ² and Student t tests were used to compare categorical and continuous variables, respectively. RESULTS: Sixty-eight lung transplant recipients developed at least one episode of pneumonia. HCAP (n = 42; 62%) was most common, followed by HAP/VAP (n = 26; 38%) stratified in HAP (n = 20; 77%) and VAP (n = 6; 23%). Pseudomonas aeruginosa was the predominantly isolated organism (n = 22; 32%), whereas invasive aspergillosis was uncommon (< 10%). Multiple-drug resistant (MDR) pathogens were less frequently isolated in patients with HCAP compared with HAP/VAP (5% vs 27%; P = .009). Opportunistic pathogens were less frequently identified in lung transplant recipients with HCAP than in those with HAP/VAP (7% vs 27%; P = .02). Lung transplant recipients with HCAP had a similar mortality at 90 days (n = 9 [21%] vs n = 4 [15%]; P = .3) compared with patients with HAP/VAP. CONCLUSIONS: HCAP was the most frequent infection in lung transplant recipients. MDR pathogens and opportunistic pathogens were more frequently isolated in HAP/VAP. There were no differences in 30- and 90-day mortality between lung transplant recipients with HCAP and those with HAP/VAP.
BACKGROUND: Limited data are available regarding the etiologic impact of health care-associated pneumonia (HCAP) in lung transplant recipients. Therefore, our aim was to evaluate the microbiologic differences between HCAP and hospital-acquired pneumonia (HAP)/ventilator-associated pneumonia (VAP) in lung transplant recipients with a radiographically confirmed diagnosis of pneumonia. METHODS: We performed a retrospective cohort study of lung transplant recipients with pneumonia at one transplant center over a 7-year period. Eligible patients included lung transplant recipients who developed a first episode of radiographically confirmed pneumonia ≥ 48 h following transplantation. HCAP, HAP, and VAP were classified according to the American Thoracic Society/Infectious Diseases Society of America 2005 guidelines. χ² and Student t tests were used to compare categorical and continuous variables, respectively. RESULTS: Sixty-eight lung transplant recipients developed at least one episode of pneumonia. HCAP (n = 42; 62%) was most common, followed by HAP/VAP (n = 26; 38%) stratified in HAP (n = 20; 77%) and VAP (n = 6; 23%). Pseudomonas aeruginosa was the predominantly isolated organism (n = 22; 32%), whereas invasive aspergillosis was uncommon (< 10%). Multiple-drug resistant (MDR) pathogens were less frequently isolated in patients with HCAP compared with HAP/VAP (5% vs 27%; P = .009). Opportunistic pathogens were less frequently identified in lung transplant recipients with HCAP than in those with HAP/VAP (7% vs 27%; P = .02). Lung transplant recipients with HCAP had a similar mortality at 90 days (n = 9 [21%] vs n = 4 [15%]; P = .3) compared with patients with HAP/VAP. CONCLUSIONS:HCAP was the most frequent infection in lung transplant recipients. MDR pathogens and opportunistic pathogens were more frequently isolated in HAP/VAP. There were no differences in 30- and 90-day mortality between lung transplant recipients with HCAP and those with HAP/VAP.
Authors: S Campos; M Caramori; R Teixeira; J Afonso; R Carraro; T Strabelli; M Samano; P Pêgo-Fernandes; F Jatene Journal: Transplant Proc Date: 2008-04 Impact factor: 1.066
Authors: M Aguilar-Guisado; J Givaldá; P Ussetti; A Ramos; P Morales; M Blanes; G Bou; J de la Torre-Cisneros; A Román; J M Borro; R Lama; J M Cisneros Journal: Am J Transplant Date: 2007-08 Impact factor: 8.086
Authors: Scott T Micek; Katherine E Kollef; Richard M Reichley; Nareg Roubinian; Marin H Kollef Journal: Antimicrob Agents Chemother Date: 2007-08-06 Impact factor: 5.191
Authors: Manuela Carugati; Letizia Corinna Morlacchi; Anna Maria Peri; Laura Alagna; Valeria Rossetti; Alessandra Bandera; Andrea Gori; Francesco Blasi; Ifalt Working Group Journal: Int J Mol Sci Date: 2020-02-12 Impact factor: 5.923