Infections in Lung Allograft Recipients

Ganciclovir Era

Vincent G. Valentine, Ryan W. Bonvillain, Meera R. Gupta, Gisele A. Lombard, Stephanie G. LaPlace, Gundeep S. Dhillon, Guoshun Wang

Research output: Contribution to journalArticle

42 Citations (Scopus)

Abstract

Background: Infections are common after lung transplantation. This report analyzes infections and associated pathogens identified in 202 lung transplant recipients. Methods: Infections were tallied according to sites of infection and associated pathogen(s). Infection events were also categorized by post-operative Days 0 to 100, 101 to 365, and after 365, and normalized to 100 patient-days before and after bronchiolitis obliterans syndrome (BOS). Results: From November 1990 to November 2005, 202 patients received 208 lung transplants. The follow-up was 702.4 patient-years. A total of 178 lung transplant patients developed 859 infections, with 944 pathogens identified. Infections were in the lung in 559 (65.1%), mucocutaneous (skin, wound, catheter-related, and oral) in 88 (10.2%), in the blood in 85 (9.8%), and in other sites (urine, bowel, eye, and peritoneum) in 127 (14.8%). Most lung pathogens were bacterial (83.6%), and 57.9% were Pseudomonas aeruginosa. Fungi comprised 10.6%, with Aspergillus spp the most common (67.1%) isolate. Cytomegalovirus pneumonitis was seen in 4.3% of respiratory infections. BOS was diagnosed in 87 patients (43.1% of the total). Of all infections seen in the BOS population, there were 0.42 episodes/100 patient-days and 0.70 episodes/100 patient-days before and after BOS, respectively (p = 0.5). Conclusions: These data provide an updated infection profile in the ganciclovir era after lung transplantation. When compared with pre-ganciclovir times, post-transplant cytomegalovirus infection incidence has notably declined, with filamentous fungi emerging as prevalent pathogens in its place. Such findings are important for refining management of infections in order to offer more stringent treatment against aggressive pathogens.

Original languageEnglish (US)
Pages (from-to)528-535
Number of pages8
JournalJournal of Heart and Lung Transplantation
Volume27
Issue number5
DOIs
StatePublished - May 2008

Fingerprint

Ganciclovir
Allografts
Lung
Bronchiolitis Obliterans
Infection
Lung Transplantation
Transplants
Fungi
Peritoneum
Cytomegalovirus Infections
Aspergillus
Cytomegalovirus
Respiratory Tract Infections
Pseudomonas aeruginosa
Pneumonia
Catheters
Urine
Skin

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Transplantation

Cite this

Valentine, V. G., Bonvillain, R. W., Gupta, M. R., Lombard, G. A., LaPlace, S. G., Dhillon, G. S., & Wang, G. (2008). Infections in Lung Allograft Recipients: Ganciclovir Era. Journal of Heart and Lung Transplantation, 27(5), 528-535. https://doi.org/10.1016/j.healun.2007.12.013

Infections in Lung Allograft Recipients : Ganciclovir Era. / Valentine, Vincent G.; Bonvillain, Ryan W.; Gupta, Meera R.; Lombard, Gisele A.; LaPlace, Stephanie G.; Dhillon, Gundeep S.; Wang, Guoshun.

In: Journal of Heart and Lung Transplantation, Vol. 27, No. 5, 05.2008, p. 528-535.

Research output: Contribution to journalArticle

Valentine, VG, Bonvillain, RW, Gupta, MR, Lombard, GA, LaPlace, SG, Dhillon, GS & Wang, G 2008, 'Infections in Lung Allograft Recipients: Ganciclovir Era', Journal of Heart and Lung Transplantation, vol. 27, no. 5, pp. 528-535. https://doi.org/10.1016/j.healun.2007.12.013
Valentine VG, Bonvillain RW, Gupta MR, Lombard GA, LaPlace SG, Dhillon GS et al. Infections in Lung Allograft Recipients: Ganciclovir Era. Journal of Heart and Lung Transplantation. 2008 May;27(5):528-535. https://doi.org/10.1016/j.healun.2007.12.013
Valentine, Vincent G. ; Bonvillain, Ryan W. ; Gupta, Meera R. ; Lombard, Gisele A. ; LaPlace, Stephanie G. ; Dhillon, Gundeep S. ; Wang, Guoshun. / Infections in Lung Allograft Recipients : Ganciclovir Era. In: Journal of Heart and Lung Transplantation. 2008 ; Vol. 27, No. 5. pp. 528-535.
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abstract = "Background: Infections are common after lung transplantation. This report analyzes infections and associated pathogens identified in 202 lung transplant recipients. Methods: Infections were tallied according to sites of infection and associated pathogen(s). Infection events were also categorized by post-operative Days 0 to 100, 101 to 365, and after 365, and normalized to 100 patient-days before and after bronchiolitis obliterans syndrome (BOS). Results: From November 1990 to November 2005, 202 patients received 208 lung transplants. The follow-up was 702.4 patient-years. A total of 178 lung transplant patients developed 859 infections, with 944 pathogens identified. Infections were in the lung in 559 (65.1{\%}), mucocutaneous (skin, wound, catheter-related, and oral) in 88 (10.2{\%}), in the blood in 85 (9.8{\%}), and in other sites (urine, bowel, eye, and peritoneum) in 127 (14.8{\%}). Most lung pathogens were bacterial (83.6{\%}), and 57.9{\%} were Pseudomonas aeruginosa. Fungi comprised 10.6{\%}, with Aspergillus spp the most common (67.1{\%}) isolate. Cytomegalovirus pneumonitis was seen in 4.3{\%} of respiratory infections. BOS was diagnosed in 87 patients (43.1{\%} of the total). Of all infections seen in the BOS population, there were 0.42 episodes/100 patient-days and 0.70 episodes/100 patient-days before and after BOS, respectively (p = 0.5). Conclusions: These data provide an updated infection profile in the ganciclovir era after lung transplantation. When compared with pre-ganciclovir times, post-transplant cytomegalovirus infection incidence has notably declined, with filamentous fungi emerging as prevalent pathogens in its place. Such findings are important for refining management of infections in order to offer more stringent treatment against aggressive pathogens.",
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