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Semin Respir Crit Care Med 2010; 31(2): 234-242
DOI: 10.1055/s-0030-1249119
© Thieme Medical Publishers

Complex Bacterial Infections Pre- and Posttransplant

Erika D. Lease1 , David W. Zaas1
  • 1Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Duke University Medical Center, Durham, North Carolina
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Publikationsverlauf

Publikationsdatum:
30. März 2010 (online)

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ABSTRACT

Infections complications following lung transplantation are associated with significant morbidity and mortality. Management of infections is most challenging in patients with cystic fibrosis (CF), but all lung transplant recipients are at heightened risk for opportunistic infections. Particularly in CF, pretransplant infections with Pseudomonas aeruginosa, other highly resistant bacteria (e.g., Stenotrophomonas, Burkholderia), and mycobacteria play a major role in recipient selection and post–lung transplant outcomes. Understanding the clinical impact and management strategies for each of these different pathogens is critical to maximizing the benefit of lung transplantation. In the review, we discuss each of these infections both as pretransplant risk factors as well as posttransplant pathogens and the individual issues that arise with each infection.

KEYWORDS

Lung transplant - pneumonia - cystic fibrosis - Pseudomonas - mycobacteria - Burkholderia

REFERENCES

  • 1 Bonvillain R W, Valentine V G, Lombard G, LaPlace S, Dhillon G, Wang G. Post-operative infections in cystic fibrosis and non-cystic fibrosis patients after lung transplantation.  J Heart Lung Transplant. 2007;  26 890-897
    CrossrefPubMedSuche in Google Scholar
  • 2 Aguilar-Guisado M, Givaldá J, Ussetti P RESITRA cohort et al. Pneumonia after lung transplantation in the RESITRA Cohort: a multicenter prospective study.  Am J Transplant. 2007;  7 1989-1996
    CrossrefPubMedSuche in Google Scholar
  • 3 Campos S, Caramori M, Teixeira R et al.. Bacterial and fungal pneumonias after lung transplantation.  Transplant Proc. 2008;  40 822-824
    CrossrefPubMedSuche in Google Scholar
  • 4 Valentine V G, Bonvillain R W, Gupta M R et al.. Infections in lung allograft recipients: ganciclovir era.  J Heart Lung Transplant. 2008;  27 528-535
    CrossrefPubMedSuche in Google Scholar
  • 5 Palmer S M, Alexander B D, Sanders L L et al.. Significance of blood stream infection after lung transplantation: analysis in 176 consecutive patients.  Transplantation. 2000;  69 2360-2366
    CrossrefPubMedSuche in Google Scholar
  • 6 Hadjiliadis D, Steele M P, Chaparro C et al.. Survival of lung transplant patients with cystic fibrosis harboring panresistant bacteria other than Burkholderia cepacia, compared with patients harboring sensitive bacteria.  J Heart Lung Transplant. 2007;  26 834-838
    CrossrefPubMedSuche in Google Scholar
  • 7 Orens J B, Estenne M, Arcasoy S Pulmonary Scientific Council of the International Society for Heart and Lung Transplantation et al. International guidelines for the selection of lung transplant candidates: 2006 update—a consensus report from the Pulmonary Scientific Council of the International Society for Heart and Lung Transplantation.  J Heart Lung Transplant. 2006;  25 745-755
    CrossrefPubMedSuche in Google Scholar
  • 8 Kumar D, Cattral M S, Robicsek A, Gaudreau C, Humar A. Outbreak of Pseudomonas aeruginosa by multiple organ transplantation from a common donor.  Transplantation. 2003;  75 1053-1055
    PubMedSuche in Google Scholar
  • 9 Walter S, Gudowius P, Bosshammer J et al.. Epidemiology of chronic Pseudomonas aeruginosa infections in the airways of lung transplant recipients with cystic fibrosis.  Thorax. 1997;  52 318-321
    CrossrefPubMedSuche in Google Scholar
  • 10 Holzmann D, Speich R, Kaufmann T et al.. Effects of sinus surgery in patients with cystic fibrosis after lung transplantation: a 10-year experience.  Transplantation. 2004;  77 134-136
    CrossrefPubMedSuche in Google Scholar
  • 11 Botha P, Archer L, Anderson R L et al.. Pseudomonas aeruginosa colonization of the allograft after lung transplantation and the risk of bronchiolitis obliterans syndrome.  Transplantation. 2008;  85 771-774
    CrossrefPubMedSuche in Google Scholar
  • 12 Vos R, Vanaudenaerde B M, Geudens N, Dupont L J, Van Raemdonck D E, Verleden G M. Pseudomonal airway colonisation: risk factor for bronchiolitis obliterans syndrome after lung transplantation?.  Eur Respir J. 2008;  31 1037-1045
    CrossrefPubMedSuche in Google Scholar
  • 13 Christenson J C, Welch D F, Mukwaya G, Muszynski M J, Weaver R E, Brenner D J. Recovery of Pseudomonas gladioli from respiratory tract specimens of patients with cystic fibrosis.  J Clin Microbiol. 1989;  27 270-273
    PubMedSuche in Google Scholar
  • 14 Church A C, Sivasothy P, Parmer J, Foweraker J. Mediastinal abscess after lung transplantation secondary to Burkholderia gladioli infection.  J Heart Lung Transplant. 2009;  28 511-514
    CrossrefPubMedSuche in Google Scholar
  • 15 Jones A M, Stanbridge T N, Isalska B J, Dodd M E, Webb A K. Burkholderia gladioli: recurrent abscesses in a patient with cystic fibrosis.  J Infect. 2001;  42 69-71
    CrossrefPubMedSuche in Google Scholar
  • 16 Kanj S S, Tapson V, Davis R D, Madden J, Browning I. Infections in patients with cystic fibrosis following lung transplantation.  Chest. 1997;  112 924-930
    CrossrefPubMedSuche in Google Scholar
  • 17 Khan S U, Gordon S M, Stillwell P C, Kirby T J, Arroliga A C. Empyema and bloodstream infection caused by Burkholderia gladioli in a patient with cystic fibrosis after lung transplantation.  Pediatr Infect Dis J. 1996;  15 637-639
    CrossrefPubMedSuche in Google Scholar
  • 18 Bernhardt S A, Spilker T, Coffey T, LiPuma J J. Burkholderia cepacia complex in cystic fibrosis: frequency of strain replacement during chronic infection.  Clin Infect Dis. 2003;  37 780-785
    CrossrefPubMedSuche in Google Scholar
  • 19 Murray S, Charbeneau J, Marshall B C, LiPuma J J. Impact of Burkholderia infection on lung transplantation in cystic fibrosis.  Am J Respir Crit Care Med. 2008;  178 363-371
    CrossrefPubMedSuche in Google Scholar
  • 20 Kennedy M P, Coakley R D, Donaldson S H et al.. Burkholderia gladioli: five year experience in a cystic fibrosis and lung transplantation center.  J Cyst Fibros. 2007;  6 267-273
    CrossrefPubMedSuche in Google Scholar
  • 21 Glass S, Govan J R. Pseudomonas cepacia—fatal pulmonary infection in a patient with cystic fibrosis.  J Infect. 1986;  13 157-158
    CrossrefPubMedSuche in Google Scholar
  • 22 De Soyza A, Corris P A. Lung transplantation and the Burkholderia cepacia complex.  J Heart Lung Transplant. 2003;  22 954-958
    CrossrefPubMedSuche in Google Scholar
  • 23 Reik R, Spilker T, Lipuma J J. Distribution of Burkholderia cepacia complex species among isolates recovered from persons with or without cystic fibrosis.  J Clin Microbiol. 2005;  43 2926-2928
    CrossrefPubMedSuche in Google Scholar
  • 24 De Soyza A, McDowell A, Archer L et al.. Burkholderia cepacia complex genomovars and pulmonary transplantation outcomes in patients with cystic fibrosis.  Lancet. 2001;  358 1780-1781
    CrossrefPubMedSuche in Google Scholar
  • 25 Aris R M, Routh J C, LiPuma J J, Heath D G, Gilligan P H. Lung transplantation for cystic fibrosis patients with Burkholderia cepacia complex: survival linked to genomovar type.  Am J Respir Crit Care Med. 2001;  164 2102-2106
    CrossrefPubMedSuche in Google Scholar
  • 26 Alexander B D, Petzold E W, Reller L B et al.. Survival after lung transplantation of cystic fibrosis patients infected with Burkholderia cepacia complex.  Am J Transplant. 2008;  8 1025-1030
    CrossrefPubMedSuche in Google Scholar
  • 27 de Perrot M, Chaparro C, McRae K et al.. Twenty-year experience of lung transplantation at a single center: influence of recipient diagnosis on long-term survival.  J Thorac Cardiovasc Surg. 2004;  127 1493-1501
    CrossrefPubMedSuche in Google Scholar
  • 28 Goss C H, Otto K, Aitken M L, Rubenfeld G D. Detecting Stenotrophomonas maltophilia does not reduce survival of patients with cystic fibrosis.  Am J Respir Crit Care Med. 2002;  166 356-361
    CrossrefPubMedSuche in Google Scholar
  • 29 Korenromp E L, Bierrenbach A L, Williams B G, Dye C. The measurement and estimation of tuberculosis mortality.  Int J Tuberc Lung Dis. 2009;  13 283-303
    PubMedSuche in Google Scholar
  • 30 Morales P, Briones A, Torres J J, Solé A, Pérez D, Pastor A. Pulmonary tuberculosis in lung and heart-lung transplantation: fifteen years of experience in a single center in Spain.  Transplant Proc. 2005;  37 4050-4055
    CrossrefPubMedSuche in Google Scholar
  • 31 Muñoz P, Rodríguez C, Bouza E. Mycobacterium tuberculosis infection in recipients of solid organ transplants.  Clin Infect Dis. 2005;  40 581-587
    CrossrefPubMedSuche in Google Scholar
  • 32 Schulman L L, Scully B, McGregor C C, Austin J H. Pulmonary tuberculosis after lung transplantation.  Chest. 1997;  111 1459-1462
    CrossrefPubMedSuche in Google Scholar
  • 33 Singh N, Paterson D L. Mycobacterium tuberculosis infection in solid-organ transplant recipients: impact and implications for management.  Clin Infect Dis. 1998;  27 1266-1277
    CrossrefPubMedSuche in Google Scholar
  • 34 Dromer C, Nashef S A, Velly J F, Martigne C, Couraud L. Tuberculosis in transplanted lungs.  J Heart Lung Transplant. 1993;  12(6 Pt 1) 924-927
    PubMedSuche in Google Scholar
  • 35 Malouf M A, Glanville A R. The spectrum of mycobacterial infection after lung transplantation.  Am J Respir Crit Care Med. 1999;  160(5 Pt 1) 1611-1616
    CrossrefPubMedSuche in Google Scholar
  • 36 Aguado J M, Herrero J A, Gavaldá J et al.. Clinical presentation and outcome of tuberculosis in kidney, liver, and heart transplant recipients in Spain. Spanish Transplantation Infection Study Group, GESITRA.  Transplantation. 1997;  63 1278-1286
    CrossrefPubMedSuche in Google Scholar
  • 37 Boedefeld R L, Eby J, Boedefeld II W M et al.. Fatal Mycobacterium tuberculosis infection in a lung transplant recipient.  J Heart Lung Transplant. 2008;  27 1176-1178
    CrossrefPubMedSuche in Google Scholar
  • 38 Bravo C, Roldán J, Roman A et al.. Tuberculosis in lung transplant recipients.  Transplantation. 2005;  79 59-64
    CrossrefPubMedSuche in Google Scholar
  • 39 Lee J, Yew W W, Wong C F, Wong P C, Chiu C S. Multidrug-resistant tuberculosis in a lung transplant recipient.  J Heart Lung Transplant. 2003;  22 1168-1173
    CrossrefPubMedSuche in Google Scholar
  • 40 Fowler S J, French J, Screaton N J et al.. Nontuberculous mycobacteria in bronchiectasis: prevalence and patient characteristics.  Eur Respir J. 2006;  28 1204-1210
    CrossrefPubMedSuche in Google Scholar
  • 41 Olivier K N, Weber D J, Wallace Jr R J Nontuberculous Mycobacteria in Cystic Fibrosis Study Group et al. Nontuberculous mycobacteria. I: multicenter prevalence study in cystic fibrosis.  Am J Respir Crit Care Med. 2003;  167 828-834
    CrossrefPubMedSuche in Google Scholar
  • 42 Chalermskulrat W, Sood N, Neuringer I P et al.. Non-tuberculous mycobacteria in end stage cystic fibrosis: implications for lung transplantation.  Thorax. 2006;  61 507-513
    CrossrefPubMedSuche in Google Scholar
  • 43 Taylor J L, Palmer S M. Mycobacterium abscessus chest wall and pulmonary infection in a cystic fibrosis lung transplant recipient.  J Heart Lung Transplant. 2006;  25 985-988
    CrossrefPubMedSuche in Google Scholar
  • 44 Chernenko S M, Humar A, Hutcheon M et al.. Mycobacterium abscessus infections in lung transplant recipients: the international experience.  J Heart Lung Transplant. 2006;  25 1447-1455
    CrossrefPubMedSuche in Google Scholar
  • 45 Zaidi S, Elidemir O, Heinle J S et al.. Mycobacterium abscessus in cystic fibrosis lung transplant recipients: report of 2 cases and risk for recurrence.  Transpl Infect Dis. 2009;  11 243-248
    CrossrefPubMedSuche in Google Scholar
  • 46 Diagnosis and treatment of disease caused by nontuberculous mycobacteria. This official statement of the American Thoracic Society was approved by the Board of Directors, March 1997. Medical Section of the American Lung Association.  Am J Respir Crit Care Med. 1997;  156(2 Pt 2) S1-S25
    PubMedSuche in Google Scholar
  • 47 Doucette K, Fishman J A. Nontuberculous mycobacterial infection in hematopoietic stem cell and solid organ transplant recipients.  Clin Infect Dis. 2004;  38 1428-1439
    CrossrefPubMedSuche in Google Scholar

David W ZaasM.D. 

Division of Pulmonary, Allergy, and Critical Care Medicine, Duke University Medical Center

DUMC Box 102354, Trent Dr., Hanes House, Rm. 122, Durham, NC 27710

eMail: david.zaas@duke.edu