Search

Abstract: Background: This publication attempted to evaluate the frequency of mold colonization and infection and the procalcitonin serum concentrations (PCT) among lung transplant recipients. Methods and materials: We included 49 patients (36 males and 13 females) of mean age at transplantation of 47.1 ± 13.6 years. Molds were isolated using routine microbiologic methods. PCT (ng/mL) was measured using an immunoluminescence assay with values below 0.5 showing no probability of infection, 0.5 to 2.0, a moderate infection risk; 2.0 to 10, a high infection risk; and above 10 high sepsis risk. Results: Twenty-four (49%) patients revealed the presence of molds in material from the lower respiratory tract (sputum, tracheal, or tracheobronchial aspirate), mini-bronchoalveolar lavage. Aspergillus species was isolated in 14 (28.6%) patients, Penicillium in 7 (14.3%) patients, and Zygomycetes fungi in 9 (18.4%) patients. The average PCT value from 61 examinations of PCT during fungal isolation was 0.5 ± 0.7 ng/mL. However, when the studied group was categorized according to the PCT range, the rates for the groups were no infection (n = 30; 49.2%), moderate (n = 20; 32.8%), high (n = 9; 14.8%) and high sepsis risk (n = 2; 3.3%). Conclusions: The mold colonization of transplanted lung is a frequent complication and should be considered even in the case of proper prophylaxis. Procalcitonin might be the marker helpful in mold infection diagnosis. [Copyright &y& Elsevier]

Abstract Introduction The aim of the study was to assess the impact of bacterial infection during hospital stay on long-term follow-up. Materials and Methods This was a retrospective single-center study of 97 recipients of lung transplantations performed between December 2004 and June 2016 at a single center. Information about age, sex, underlying lung disease, and date and type of procedure was gathered from patients' charts. Immunosuppressive treatment has been analyzed individually among the cohort. Microbiological evaluation included the presence of infection, bacterial species in recipients and donors, as well as type of biological material. Results During a mean hospitalization time of 57 days (range 4–398 days), 67 patients (69%) were diagnosed with bacterial infection. There were 120 episodes of infection caused by 32 species of bacteria. The most common were Pseudomonas aeruginosa (27%), Acinetobacter baumanii (21%), Klebsiella pneumoniae (10%) and Stenotrophomonas maltophilia (11%). Analysis revealed that 39 patients developed bronchiolitis obliterans syndrome (43%). Patients with A baumanii had a lower probability of survival than the rest of the population (P <.05). Patients treated with mammalian target of rapamycin inhibitors had a higher probability of survival. Conclusions Infection with A baumanii affects lung transplant recipients' survival. Incorporating sirolimus could be beneficial for the lung transplant recipients' survival. Highlights • A baumanii seems to be the important risk factor for long-term mortality. • Bacterial epidemiology analysis in single lung transplantation centre was performed. • Bacterial infection is frequent in low-volume lung transplantation program. [ABSTRACT FROM AUTHOR]

Background: New diseases and therapies that lead to marked immunocompromise, have brought to medicine so-called opportunistic infections, caused by pathogens that usually do not cause disease in the presence of a healthy immune system. First diagnosed in AIDS patients, opportunistic infections have appeared in many other situations, including transplant recipients, other immunosuppressed patients, and even in otherwise healthy patients undergoing major elective surgery. Among the most common pathogens causing atypical infections are: Pneumocistis jiroveci, Chlamydia, Mycoplasma and Legionella. The aim of this retrospective study was to assess the incidence of the above mentioned infections in cardiac surgical patients whose early postoperative period was complicated by respiratory distress., Methods: The postoperative course of 5026 cardiac surgical patients was analysed retrospectively. In 196 cases (3.9%), important respiratory complications, defined as prolonged (>24h) requirement for mechanical ventilation, pulmonary oedema, atelectasis, pneumothorax, haemothorax, infiltrations present on chest x-ray, or ARDS, were detected., Results: Positive atypical sputum cultures (Chlamydia pneumoniae, Mycoplasma pneumoniae or Pneumocistis jiroveci) were obtained from 27 patients (16%). Pneumocistis jiroveci was the most common pathogen identified. Legionella pneumoniae was never cultured. The average duration of mechanical ventilation in the study group was 253 h, and the mortality 18.5% (5 patients)., Conclusions: Opportunistic infection with atypical pathogens should be suspected in the postoperative period when complicated by prolonged respiratory distress and difficulties with weaning from mechanical ventilation. Since these infections do not present with obvious symptoms, the diagnostic process should be extended and appropriate treatment introduced.

A retrospective analysis was performed on the records of 95 pts who underwent heart transplantation at Dept. Of Cardiac Surgery & Transplantation in 1999 and 2000 y. In 34 pts lower respiratory tract infections were observed. In all cases bacterial factor was detected in sputum or bronchoalveolar lavage. In study population we analysed influence of such factors as age of the patients, the intensity and duration of immunosuppression, pre-existing diseases and timing after transplantation on the incidence of infection. Most often, in 43 pts gram negative stains bacteria was detected. Pseudomonas aeruginosa (15 pts), Acinetobacter baumanii (7 pts) and Enterobacter cloacae (6 pts) were predominant. Gram positive stains bacteria was detected only in two cases (Streptococcus pneumoniae and Staphylococcus aureus). In 1 pt we observed lung tuberculosis and in 2 pts Pneumocystis carinii pneumonia. Older recipient age was the only risk factor leading to occurrence of respiratory tract infections in patients after heart transplantation.

Pulmonary infections remain the leading cause of death in patients after heart transplantation. Lung tuberculosis is more common in transplant recipients than in general population. Two cases of tuberculosis are presented in patients after heart transplantation. Regarding to influence of rifampicin on immunosuppressive therapy, those patients were treated with antimycobacterial drugs except rifampicin. A cure without recurrence can be achieved with a scheme of treatment regimes without rifampicin.