Infections after lung transplantation: time of occurrence, sites, and microbiologic etiologies

Korean J Intern Med. 2015 Jul;30(4):506-14. doi: 10.3904/kjim.2015.30.4.506. Epub 2015 Jun 29.

Abstract

Background/aims: Infections are major causes of both early and late death after lung transplantation (LT). The development of prophylaxis strategies has altered the epidemiology of post-LT infections; however, recent epidemiological data are limited. We evaluated infections after LT at our institution by time of occurrence, site of infections, and microbiologic etiologies.

Methods: All consecutive patients undergoing lung or heart-lung transplantation between October 2008 and August 2014 at our institution were enrolled. Cases of infections after LT were initially identified from the prospective registry database, which was followed by a detailed review of the patients' medical records.

Results: A total of 108 episodes of post-LT infections (56 bacterial, 43 viral, and nine fungal infections) were observed in 34 LT recipients. Within 1 month after LT, the most common bacterial infections were catheter-related bloodstream infections (42%). Pneumonia was the most common site of bacterial infection in the 2- to 6-month period (28%) and after 6 months (47%). Cytomegalovirus was the most common viral infection within 1 month (75%) and in the 2- to 6-month period (80%). Respiratory viruses were the most common viruses after 6 months (48%). Catheter-related candidemia was the most common fungal infection. Invasive pulmonary aspergillosis developed after 6 months. Survival rates at the first and third years were 79% and 73%, respectively.

Conclusions: Although this study was performed in a single center, we provide valuable and recent detailed epidemiology data for post-LT infections. A further multicenter study is required to properly evaluate the epidemiology of post-LT infections in Korea.

Keywords: Epidemiology; Infection; Lung transplantation.

MeSH terms

  • Adult
  • Bacterial Infections / diagnosis
  • Bacterial Infections / microbiology*
  • Bacterial Infections / mortality
  • Catheter-Related Infections / microbiology
  • Catheter-Related Infections / virology
  • Cytomegalovirus Infections / virology
  • Female
  • Heart-Lung Transplantation / adverse effects*
  • Heart-Lung Transplantation / mortality
  • Humans
  • Kaplan-Meier Estimate
  • Lung Transplantation / adverse effects*
  • Lung Transplantation / mortality
  • Male
  • Medical Records
  • Middle Aged
  • Mycoses / diagnosis
  • Mycoses / microbiology*
  • Mycoses / mortality
  • Pneumonia, Bacterial / microbiology
  • Registries
  • Republic of Korea / epidemiology
  • Risk Factors
  • Time Factors
  • Treatment Outcome
  • Virus Diseases / diagnosis
  • Virus Diseases / mortality
  • Virus Diseases / virology*