Staphylococcus aureus infections in the early period after lung transplantation : epidemiology, risk factors, and outcomes
Published by Elsevier Inc..
BACKGROUND: Staphylococcus aureus infections among lung transplant recipients are poorly studied.
METHODS: We conducted a 5-year retrospective study of the epidemiology, clinical manifestations, risk factors, and outcomes of patients infected with S aureus within the first 90 days after lung transplantation.
RESULTS: An S aureus infection developed in 109 of 596 lung transplant (18%) recipients. Methicillin-susceptible S aureus (MSSA; 62%) was more common than methicillin-resistant S aureus (MRSA; 38%); however, the proportion of infections caused by MRSA increased over time. Pneumonia (48%) was the most common infection, followed by tracheobronchitis (26%), bacteremia (12%), intrathoracic infections (7%), and skin/soft tissue infections (7%). Risk factors included mechanical ventilation for > 5 days and isolation of S aureus from recipients' sterility cultures. Patients with MRSA cultured from the nares or respiratory tract at the time of transplant were at an increased risk for MRSA infection (p < 0.0001 and p = 0.02, respectively). Infected patients required longer hospital and intensive care unit stays (p < 0.0001 for both), but the 30- and 90-day mortality rates from the onset of infection were only 7% and 12%, respectively. However, infected patients had higher rates of acute and chronic rejection at 1 (p = 0.048) and 3 years (p = 0.002), and higher rates of mortality at 1 (p = 0.058) and 3 years (p = 0.009).
CONCLUSIONS: S aureus infections within the first 90 days of lung transplant were associated with low short-term mortality but increased long-term rates of mortality and acute and chronic rejection. Future studies are needed to explore the utility of S aureus eradication strategies in reducing disease burden and improving outcomes.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2012 |
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| Erschienen: |
2012 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:31 |
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| Enthalten in: |
The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation - 31(2012), 11 vom: 21. Nov., Seite 1199-206 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Shields, Ryan K [VerfasserIn] |
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| Links: |
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| Themen: |
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| Anmerkungen: |
Date Completed 09.04.2013 Date Revised 21.10.2021 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.healun.2012.08.012 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM221099360 |
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| 100 | 1 | |a Shields, Ryan K |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Staphylococcus aureus infections in the early period after lung transplantation |b epidemiology, risk factors, and outcomes |
| 264 | 1 | |c 2012 | |
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| 500 | |a Date Completed 09.04.2013 | ||
| 500 | |a Date Revised 21.10.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Published by Elsevier Inc. | ||
| 520 | |a BACKGROUND: Staphylococcus aureus infections among lung transplant recipients are poorly studied | ||
| 520 | |a METHODS: We conducted a 5-year retrospective study of the epidemiology, clinical manifestations, risk factors, and outcomes of patients infected with S aureus within the first 90 days after lung transplantation | ||
| 520 | |a RESULTS: An S aureus infection developed in 109 of 596 lung transplant (18%) recipients. Methicillin-susceptible S aureus (MSSA; 62%) was more common than methicillin-resistant S aureus (MRSA; 38%); however, the proportion of infections caused by MRSA increased over time. Pneumonia (48%) was the most common infection, followed by tracheobronchitis (26%), bacteremia (12%), intrathoracic infections (7%), and skin/soft tissue infections (7%). Risk factors included mechanical ventilation for > 5 days and isolation of S aureus from recipients' sterility cultures. Patients with MRSA cultured from the nares or respiratory tract at the time of transplant were at an increased risk for MRSA infection (p < 0.0001 and p = 0.02, respectively). Infected patients required longer hospital and intensive care unit stays (p < 0.0001 for both), but the 30- and 90-day mortality rates from the onset of infection were only 7% and 12%, respectively. However, infected patients had higher rates of acute and chronic rejection at 1 (p = 0.048) and 3 years (p = 0.002), and higher rates of mortality at 1 (p = 0.058) and 3 years (p = 0.009) | ||
| 520 | |a CONCLUSIONS: S aureus infections within the first 90 days of lung transplant were associated with low short-term mortality but increased long-term rates of mortality and acute and chronic rejection. Future studies are needed to explore the utility of S aureus eradication strategies in reducing disease burden and improving outcomes | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, N.I.H., Extramural | |
| 700 | 1 | |a Clancy, Cornelius J |e verfasserin |4 aut | |
| 700 | 1 | |a Minces, Lucio R |e verfasserin |4 aut | |
| 700 | 1 | |a Kwak, Eun J |e verfasserin |4 aut | |
| 700 | 1 | |a Silveira, Fernanda P |e verfasserin |4 aut | |
| 700 | 1 | |a Abdel Massih, Rima C |e verfasserin |4 aut | |
| 700 | 1 | |a Toyoda, Yoshiya |e verfasserin |4 aut | |
| 700 | 1 | |a Bermudez, Christian |e verfasserin |4 aut | |
| 700 | 1 | |a Bhama, Jay K |e verfasserin |4 aut | |
| 700 | 1 | |a Shigemura, Norihisa |e verfasserin |4 aut | |
| 700 | 1 | |a Pilewski, Joseph M |e verfasserin |4 aut | |
| 700 | 1 | |a Crespo, Maria |e verfasserin |4 aut | |
| 700 | 1 | |a Hong Nguyen, M |e verfasserin |4 aut | |
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