Pneumonia in solid organ transplant recipients : a prospective multicenter study
© 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd..
BACKGROUND: Pneumonia frequently affects solid organ transplant (SOT) recipients, with high morbidity and mortality. However, the few studies on pneumonia in this population are mainly retrospective, single-center, and long-term studies, or include patients with only one type of SOT or a specific etiology. We performed a point prevalence study to investigate epidemiology, diagnosis, therapy, and outcome of pneumonia in an unselected SOT population.
METHODS: Italian and Spanish transplant centers were invited to report on all SOT recipients with pneumonia treated during 2 separate weeks (1 each in February and June 2012).
RESULTS: In total, 35 centers (18 in Italy, 17 in Spain) agreed to participate and collected 54 cases. The incidence of pneumonia was 10.1 episodes/1000 recipients/year. Pneumonia was classified as late (>6 months) in 70.4% of cases. Pneumonia was also classified as community-acquired (CAP), healthcare-associated (HCAP), and hospital-acquired (HAP) pneumonia in 40.7%, 38.9%, and 20.4% of cases, respectively. An attempt to microbiological diagnosis (≥1 sample) was made in 94.4% of patients, with a diagnostic yield of 60.7%. Causative agents included bacteria (87.1%), virus (29%), and fungi (6.4%). A multidrug-resistant bacterium was isolated in 18.2%, 40%, and 100% of patients with CAP, HCAP, and HAP (P = 0.007), respectively. Overall, 11.1% of patients were admitted to the intensive care unit, 3.7% developed graft rejection, and graft function deteriorated in 18.5%. In-hospital mortality was 1.9%.
CONCLUSION: Pneumonia remains a frequent problem in SOT recipients, although it occurs later in patients who are in better physical health. Therefore, harmful pathogens and worse outcome are less common than previously thought.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2014 |
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| Erschienen: |
2014 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:16 |
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| Enthalten in: |
Transplant infectious disease : an official journal of the Transplantation Society - 16(2014), 2 vom: 01. Apr., Seite 232-41 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Giannella, M [VerfasserIn] |
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| Links: |
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| Themen: |
Health care-associated pneumonia |
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| Anmerkungen: |
Date Completed 21.01.2015 Date Revised 19.11.2015 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1111/tid.12193 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM236070398 |
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| 520 | |a © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. | ||
| 520 | |a BACKGROUND: Pneumonia frequently affects solid organ transplant (SOT) recipients, with high morbidity and mortality. However, the few studies on pneumonia in this population are mainly retrospective, single-center, and long-term studies, or include patients with only one type of SOT or a specific etiology. We performed a point prevalence study to investigate epidemiology, diagnosis, therapy, and outcome of pneumonia in an unselected SOT population | ||
| 520 | |a METHODS: Italian and Spanish transplant centers were invited to report on all SOT recipients with pneumonia treated during 2 separate weeks (1 each in February and June 2012) | ||
| 520 | |a RESULTS: In total, 35 centers (18 in Italy, 17 in Spain) agreed to participate and collected 54 cases. The incidence of pneumonia was 10.1 episodes/1000 recipients/year. Pneumonia was classified as late (>6 months) in 70.4% of cases. Pneumonia was also classified as community-acquired (CAP), healthcare-associated (HCAP), and hospital-acquired (HAP) pneumonia in 40.7%, 38.9%, and 20.4% of cases, respectively. An attempt to microbiological diagnosis (≥1 sample) was made in 94.4% of patients, with a diagnostic yield of 60.7%. Causative agents included bacteria (87.1%), virus (29%), and fungi (6.4%). A multidrug-resistant bacterium was isolated in 18.2%, 40%, and 100% of patients with CAP, HCAP, and HAP (P = 0.007), respectively. Overall, 11.1% of patients were admitted to the intensive care unit, 3.7% developed graft rejection, and graft function deteriorated in 18.5%. In-hospital mortality was 1.9% | ||
| 520 | |a CONCLUSION: Pneumonia remains a frequent problem in SOT recipients, although it occurs later in patients who are in better physical health. Therefore, harmful pathogens and worse outcome are less common than previously thought | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a health care-associated pneumonia | |
| 650 | 4 | |a pneumonia | |
| 650 | 4 | |a solid organ transplantation | |
| 700 | 1 | |a Muñoz, P |e verfasserin |4 aut | |
| 700 | 1 | |a Alarcón, J M |e verfasserin |4 aut | |
| 700 | 1 | |a Mularoni, A |e verfasserin |4 aut | |
| 700 | 1 | |a Grossi, P |e verfasserin |4 aut | |
| 700 | 1 | |a Bouza, E |e verfasserin |4 aut | |
| 700 | 0 | |a PISOT study group |e verfasserin |4 aut | |
| 700 | 1 | |a Ranghino, Andrea |e investigator |4 oth | |
| 700 | 1 | |a Segoloni, Giuseppe |e investigator |4 oth | |
| 700 | 1 | |a Durante Mangoni, Emanuele |e investigator |4 oth | |
| 700 | 1 | |a Pinto, Daniela |e investigator |4 oth | |
| 700 | 1 | |a Utili, Riccardo |e investigator |4 oth | |
| 700 | 1 | |a Maiello, Ciro |e investigator |4 oth | |
| 700 | 1 | |a Mularoni, Alessandra |e investigator |4 oth | |
| 700 | 1 | |a Vizzini, Giovanni |e investigator |4 oth | |
| 700 | 1 | |a Gandolfini, Ilaria |e investigator |4 oth | |
| 700 | 1 | |a Maggiore, Umberto |e investigator |4 oth | |
| 700 | 1 | |a Grossi, Paolo |e investigator |4 oth | |
| 700 | 1 | |a Dalla Gasperina, Daniella |e investigator |4 oth | |
| 700 | 1 | |a Lappa, Angela |e investigator |4 oth | |
| 700 | 1 | |a Musumeci, Francesco |e investigator |4 oth | |
| 700 | 1 | |a Forni, Alberto |e investigator |4 oth | |
| 700 | 1 | |a Faggian, Giuseppe |e investigator |4 oth | |
| 700 | 1 | |a Giaquinta, Alessia |e investigator |4 oth | |
| 700 | 1 | |a Veroux, Pierfrancesco |e investigator |4 oth | |
| 700 | 1 | |a Antonelli, Barbara |e investigator |4 oth | |
| 700 | 1 | |a Rossi, Giorgio |e investigator |4 oth | |
| 700 | 1 | |a Parisi, Francesco |e investigator |4 oth | |
| 700 | 1 | |a Alfieri, Sara |e investigator |4 oth | |
| 700 | 1 | |a Balzano, Emanuele |e investigator |4 oth | |
| 700 | 1 | |a Filipponi, Franco |e investigator |4 oth | |
| 700 | 1 | |a Valerio, Francesca |e investigator |4 oth | |
| 700 | 1 | |a Sandrini, Silvio |e investigator |4 oth | |
| 700 | 1 | |a Onano, Bruno |e investigator |4 oth | |
| 700 | 1 | |a Piredda, Gianni |e investigator |4 oth | |
| 700 | 1 | |a Frascà, Giovanni Maria |e investigator |4 oth | |
| 700 | 1 | |a Gaffi, Giovanni |e investigator |4 oth | |
| 700 | 1 | |a Dello Strologo, Luca |e investigator |4 oth | |
| 700 | 1 | |a Guzzo, Isabella |e investigator |4 oth | |
| 700 | 1 | |a Berardinelli, Luisa |e investigator |4 oth | |
| 700 | 1 | |a Pasciucco, Antonio |e investigator |4 oth | |
| 700 | 1 | |a Bonofiglio, Renzo |e investigator |4 oth | |
| 700 | 1 | |a Leone, Francesca |e investigator |4 oth | |
| 700 | 1 | |a Musso, Maria |e investigator |4 oth | |
| 700 | 1 | |a Petrosillo, Nicola |e investigator |4 oth | |
| 700 | 1 | |a Lopez Medrano, Francisco |e investigator |4 oth | |
| 700 | 1 | |a Aguado, Jose Maria |e investigator |4 oth | |
| 700 | 1 | |a Charo, Lara |e investigator |4 oth | |
| 700 | 1 | |a de la Torre Cisneros, Julian |e investigator |4 oth | |
| 700 | 1 | |a Ulica, Irma Hoyo |e investigator |4 oth | |
| 700 | 1 | |a Moreno Camacho, Asuncion |e investigator |4 oth | |
| 700 | 1 | |a Fernandez, Nuria Sabe |e investigator |4 oth | |
| 700 | 1 | |a Carratala, Jordi |e investigator |4 oth | |
| 700 | 1 | |a Giannella, Maddalena |e investigator |4 oth | |
| 700 | 1 | |a Eworo, Alia |e investigator |4 oth | |
| 700 | 1 | |a Valerio, Maricela |e investigator |4 oth | |
| 700 | 1 | |a Muñoz, Patricia |e investigator |4 oth | |
| 700 | 1 | |a Bouza, Emilio |e investigator |4 oth | |
| 700 | 1 | |a Roca, Cristina |e investigator |4 oth | |
| 700 | 1 | |a Cordero Matia, Maria Elisa |e investigator |4 oth | |
| 700 | 1 | |a Arribi Vilela, Anna |e investigator |4 oth | |
| 700 | 1 | |a Picazo de la Garza, Juan Jose |e investigator |4 oth | |
| 700 | 1 | |a Portilla Sogorb, Joaquin |e investigator |4 oth | |
| 700 | 1 | |a De Lucas, Esperanza Merino |e investigator |4 oth | |
| 700 | 1 | |a Munoz Sanz, Augustin |e investigator |4 oth | |
| 700 | 1 | |a Vera Tome, Araceli |e investigator |4 oth | |
| 700 | 1 | |a Montejo, Jose Miguel |e investigator |4 oth | |
| 700 | 1 | |a Gurgui Ferrer, Merce |e investigator |4 oth | |
| 700 | 1 | |a Mirabet, Sonia |e investigator |4 oth | |
| 700 | 1 | |a Canas, Laura |e investigator |4 oth | |
| 700 | 1 | |a Lausturica Valdemoros, Ricardo |e investigator |4 oth | |
| 700 | 1 | |a Silva, Irene |e investigator |4 oth | |
| 700 | 1 | |a Guirado, Luis |e investigator |4 oth | |
| 700 | 1 | |a Meije Castillo, Yolanda |e investigator |4 oth | |
| 700 | 1 | |a Fortun Abete, Jesus |e investigator |4 oth | |
| 700 | 1 | |a Diaz Molina, Beatriz |e investigator |4 oth | |
| 700 | 1 | |a Bernardo Rodriguez, Maria Jose |e investigator |4 oth | |
| 700 | 1 | |a Farinas, Carmen |e investigator |4 oth | |
| 700 | 1 | |a Luzano, Felipe |e investigator |4 oth | |
| 700 | 1 | |a de Valdecilla, Marques |e investigator |4 oth | |
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