Microbiological Findings in Bronchoalveolar Lavage Fluid from Lung Transplant Patients in Sweden

Overview

Journal Transpl Infect Dis

Specialties General Surgery
Infectious Diseases

Date 2018 Aug 15

PMID 30107073

Citations 10

Authors

Anna Stjarne Aspelund

Helena Hammarstrom

Malin Inghammar

Hillevi Larsson

Lennart Hansson

Gerdt C Riise

Vanda Friman

Bertil Christensson

Lisa I Pahlman

Affiliations

Soon will be listed here.

Abstract

Background: Lung transplant patients experience a high risk of airway infections and microbial colonization of the lung due to constant exposure to the environment through inhaled microorganisms, denervation, reduced ciliary transport, and decreased cough.

Methods: In this nationwide prospective study on Swedish lung transplant patients, we evaluated the microbiological panorama of bacteria, fungi, and virus found in bronchoalveolar lavage fluid (BALF) obtained the first year after lung transplantation (LTx). Differences in microbiological findings depending of concomitant signs of infection and background factors were assessed.

Results: A total of 470 bronchoscopies from 126 patients were evaluated. Sixty-two percent (n = 293) of BALF samples had positive microbiological finding(s). Forty-six percent (n = 217) had bacterial growth, 29% (n = 137) fungal growth, and 9% (n = 43) were positive in viral PCR. In 38% of BALF samples (n = 181), a single microbe was found, whereas a combination of bacteria, fungi or virus was found in 24% (n = 112) of bronchoscopies. The most common microbiological findings were Candida albicans, Pseudomonas aeruginosa and coagulase negative Staphylococcus (in 42 (33%), 36 (29%), and 25 (20%) patients, respectively). Microbiological findings were similar in BALF from patients with and without signs of lung infection and the frequency of multidrug resistant (MDR) bacteria was low. No significant association was found between background factors and time to first lung infection.

Conclusion: This study gives important epidemiologic insights and reinforces that microbiological findings have to be evaluated in the light of clinical symptoms and endobronchial appearance in the assessment of lung infections in lung transplant patients.

Citing Articles

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Burden and Management of Multi-Drug Resistant Organism Infections in Solid Organ Transplant Recipients Across the World: A Narrative Review.

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Fungal Tracheobronchitis in Lung Transplant Recipients: Incidence and Utility of Diagnostic Markers.

Hammarstrom H, Magnusson J, Stjarne Aspelund A, Stenmark J, Isaksson J, Kondori N J Fungi (Basel). 2023; 9(1).

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