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

OBJECTIVE: The purpose of this study was to determine the incidence and risk factors of infections associated with implantable venous access ports (IVAPs). MATERIALS AND METHODS: From August 2003 through November 2011, 1747 IVAPs were placed in our interventional radiology suite. One hundred forty four IVAPs were inserted in patients with hematologic malignancy and 1603 IVAPs in patients with solid tumors. Among them, 40 ports (23 women and 17 men; mean age, 57.1 years; range, 13-83) were removed to treat port-related infections. We evaluated the incidence of port-related infection, patient characteristics, bacteriologic data, and patient progress. Univariable analyses (t test, chi-square test, and Fisher's exact test) and multiple logistic regression analyses were used to determine the risk factors for IVAP related infection. RESULTS: Overall, 40 (2.3%) of 1747 ports were removed for symptoms of infection with an incidence rate of 0.067 events/1000 catheter-days. According to the univariable study, the incidences of infection were seemingly higher in the patients who received the procedure during inpatient treatment (p = 0.016), the patients with hematologic malignancy (p = 0.041), and the patients receiving palliative chemotherapy (p = 0.022). From the multiple binary logistic regression, the adjusted odds ratios of infection in patients with hematologic malignancies and those receiving palliative chemotherapy were 7.769 (p = 0.001) and 4.863 (p = 0.003), respectively. Microorganisms were isolated from 26 (65%) blood samples, and two of the most causative organisms were found to be Staphylococcus (n = 10) and Candida species (n = 7). CONCLUSION: The underlying hematologic malignancy and the state of receiving palliative chemotherapy were the independent risk factors of IVAP-related infection.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Analysis of Variance ; Catheter-Related Infections/*epidemiology/microbiology ; Catheters, Indwelling/*adverse effects ; Female ; Hematologic Neoplasms/drug therapy ; Humans ; Incidence ; Male ; Middle Aged ; Neoplasms/drug therapy ; Palliative Care/statistics & numerical data ; Retrospective Studies ; Risk Factors ; Vascular Access Devices/*adverse effects ; Young Adult