1.Infections after lung transplantation: time of occurrence, sites, and microbiologic etiologies.
Ji Hyun YUN ; Sang Oh LEE ; Kyung Wook JO ; Se Hoon CHOI ; Jina LEE ; Eun Jin CHAE ; Kyung Hyun DO ; Dae Kee CHOI ; In Cheol CHOI ; Sang Bum HONG ; Tae Sun SHIM ; Hyeong Ryul KIM ; Dong Kwan KIM ; Seung Il PARK
The Korean Journal of Internal Medicine 2015;30(4):506-514
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
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Bacterial Infections/diagnosis/*microbiology/mortality
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Catheter-Related Infections/microbiology/virology
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Cytomegalovirus Infections/virology
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Female
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Heart-Lung Transplantation/*adverse effects/mortality
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Humans
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Kaplan-Meier Estimate
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Lung Transplantation/*adverse effects/mortality
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Male
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Medical Records
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Middle Aged
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Mycoses/diagnosis/*microbiology/mortality
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Pneumonia, Bacterial/microbiology
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Registries
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Republic of Korea/epidemiology
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Risk Factors
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Time Factors
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Treatment Outcome
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Virus Diseases/diagnosis/mortality/*virology