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Microbiological findings in bronchoalveolar lavage fluid from lung transplant patients in Sweden

Stjärne Aspelund, Anna LU ; Hammarström, Helena; Inghammar, Malin LU ; Larsson, Hillevi LU ; Hansson, Lennart LU ; Riise, Gerdt C.; Friman, Vanda; Christensson, Bertil LU and Påhlman, Lisa I. LU (2018) In Transplant Infectious Disease 20(6).
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... (More)

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.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
bronchoalveolar lavage fluid, lung infections, lung transplantation, microbiology
in
Transplant Infectious Disease
volume
20
issue
6
publisher
Wiley-Blackwell Publishing Ltd
external identifiers
  • scopus:85052823059
ISSN
1398-2273
DOI
10.1111/tid.12973
language
English
LU publication?
yes
id
c6165ff6-d889-4ca8-968e-96fa2192d8e5
date added to LUP
2018-10-04 12:36:53
date last changed
2019-02-20 11:28:50
@article{c6165ff6-d889-4ca8-968e-96fa2192d8e5,
  abstract     = {<p>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.</p>},
  articleno    = {e12973},
  author       = {Stjärne Aspelund, Anna and Hammarström, Helena and Inghammar, Malin and Larsson, Hillevi and Hansson, Lennart and Riise, Gerdt C. and Friman, Vanda and Christensson, Bertil and Påhlman, Lisa I.},
  issn         = {1398-2273},
  keyword      = {bronchoalveolar lavage fluid,lung infections,lung transplantation,microbiology},
  language     = {eng},
  month        = {08},
  number       = {6},
  publisher    = {Wiley-Blackwell Publishing Ltd},
  series       = {Transplant Infectious Disease},
  title        = {Microbiological findings in bronchoalveolar lavage fluid from lung transplant patients in Sweden},
  url          = {http://dx.doi.org/10.1111/tid.12973},
  volume       = {20},
  year         = {2018},
}