title: Significance of blood stream infection after lung transplantation: analysis in 176 consecutive patients.
abstract: BACKGROUND
  Although infection is a leading cause of death after lung transplantation, very little is known about the incidence, epidemiology, and clinical significance of bloodstream infections in lung transplant recipients.
  
  
  METHODS
  All blood cultures were reviewed in 176 consecutive lung transplant recipients over a 6-year period. Data were obtained from a prospectively collected microbiological database.
  
  
  RESULTS
  Bloodstream infection (BSI) occurred in 25% (44/176) of all lung transplant recipients over the 6-year study period. Staphylococcus aureus, Pseudomonas aeruginosa, and Candida species were the most common bloodstream isolates after lung transplantation. The epidemiology of posttransplant BSI, however, varied considerably between early and late posttransplant time periods and also differed between cystic fibrosis (CF) and non-CF patients. BSI infection after transplantation was associated with significantly worse survival by Kaplan-Meir analysis (P value log rank test=0.0001). In a multivariable logistic regression model, posttransplant BSI was a significant predictor of posttransplant death (odds ratio 5.62, CI 2.41-13.11, P=0.001), independent of other pre- and posttransplant factors.
  
  
  CONCLUSIONS
  Bloodstream infection represents a serious complication after lung transplantation, occurring more frequently than previously recognized, and independently contributing to posttransplant mortality.
authors.affiliation: Department of Medicine, Duke University Medical Center, Durham, NC 27710, USA.
authors.forename: S M
authors.initials: SM
authors.lastname: Palmer
authors.forename: B D
authors.initials: BD
authors.lastname: Alexander
authors.forename: L L
authors.initials: LL
authors.lastname: Sanders
authors.forename: L J
authors.initials: LJ
authors.lastname: Edwards
authors.forename: L B
authors.initials: LB
authors.lastname: Reller
authors.forename: R D
authors.initials: RD
authors.lastname: Davis
authors.forename: V F
authors.initials: VF
authors.lastname: Tapson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003550:Cystic Fibrosis / Q000150:complications; D019992:Databases as Topic; D005260:Female; D006801:Humans; D015994:Incidence; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D009026:Mortality; D011183:Postoperative Complications; D018805:Sepsis / Q000150:complications / Q000209:etiology* / Q000382:microbiology / Q000401:mortality; D016019:Survival Analysis