Invasive pneumococcal infections in adult lung transplant recipients.
An increased risk of invasive pneumococcal infection (IPI) has been described among kidney or heart transplant recipients, but the epidemiology of IPI among lung transplant recipients has not been previously reported. We undertook a single center, retrospective cohort study to define the incidence, timing, clinical, and microbiologic features of IPI in lung transplant patients. Fourteen out of 220 recipients (6.4%) developed IPI at a median of 1.3 years after transplantation (incidence rate: 22.7 cases per 1000 person-years). All patients were receiving trimethoprim-sulfamethoxazole (TMP-SMX) prophylaxis at the time of diagnosis, and 10 (71%) had TMP-SMX-resistant isolates. All isolates were from the 23 valent polysaccharide vaccine-associated serogroups. The high incidence of IPI in lung transplant recipients is similar to that reported in kidney and heart recipients. Alternative prevention strategies, including use of the conjugated pneumococcal vaccine, should be explored in future studies.
Department of Medicine, University of Washington, Washington, WA, USA.
Guy
G
de Bruyn
Timothy P
TP
Whelan
Michael S
MS
Mulligan
Ganesh
G
Raghu
Ajit P
AP
Limaye
D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D018893:Bronchoalveolar Lavage; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007668:Kidney / Q000378:metabolism; D016040:Lung Transplantation / Q000009:adverse effects* / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011008:Pneumococcal Infections / Q000209:etiology* / Q000401:mortality; D011134:Polysaccharides / Q000378:metabolism; D012189:Retrospective Studies; D012306:Risk; D015996:Survival Rate; D013997:Time Factors; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000494:pharmacology; D014612:Vaccines
D000900:Anti-Bacterial Agents; D011134:Polysaccharides; D014612:Vaccines; D015662:Trimethoprim, Sulfamethoxazole Drug Combination