title: Simkania negevensis in bronchoalveolar lavage of lung transplant recipients: a possible association with acute rejection.
abstract: BACKGROUND
  Simkania negevensis is a novel organism closely related to chlamydiae. The organism has been associated with community acquired pneumonia and acute exacerbation of chronic obstructive pulmonary disease. The prevalence and pathogenic potential of S. negevensis is not known in lung transplant recipients.
  
  
  METHODS
  In this multicenter study comparative analysis of bronchoalveolar lavage (BAL) in lung transplants (Tx) and kidney Tx, immunocompromised and nasopharyngeal (NP) washes of immunocompetent patients was done. The BAL specimens were tested by nested polymerase chain reaction (PCR) for C. pneumoniae and S. negevensis. Selected S. negevensis positive PCR cases were confirmed by culture.
  
  
  RESULTS
  In the initial 41 BAL samples S. negevensis was detected in 97.5% (40/41) of lung transplant recipients as compared to 14.1% (1/7) in other organ transplant recipients (P<0.0001). In the sequential samples of 19 lung transplant recipients, 59% (24/41) had concomitant positive PCR and rejection as compared to 30% (3/10) who had negative PCR but had rejection (P=0.16). S. negevensis infection had hazard ratio of 3.29 (95% CI: 0.73-14.76; P=0.11) for developing acute rejection.
  
  
  CONCLUSIONS
  S. negevensis is highly prevalent in liver Tx recipients and may be associated with acute rejection.
authors.affiliation: Division of Infectious Diseases, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA. husains@dom.pitt.edu
authors.forename: Shahid
authors.initials: S
authors.lastname: Husain
authors.forename: Simona
authors.initials: S
authors.lastname: Kahane
authors.forename: Maureen G
authors.initials: MG
authors.lastname: Friedman
authors.forename: David L
authors.initials: DL
authors.lastname: Paterson
authors.forename: Sean
authors.initials: S
authors.lastname: Studer
authors.forename: Kenneth R
authors.initials: KR
authors.lastname: McCurry
authors.forename: Dana G
authors.initials: DG
authors.lastname: Wolf
authors.forename: Adriana
authors.initials: A
authors.lastname: Zeevi
authors.forename: Joseph
authors.initials: J
authors.lastname: Pilewski
authors.forename: David
authors.initials: D
authors.lastname: Greenberg
mesh_terms: D000328:Adult; D001992:Bronchoalveolar Lavage Fluid / Q000276:immunology / Q000382:microbiology*; D002695:Chlamydiales / Q000502:physiology*; D005260:Female; D006084:Graft Rejection / Q000382:microbiology*; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology / Q000276:immunology* / Q000382:microbiology*; D006801:Humans; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D013997:Time Factors