title: Clinical implications of respiratory virus infections in solid organ transplant recipients: a prospective study.
abstract: BACKGROUND
  There is limited information about clinical consequences of respiratory virus infections (RVI) in solid organ transplant recipients. No prospective epidemiological study has been published previously.
  
  
  METHODS
  We selected a cohort of 152 transplant recipients (cardiac, hepatic and renal transplant recipients). Median time from transplantation was 17 months (range 1-50). They were prospectively followed-up for RVI during 7 months (October to April). Clinical and microbiological evaluation (cell culture, shell vial and polymerase chain reaction technique) of each RVI episode was made.
  
  
  RESULTS
  We detected 81 RVI (0.91 episodes/patient/year). Complications were detected in 15/81 episodes (18.5%): acute bronchitis (10 cases), pneumonia (three cases; 3.7% of RVI episodes) and bacterial sinusitis (2 cases). In 4 of 81 episodes (5%), patients needed hospitalization. A respiratory virus was isolated in 17 of 68 nasopharyngeal samples (six respiratory syncytial virus, six influenza, four picornavirus, one adenovirus). Fever presented an 83% positive predictive value for the diagnosis of influenza virus infection among those with a positive microbiological isolation. There were no episodes of acute rejection coincidentally with RVI. Only 54% of the subjects had been previously vaccinated against influenza.
  
  
  CONCLUSIONS
  Incidence of RVI among solid organ transplant recipients is similar to general population but complications are higher. A relationship between RVI and rejection was not detected. The rate of influenza vaccination was lower than expected. The presence of fever in a transplant recipient with RVI strongly suggests influenza infection.
authors.affiliation: Infectious Diseases Unit, University Hospital 12 de Octubre, Madrid, Spain. flmedrano@yahoo.es
authors.forename: Francisco
authors.initials: F
authors.lastname: López-Medrano
authors.forename: Jose M
authors.initials: JM
authors.lastname: Aguado
authors.forename: Manuel
authors.initials: M
authors.lastname: Lizasoain
authors.forename: Dolores
authors.initials: D
authors.lastname: Folgueira
authors.forename: Rafael San
authors.initials: RS
authors.lastname: Juan
authors.forename: Carmen
authors.initials: C
authors.lastname: Díaz-Pedroche
authors.forename: Carlos
authors.initials: C
authors.lastname: Lumbreras
authors.forename: Jose M
authors.initials: JM
authors.lastname: Morales
authors.forename: Juan F
authors.initials: JF
authors.lastname: Delgado
authors.forename: Enrique
authors.initials: E
authors.lastname: Moreno-González
mesh_terms: D000818:Animals; D002460:Cell Line; D045744:Cell Line, Tumor; D004285:Dogs; D016027:Heart Transplantation / Q000009:adverse effects; D006801:Humans; D015994:Incidence; D007251:Influenza, Human / Q000150:complications; D016030:Kidney Transplantation / Q000009:adverse effects; D016031:Liver Transplantation / Q000009:adverse effects; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D012141:Respiratory Tract Infections / Q000150:complications*; D012307:Risk Factors; D012621:Seasons; D013997:Time Factors; D014777:Virus Diseases / Q000150:complications*