title: Opportunistic pulmonary infections in solid organ transplant recipients.
abstract: BACKGROUND
  Opportunistic pulmonary infections (OPI) represent common life-threatening complications after solid organ transplantation. Our objective was to describe pulmonary infections caused by opportunistic pathogens in solid-organ transplant patients.
  
  
  METHODS
  We analyzed all adult solid organ recipients (liver, heart, kidney, and pancreas) between July 2003 and June 2010, reporting all episodes of pulmonary opportunistic infection.
  
  
  RESULTS
  During the study period, 1656 solid organ transplants were performed and 188 opportunistic infections were diagnosed in 163 patients (incidence 10%). In 40 cases, the site of infection was the lung (21%) with 57.5% occurring between the first and sixth month posttransplantation. The most frequently isolated microorganism was Aspergillus spp (n = 25, 63%), followed by Pneumocystis jirovecii (n = 6 cs, 15%). Twenty-five patients with an opportunistic pulmonary infections died during the follow-up including, 16 related to the infection (40%). The causative organism responsible for the highest mortality was Aspergillus spp (n = 12; 48%). Twenty-one patients with an opportunistic nonrespiratory infection died, five of them related to it (4%). Opportunistic pulmonary infection was associated with an increased mortality rate (P < .001). There was a trend toward a higher mortality among patients who developed OPI during the first 6 months after transplantation.
  
  
  CONCLUSIONS
  Opportunistic pulmonary infections after solid organ transplantation are not infrequent. The period of risk for developing this infectious complications goes beyond the first 6 months posttransplantation. Mortality due to these infections was high in comparison to that of opportunistic nonrespiratory infections. It is important to keep a high index of suspicion for infectious complications during all posttransplant periods, as this is the first step toward a rapid diagnosis and adequate treatment.
authors.affiliation: Service of Infectious Disease, Hospital Clinic of Barcelona-IDIBAPS, Barcelona, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Hoyo
authors.forename: G
authors.initials: G
authors.lastname: Sanclemente
authors.forename: C
authors.initials: C
authors.lastname: Cervera
authors.forename: F
authors.initials: F
authors.lastname: Cofán
authors.forename: M J
authors.initials: MJ
authors.lastname: Ricart
authors.forename: F
authors.initials: F
authors.lastname: Perez-Villa
authors.forename: M
authors.initials: M
authors.lastname: Navasa
authors.forename: M A
authors.initials: MA
authors.lastname: Marcos
authors.forename: J
authors.initials: J
authors.lastname: Puig de la Bellacasa
authors.forename: A
authors.initials: A
authors.lastname: Moreno
mesh_terms: D000328:Adult; D001230:Aspergillus / Q000302:isolation & purification; D016009:Chi-Square Distribution; D005260:Female; D016027:Heart Transplantation / Q000009:adverse effects; D006801:Humans; D015994:Incidence; D016030:Kidney Transplantation / Q000009:adverse effects; D016031:Liver Transplantation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009894:Opportunistic Infections / Q000175:diagnosis / Q000382:microbiology* / Q000401:mortality / Q000628:therapy; D016377:Organ Transplantation / Q000009:adverse effects* / Q000401:mortality; D016035:Pancreas Transplantation / Q000009:adverse effects; D045363:Pneumocystis carinii / Q000302:isolation & purification; D011020:Pneumonia, Pneumocystis / Q000382:microbiology; D055732:Pulmonary Aspergillosis / Q000382:microbiology; D012141:Respiratory Tract Infections / Q000175:diagnosis / Q000382:microbiology* / Q000401:mortality / Q000628:therapy; D018570:Risk Assessment; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D013997:Time Factors