title: Gram-negative infection and bronchiectasis in lung transplant recipients with bronchiolitis obliterans syndrome.
abstract: BACKGROUND
  Bronchiolitis obliterans syndrome (BOS) after lung transplantation manifests as a gradual decline in forced expiratory volume in 1 second. Bronchiectasis is often seen but occurs at variable rates with the underlying pathogenesis being unclear.
  
  
  OBJECTIVE
  We completed a study to determine whether lower airway infection with gram-negative bacilli was associated with the development of bronchiectasis in lung transplant recipients with BOS.
  
  
  METHODS
  A retrospective review of 17 lung transplant recipients (age: 28 ± 7 years, range: 13 to 40 years) in a patient population transplanted for cystic fibrosis (CF) 82% (14/17), bronchiolitis obliterans 12% (2/17), and sarcoidosis 6% (1/17) was completed. Each patient completed pulmonary function testing and underwent annual computed tomographic imaging of the chest for surveillance posttransplant at a single transplant center.
  
  
  RESULTS
  Bronchiectasis was present in 70% (12/17) of patients whereas 94% (16/17) of patients had varying severity of BOS: 1 (n = 7), 2 (n = 3), and 3 (n = 6). All 12 patients with bronchiectasis had an allograft gram-negative rod infection and 92% (11/12) of them had BOS.
  
  
  CONCLUSIONS
  The presence of bronchiectasis in lung transplant recipients with BOS was associated with a gram-negative bacterial airway infection of the allograft in a small cohort of predominately lung transplant recipients with CF.
authors.affiliation: Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio, United States. hayes.705@osu.edu
authors.forename: Don
authors.initials: D
authors.lastname: Hayes
authors.forename: Aaron
authors.initials: A
authors.lastname: Weiland
authors.forename: Stephen
authors.initials: S
authors.lastname: Kirkby
authors.forename: Mark
authors.initials: M
authors.lastname: Galantowicz
authors.forename: Patrick I
authors.initials: PI
authors.lastname: McConnell
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Tobias
mesh_terms: D000293:Adolescent; D000328:Adult; D001987:Bronchiectasis / Q000453:epidemiology* / Q000209:etiology; D001989:Bronchiolitis Obliterans / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D015994:Incidence; D016040:Lung Transplantation; D008297:Male; D009820:Ohio / Q000453:epidemiology; D011379:Prognosis; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000209:etiology; D015996:Survival Rate / Q000639:trends; D013577:Syndrome; D055815:Young Adult