title: Late respiratory infection after lung transplantation.
abstract: BACKGROUND
  Aiming to improve outcome of lung transplantation (LTx) patients, we reviewed risk factors and treatment practices for the LTx recipients who experienced respiratory infection in the late post-LTx period (>1 month after LTx).
  
  
  METHODS
  We analyzed the clinical data of 48 recipients and donors from 61 LTx, who experienced late respiratory infections. Late respiratory infections were classified according to the etiology, time of occurrence, and frequency of donor-to-host transmission or colonization of the recipient prior to transplantation.
  
  
  RESULTS
  During the period of observation, 42 episodes of respiratory infections occurred. The organisms most frequently involved were gram (-) bacteria: Acinetobacter baumannii (n=13, 31.0%), Pseudomonas aeruginosa (n=7, 16.7%), and Klebsiella pneumoniae (n=4, 10.0%). Among the 42 episodes recorded, 14 occurred in the late post-LTx period. These were bacterial (n=6, 42.9%), fungal (n=2, 14.3%), viral (n=4, 28.5%), and mycobacterial (n=2, 14.3%) infections. Of 6 bacterial infections, 2 were from multidrug-resistant (MDR) A. baumannii and one from each of MDR P. aeruginosa, extended spectrum β-lactamase (+) K. pneumoniae, methicillin-resistant Staphylococcus aureus and Streptococcus pneumoniae. Infection-related death occurred in 6 of the 14 episodes (43%).
  
  
  CONCLUSIONS
  Although the frequency of respiratory infection decreased sharply in the late post-LTx period, respiratory infection was still a major cause of mortality. Gram (-) MDR bacteria were the agents most commonly identified in these infections.
authors.affiliation: Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Sang Young
authors.initials: SY
authors.lastname: Kim
authors.forename: Jung Ar
authors.initials: JA
authors.lastname: Shin
authors.forename: Eun Na
authors.initials: EN
authors.lastname: Cho
authors.forename: Min Kwang
authors.initials: MK
authors.lastname: Byun
authors.forename: Hyung Jung
authors.initials: HJ
authors.lastname: Kim
authors.forename: Chul Min
authors.initials: CM
authors.lastname: Ahn
authors.forename: Suk Jin
authors.initials: SJ
authors.lastname: Haam
authors.forename: Doo Yun
authors.initials: DY
authors.lastname: Lee
authors.forename: Hyo Chae
authors.initials: HC
authors.lastname: Paik
authors.forename: Yoon Soo
authors.initials: YS
authors.lastname: Chang
keywords: Lung Transplantation; Respiratory Tract Infections