Staphylococcus aureus infections among lung transplant recipients are poorly studied.We conducted a 5-year retrospective study of the epidemiology, clinical manifestations, risk factors, and outcomes of patients infected with S aureus within the first 90 days after lung transplantation.An S aureus infection developed in 109 of 596 lung transplant (18\%) recipients. Methicillin-susceptible S aureus (MSSA; 62\%) was more common than methicillin-resistant S aureus (MRSA; 38\%); however, the proportion of infections caused by MRSA increased over time. Pneumonia (48\%) was the most common infection, followed by tracheobronchitis (26\%), bacteremia (12\%), intrathoracic infections (7\%), and skin/soft tissue infections (7\%). Risk factors included mechanical ventilation for > 5 days and isolation of S aureus from recipients' sterility cultures. Patients with MRSA cultured from the nares or respiratory tract at the time of transplant were at an increased risk for MRSA infection (p < 0.0001 and p = 0.02, respectively). Infected patients required longer hospital and intensive care unit stays (p < 0.0001 for both), but the 30- and 90-day mortality rates from the onset of infection were only 7\% and 12\%, respectively. However, infected patients had higher rates of acute and chronic rejection at 1 (p = 0.048) and 3 years (p = 0.002), and higher rates of mortality at 1 (p = 0.058) and 3 years (p = 0.009).S aureus infections within the first 90 days of lung transplant were associated with low short-term mortality but increased long-term rates of mortality and acute and chronic rejection. Future studies are needed to explore the utility of S aureus eradication strategies in reducing disease burden and improving outcomes.
%0 Journal Article
%1 Shields2012a
%A Shields, Ryan K.
%A Clancy, Cornelius J.
%A Minces, Lucio R.
%A Kwak, Eun J.
%A Silveira, Fernanda P.
%A Abdel Massih, Rima C.
%A Toyoda, Yoshiya
%A Bermudez, Christian
%A Bhama, Jay K.
%A Shigemura, Norihisa
%A Pilewski, Joseph M.
%A Crespo, Maria
%A Hong Nguyen, M.
%D 2012
%J J Heart Lung Transplant
%K staph pneumonia transplantation bos rejection
%N 11
%P 1199--1206
%R 10.1016/j.healun.2012.08.012
%T Staphylococcus aureus infections in the early period after lung transplantation: epidemiology, risk factors, and outcomes.
%U http://dx.doi.org/10.1016/j.healun.2012.08.012
%V 31
%X Staphylococcus aureus infections among lung transplant recipients are poorly studied.We conducted a 5-year retrospective study of the epidemiology, clinical manifestations, risk factors, and outcomes of patients infected with S aureus within the first 90 days after lung transplantation.An S aureus infection developed in 109 of 596 lung transplant (18\%) recipients. Methicillin-susceptible S aureus (MSSA; 62\%) was more common than methicillin-resistant S aureus (MRSA; 38\%); however, the proportion of infections caused by MRSA increased over time. Pneumonia (48\%) was the most common infection, followed by tracheobronchitis (26\%), bacteremia (12\%), intrathoracic infections (7\%), and skin/soft tissue infections (7\%). Risk factors included mechanical ventilation for > 5 days and isolation of S aureus from recipients' sterility cultures. Patients with MRSA cultured from the nares or respiratory tract at the time of transplant were at an increased risk for MRSA infection (p < 0.0001 and p = 0.02, respectively). Infected patients required longer hospital and intensive care unit stays (p < 0.0001 for both), but the 30- and 90-day mortality rates from the onset of infection were only 7\% and 12\%, respectively. However, infected patients had higher rates of acute and chronic rejection at 1 (p = 0.048) and 3 years (p = 0.002), and higher rates of mortality at 1 (p = 0.058) and 3 years (p = 0.009).S aureus infections within the first 90 days of lung transplant were associated with low short-term mortality but increased long-term rates of mortality and acute and chronic rejection. Future studies are needed to explore the utility of S aureus eradication strategies in reducing disease burden and improving outcomes.
@article{Shields2012a,
abstract = {Staphylococcus aureus infections among lung transplant recipients are poorly studied.We conducted a 5-year retrospective study of the epidemiology, clinical manifestations, risk factors, and outcomes of patients infected with S aureus within the first 90 days after lung transplantation.An S aureus infection developed in 109 of 596 lung transplant (18\%) recipients. Methicillin-susceptible S aureus (MSSA; 62\%) was more common than methicillin-resistant S aureus (MRSA; 38\%); however, the proportion of infections caused by MRSA increased over time. Pneumonia (48\%) was the most common infection, followed by tracheobronchitis (26\%), bacteremia (12\%), intrathoracic infections (7\%), and skin/soft tissue infections (7\%). Risk factors included mechanical ventilation for > 5 days and isolation of S aureus from recipients' sterility cultures. Patients with MRSA cultured from the nares or respiratory tract at the time of transplant were at an increased risk for MRSA infection (p < 0.0001 and p = 0.02, respectively). Infected patients required longer hospital and intensive care unit stays (p < 0.0001 for both), but the 30- and 90-day mortality rates from the onset of infection were only 7\% and 12\%, respectively. However, infected patients had higher rates of acute and chronic rejection at 1 (p = 0.048) and 3 years (p = 0.002), and higher rates of mortality at 1 (p = 0.058) and 3 years (p = 0.009).S aureus infections within the first 90 days of lung transplant were associated with low short-term mortality but increased long-term rates of mortality and acute and chronic rejection. Future studies are needed to explore the utility of S aureus eradication strategies in reducing disease burden and improving outcomes.},
added-at = {2013-12-13T23:51:10.000+0100},
author = {Shields, Ryan K. and Clancy, Cornelius J. and Minces, Lucio R. and Kwak, Eun J. and Silveira, Fernanda P. and {Abdel Massih}, Rima C. and Toyoda, Yoshiya and Bermudez, Christian and Bhama, Jay K. and Shigemura, Norihisa and Pilewski, Joseph M. and Crespo, Maria and {Hong Nguyen}, M.},
biburl = {https://www.bibsonomy.org/bibtex/21ffa8899ca7f235d8a35e35597dca9db/aorchid},
description = {too similar?},
doi = {10.1016/j.healun.2012.08.012},
file = {:ID_General/TransplantClinical/JHeartLungTransplant.31.1199.pdf:PDF},
groups = {public},
institution = {Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.},
interhash = {b76d8ba221b7f50077544e9823850d44},
intrahash = {1ffa8899ca7f235d8a35e35597dca9db},
journal = {J Heart Lung Transplant},
keywords = {staph pneumonia transplantation bos rejection},
language = {eng},
medline-pst = {ppublish},
month = Nov,
number = 11,
pages = {1199--1206},
pii = {S1053-2498(12)01220-X},
pmid = {22986156},
timestamp = {2013-12-13T23:51:10.000+0100},
title = {Staphylococcus aureus infections in the early period after lung transplantation: epidemiology, risk factors, and outcomes.},
url = {http://dx.doi.org/10.1016/j.healun.2012.08.012},
username = {aorchid},
volume = 31,
year = 2012
}