%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 }