Non-tuberculous mycobacteria in lung transplant recipients: Prevalence, risk factors, and impact on survival and chronic lung allograft dysfunction.
Adolescent
Adult
Aged
Allografts
Canada
/ epidemiology
Chronic Disease
/ epidemiology
Female
Humans
Lung
/ microbiology
Lung Transplantation
/ statistics & numerical data
Male
Middle Aged
Mycobacterium Infections, Nontuberculous
/ epidemiology
Nontuberculous Mycobacteria
/ classification
Prevalence
Primary Graft Dysfunction
/ microbiology
Regression Analysis
Retrospective Studies
Risk Factors
Transplant Recipients
/ statistics & numerical data
Young Adult
Mycobacterium abscessus
Mycobacterium avium complex
Nontuberculous mycobacteria
atypical mycobacteria
chronic lung allograft dysfunction
lung transplant
Journal
Transplant infectious disease : an official journal of the Transplantation Society
ISSN: 1399-3062
Titre abrégé: Transpl Infect Dis
Pays: Denmark
ID NLM: 100883688
Informations de publication
Date de publication:
Apr 2020
Apr 2020
Historique:
received:
03
09
2019
revised:
25
11
2019
accepted:
01
12
2019
pubmed:
4
12
2019
medline:
21
11
2020
entrez:
4
12
2019
Statut:
ppublish
Résumé
Non-tuberculous mycobacteria (NTM) are environmental organisms that colonize or infect lung transplant recipients. Because of differences in populations studied and geographical diversity of species, risk factors for infection and its impact on patient outcomes post transplant are conflicting in the literature. We reviewed the charts of 375 lung transplant recipients at the University of Alberta Hospital (Edmonton, Canada) between 2005 and 2014 to assess NTM epidemiology and risk factors. NTM positivity was determined from a laboratory database. The impact of NTM on patient and graft survival was tested by multivariate Cox regression analysis. Non-tuberculous mycobacteria were cultured from 26 patients before and 17 patients after transplant. The most commonly isolated species were Mycobacterium avium complex (55%) and Mycobacterium abscessus (20%). Five-year mortality was significantly higher in those infected with NTM after transplant (P = .016), but there was no difference in chronic lung allograft dysfunction (CLAD) at 5 years (P = .999). Cystic fibrosis and lower body mass index were associated with pre-transplant but not post-transplant NTM. Isolation of NTM occurred in 7% of patients before and 4.5% of patients after transplant. In this cohort, NTM isolation was associated with increased risk of death but not CLAD onset at 5 years.
Sections du résumé
BACKGROUND
BACKGROUND
Non-tuberculous mycobacteria (NTM) are environmental organisms that colonize or infect lung transplant recipients. Because of differences in populations studied and geographical diversity of species, risk factors for infection and its impact on patient outcomes post transplant are conflicting in the literature.
METHODS
METHODS
We reviewed the charts of 375 lung transplant recipients at the University of Alberta Hospital (Edmonton, Canada) between 2005 and 2014 to assess NTM epidemiology and risk factors. NTM positivity was determined from a laboratory database. The impact of NTM on patient and graft survival was tested by multivariate Cox regression analysis.
RESULTS
RESULTS
Non-tuberculous mycobacteria were cultured from 26 patients before and 17 patients after transplant. The most commonly isolated species were Mycobacterium avium complex (55%) and Mycobacterium abscessus (20%). Five-year mortality was significantly higher in those infected with NTM after transplant (P = .016), but there was no difference in chronic lung allograft dysfunction (CLAD) at 5 years (P = .999). Cystic fibrosis and lower body mass index were associated with pre-transplant but not post-transplant NTM.
CONCLUSIONS
CONCLUSIONS
Isolation of NTM occurred in 7% of patients before and 4.5% of patients after transplant. In this cohort, NTM isolation was associated with increased risk of death but not CLAD onset at 5 years.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e13229Informations de copyright
© 2019 Wiley Periodicals, Inc.
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