Seasonal changes of lower respiratory tract infections in lung transplant recipients during the first post-transplant year

The Hungarian experience

Zsuzsanna Kovats, Aniko Bohacs, Zoltan Sutto, Krisztina Vincze, Jozsef Lukacsovits, Gyorgy Losonczy, V. Müller

Research output: Contribution to journalArticle

Abstract

Background: After lung transplantation (LuTX) a high level of immunosuppression is needed to prevent rejection of the graft. Together with earlier colonization by pathogens, immunosuppression makes recipients more susceptible to infections, especially during the first postoperative year. As seasonality of lower respiratory tract infections (LRTI) is well-known in chronic lung diseases, we assessed seasonal changes of pathogen spectrum and number of infections in the first postoperative year in LuTX recipients. Methods: LRTI were analyzed in 28 Hungarian adult LuTX patients. Incidence and spectrum of microorganism causing LRTI were evaluated according to post-transplant time and seasonal temperature and humidity changes. Results: A total of 69 cases of LRTI were registered (average: 1.9 cases/patient; range: 0-14). Gram-negative=59, gram-positive=26, and fungal=31 pathogens were detected, with polymicrobial samples in 46% of all cases. Increased number of LRTI was observed in the cold season (1.68±1.54 vs 0.79±0.92 case/month/patient, P<.01) and significant negative correlations were identified between the incidence of polymicrobial and bacterial infections and temperature (r2=0.1535, P<.05, r2=0.3144, P<.01, respectively). In addition, positive correlation was observed between polymicrobial infections and humidity (r2=0.1403, P<.05). Higher incidence of LRTI was also noted in the cold season, when accounting for the differences in immunosuppression. Conclusion: Seasons influenced the incidence of LRTI in the first postoperative year in LuTX recipients. More intensive vigilance for possible gram-negative and polymicrobial infections is needed in these patients in cold and wet seasons in the continental climate zone, regardless of underlying disease.

Original languageEnglish
Article numbere12671
JournalTransplant Infectious Disease
Volume19
Issue number2
DOIs
Publication statusPublished - Apr 1 2017

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Respiratory Tract Infections
Transplants
Lung
Coinfection
Immunosuppression
Incidence
Humidity
Temperature
Lung Transplantation
Graft Rejection
Infection
Transplant Recipients
Climate
Bacterial Infections
Lung Diseases
Chronic Disease

Keywords

  • bacteria
  • first year
  • humidity
  • infection
  • lung transplantation
  • seasons
  • temperature

ASJC Scopus subject areas

  • Transplantation
  • Infectious Diseases

Cite this

Seasonal changes of lower respiratory tract infections in lung transplant recipients during the first post-transplant year : The Hungarian experience. / Kovats, Zsuzsanna; Bohacs, Aniko; Sutto, Zoltan; Vincze, Krisztina; Lukacsovits, Jozsef; Losonczy, Gyorgy; Müller, V.

In: Transplant Infectious Disease, Vol. 19, No. 2, e12671, 01.04.2017.

Research output: Contribution to journalArticle

Kovats, Zsuzsanna ; Bohacs, Aniko ; Sutto, Zoltan ; Vincze, Krisztina ; Lukacsovits, Jozsef ; Losonczy, Gyorgy ; Müller, V. / Seasonal changes of lower respiratory tract infections in lung transplant recipients during the first post-transplant year : The Hungarian experience. In: Transplant Infectious Disease. 2017 ; Vol. 19, No. 2.
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abstract = "Background: After lung transplantation (LuTX) a high level of immunosuppression is needed to prevent rejection of the graft. Together with earlier colonization by pathogens, immunosuppression makes recipients more susceptible to infections, especially during the first postoperative year. As seasonality of lower respiratory tract infections (LRTI) is well-known in chronic lung diseases, we assessed seasonal changes of pathogen spectrum and number of infections in the first postoperative year in LuTX recipients. Methods: LRTI were analyzed in 28 Hungarian adult LuTX patients. Incidence and spectrum of microorganism causing LRTI were evaluated according to post-transplant time and seasonal temperature and humidity changes. Results: A total of 69 cases of LRTI were registered (average: 1.9 cases/patient; range: 0-14). Gram-negative=59, gram-positive=26, and fungal=31 pathogens were detected, with polymicrobial samples in 46{\%} of all cases. Increased number of LRTI was observed in the cold season (1.68±1.54 vs 0.79±0.92 case/month/patient, P<.01) and significant negative correlations were identified between the incidence of polymicrobial and bacterial infections and temperature (r2=0.1535, P<.05, r2=0.3144, P<.01, respectively). In addition, positive correlation was observed between polymicrobial infections and humidity (r2=0.1403, P<.05). Higher incidence of LRTI was also noted in the cold season, when accounting for the differences in immunosuppression. Conclusion: Seasons influenced the incidence of LRTI in the first postoperative year in LuTX recipients. More intensive vigilance for possible gram-negative and polymicrobial infections is needed in these patients in cold and wet seasons in the continental climate zone, regardless of underlying disease.",
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AU - Kovats, Zsuzsanna

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AB - Background: After lung transplantation (LuTX) a high level of immunosuppression is needed to prevent rejection of the graft. Together with earlier colonization by pathogens, immunosuppression makes recipients more susceptible to infections, especially during the first postoperative year. As seasonality of lower respiratory tract infections (LRTI) is well-known in chronic lung diseases, we assessed seasonal changes of pathogen spectrum and number of infections in the first postoperative year in LuTX recipients. Methods: LRTI were analyzed in 28 Hungarian adult LuTX patients. Incidence and spectrum of microorganism causing LRTI were evaluated according to post-transplant time and seasonal temperature and humidity changes. Results: A total of 69 cases of LRTI were registered (average: 1.9 cases/patient; range: 0-14). Gram-negative=59, gram-positive=26, and fungal=31 pathogens were detected, with polymicrobial samples in 46% of all cases. Increased number of LRTI was observed in the cold season (1.68±1.54 vs 0.79±0.92 case/month/patient, P<.01) and significant negative correlations were identified between the incidence of polymicrobial and bacterial infections and temperature (r2=0.1535, P<.05, r2=0.3144, P<.01, respectively). In addition, positive correlation was observed between polymicrobial infections and humidity (r2=0.1403, P<.05). Higher incidence of LRTI was also noted in the cold season, when accounting for the differences in immunosuppression. Conclusion: Seasons influenced the incidence of LRTI in the first postoperative year in LuTX recipients. More intensive vigilance for possible gram-negative and polymicrobial infections is needed in these patients in cold and wet seasons in the continental climate zone, regardless of underlying disease.

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