Tags

Type your tag names separated by a space and hit enter

Community-acquired respiratory viral infections in lung transplant recipients: a single season cohort study.
Transplantation. 2009 May 27; 87(10):1530-7.T

Abstract

BACKGROUND

The impact of community-acquired respiratory virus (CARV) infections on bronchiolitis obliterans syndrome (BOS) and outcome after lung transplantation (LTx) and diagnostic techniques were prospectively evaluated.

METHODS

A single-center prospective cohort study was performed in LTx-outpatients between October 31, 2005 and April 30, 2006. Symptoms of respiratory tract infections were recorded and nasopharyngeal and oropharyngeal swabs were obtained. Lower respiratory sampling was performed when indicated. Immunofluorescence testing, cultures, and polymerase chain reaction for 12 different CARV were applied. Patients were followed up until December 31, 2007. New onset and BOS-stage was recorded 1 year after presentation.

RESULTS

Three hundred eighty-eight LTx-recipients were screened. Fifty-one percent reported of symptoms of respiratory tract infection. Seven hundred seventy upper and 180 lower respiratory samples were obtained. Thirty-four CARV were detected in 30 patients (7.7%): 12 parainfluenza, 7 respiratory syncytial virus, 6 metapneumovirus, 5 coronavirus, 3 rhinovirus, and 1 influenza virus. At 1 year, 43 new cases of BOS developed. One-year incidence of BOS was 25.0% in CARV-positive versus 9.0% in CARV-negative patients (log-rank P=0.01). Symptomatic CARV-infection proved to be a significant covariate for 1-year BOS-free survival in multivariate analysis (P=0.002, adjusted hazard ratio 4.13). CARV-infection did not influence BOS progression in 88 patients with prior BOS (P 0.45). After paramyxovirus infection, 8 of 24 patients developed new-onset BOS, whereas no case was recorded after rhinovirus and coronavirus infection.

DISCUSSION

Surveillance detected CARV in LTx outpatients infrequently. Symptomatic CARV-infection increases the risk for new onset of BOS, but not progression. Risk to develop BOS was especially increased after paramyxovirus infection.

Authors+Show Affiliations

Department of Pulmonary Medicine, Hannover Medical School, Hannover, Germany. gottlieb.jens@mh-hannover.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19461490

Citation

Gottlieb, Jens, et al. "Community-acquired Respiratory Viral Infections in Lung Transplant Recipients: a Single Season Cohort Study." Transplantation, vol. 87, no. 10, 2009, pp. 1530-7.
Gottlieb J, Schulz TF, Welte T, et al. Community-acquired respiratory viral infections in lung transplant recipients: a single season cohort study. Transplantation. 2009;87(10):1530-7.
Gottlieb, J., Schulz, T. F., Welte, T., Fuehner, T., Dierich, M., Simon, A. R., & Engelmann, I. (2009). Community-acquired respiratory viral infections in lung transplant recipients: a single season cohort study. Transplantation, 87(10), 1530-7. https://doi.org/10.1097/TP.0b013e3181a4857d
Gottlieb J, et al. Community-acquired Respiratory Viral Infections in Lung Transplant Recipients: a Single Season Cohort Study. Transplantation. 2009 May 27;87(10):1530-7. PubMed PMID: 19461490.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Community-acquired respiratory viral infections in lung transplant recipients: a single season cohort study. AU - Gottlieb,Jens, AU - Schulz,Thomas F, AU - Welte,Tobias, AU - Fuehner,Thomas, AU - Dierich,Martin, AU - Simon,Andre R, AU - Engelmann,Ilka, PY - 2009/5/23/entrez PY - 2009/5/23/pubmed PY - 2009/7/9/medline SP - 1530 EP - 7 JF - Transplantation JO - Transplantation VL - 87 IS - 10 N2 - BACKGROUND: The impact of community-acquired respiratory virus (CARV) infections on bronchiolitis obliterans syndrome (BOS) and outcome after lung transplantation (LTx) and diagnostic techniques were prospectively evaluated. METHODS: A single-center prospective cohort study was performed in LTx-outpatients between October 31, 2005 and April 30, 2006. Symptoms of respiratory tract infections were recorded and nasopharyngeal and oropharyngeal swabs were obtained. Lower respiratory sampling was performed when indicated. Immunofluorescence testing, cultures, and polymerase chain reaction for 12 different CARV were applied. Patients were followed up until December 31, 2007. New onset and BOS-stage was recorded 1 year after presentation. RESULTS: Three hundred eighty-eight LTx-recipients were screened. Fifty-one percent reported of symptoms of respiratory tract infection. Seven hundred seventy upper and 180 lower respiratory samples were obtained. Thirty-four CARV were detected in 30 patients (7.7%): 12 parainfluenza, 7 respiratory syncytial virus, 6 metapneumovirus, 5 coronavirus, 3 rhinovirus, and 1 influenza virus. At 1 year, 43 new cases of BOS developed. One-year incidence of BOS was 25.0% in CARV-positive versus 9.0% in CARV-negative patients (log-rank P=0.01). Symptomatic CARV-infection proved to be a significant covariate for 1-year BOS-free survival in multivariate analysis (P=0.002, adjusted hazard ratio 4.13). CARV-infection did not influence BOS progression in 88 patients with prior BOS (P 0.45). After paramyxovirus infection, 8 of 24 patients developed new-onset BOS, whereas no case was recorded after rhinovirus and coronavirus infection. DISCUSSION: Surveillance detected CARV in LTx outpatients infrequently. Symptomatic CARV-infection increases the risk for new onset of BOS, but not progression. Risk to develop BOS was especially increased after paramyxovirus infection. SN - 1534-6080 UR - https://www.unboundmedicine.com/medline/citation/19461490/Community_acquired_respiratory_viral_infections_in_lung_transplant_recipients:_a_single_season_cohort_study_ L2 - http://dx.doi.org/10.1097/TP.0b013e3181a4857d DB - PRIME DP - Unbound Medicine ER -