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. 2020 Feb 24;20(1):176.
doi: 10.1186/s12879-020-4877-3.

Late viral or bacterial respiratory infections in lung transplanted patients: impact on respiratory function

Marie Dubert  1 , Benoit Visseaux  2   3   4 , André Birgy  2   3   5 , Pierre Mordant  6 , Anne-Cécile Metivier  7 , Gaelle Dauriat  7 , Nadhira Fidouh  4 , Yazdan Yazdanpanah  8   2   3 , Nathalie Grall  2   3   9 , Yves Castier  6 , Hervé Mal  7 , Gabriel Thabut  7 , François-Xavier Lescure  10   11   12
Affiliations

Late viral or bacterial respiratory infections in lung transplanted patients: impact on respiratory function

Marie Dubert et al. BMC Infect Dis. .

Abstract

Background: Respiratory infections are a major threat for lung recipients. We aimed to compare with a monocentric study the impact of late viral and bacterial respiratory infections on the graft function.

Methods: Patients, who survived 6 months or more following lung transplantation that took place between 2009 and 2014, were classified into three groups: a viral infection group (VIG) (without any respiratory bacteria), a bacterial infection group (BIG) (with or without any respiratory viruses), and a control group (CG) (no documented infection). Chronic lung allograft dysfunction (CLAD) and acute rejection were analysed 6 months after the inclusion in the study.

Results: Among 99 included lung recipients, 57 (58%) had at least one positive virological respiratory sample during the study period. Patients were classified as follows: 38 in the VIG, 25 in the BIG (among which 19 co-infections with a virus) and 36 in the CG. The BIG presented a higher initial deterioration in lung function (p = 0.05) than the VIG. But 6 months after the infection, only the VIG presented a median decrease of forced expiratory volume in 1 s; - 35 mL (IQR; - 340; + 80) in the VIG, + 140 mL (+ 60;+ 330) in the BIG and + 10 (- 84;+ 160) in the CG, p < 0.01. Acute rejection was more frequent in the VIG (n = 12 (32%)), than the BIG (n = 6 (24%)) and CG (n = 3 (8%)), p < 0.05, despite presenting no more CLAD (p = 0.21).

Conclusions: Despite a less severe initial presentation, single viral respiratory infections seem to lead to a greater deterioration in lung function, and to more acute rejection, than bacterial infections.

Keywords: Bacterial respiratory infection; Chronic lung allograft dysfunction; Lung graft acute rejection; Lung graft patients; Viral respiratory infections.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart. After the exclusion of 53 patients, 99 lung transplant recipients were included. Among them, 59 presented at least one positive respiratory virologic sample during the follow-up. Patients were divided into 3 groups viral infection (n = 38), bacterial infection (n = 25) and controls (n = 36)
See this image and copyright information in PMC

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