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. 2024 Nov;89(5):106273.
doi: 10.1016/j.jinf.2024.106273. Epub 2024 Sep 13.

Pulmonary bacterial infection after lung transplantation: risk factors and impact on short-term mortality

Rong Gao  1 , Wenjing Wang  2 , Ting Qian  3 , Xiaoshan Li  3 , Hang Yang  3 , Tianyang Liu  3 , Huaqing Yu  3 , Lin Man  3 , Min Xiong  3 , Jingyu Chen  4 , Bo Wu  5
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Free article

Pulmonary bacterial infection after lung transplantation: risk factors and impact on short-term mortality

Rong Gao et al. J Infect. 2024 Nov.
Free article

Abstract

Objective: To explore the risk factors for pulmonary bacterial infection (PBI) after lung transplantation (LTX) and to evaluate the impact of PBI on short-term postoperative mortality.

Methods: We retrospectively analyzed data on 549 recipients who underwent LTX at the Affiliated Wuxi People's Hospital of Nanjing Medical University, China, between January 2018 and December 2021. The risk factors for PBI after LTX were explored by univariate analysis and multivariate logistic regression. Cox proportional hazards regression models were used to estimate the hazard ratios (HR) and 95% confidence intervals (CI) of one-, two-, and three-year mortality. Subgroup analysis was performed by the time of postoperative PBI (≤7 days or 8-30 day after surgery).

Results: The incidence of postoperative PBI in 549 recipients was 82.70% (454/549). Preoperative history of infections with multidrug-resistant bacteria (OR 12.34, 95% CI 1.69-1572.39), Acinetobacter baumannii infection in donor (OR 3.08, 95% CI 1.26-9.66), and longer cold ischemia time (OR 1.16, 95% CI 1.03-1.32) were risk factors for postoperative PBI. Postoperative PBI was associated with one-year (HR 1.80, 95% CI 1.09-2.96), two-year (HR 1.91, 95% CI 1.20-3.04), and three-year mortality (HR 2.03, 95% CI 1.29-3.19). Subgroup analysis showed that PBI within 7 days after surgery was associated with one-year (HR 1.86, 95% CI 1.12-3.08), two-year (HR 1.99, 95% CI 1.25-3.17), and three-year mortality (HR 2.13, 95% CI 1.35-3.36), while PBI at 8-30 days after surgery was not associated with short-term mortality (one-year: HR 1.36, 95% CI 0.69-2.69; two-year: HR 1.48, 95% CI 0.80-2.76; three-year: HR 1.51, 95% CI 0.82-2.77).

Conclusions: Donor-recipient and surgical factors are risk factors for PBI after LTX. Active prevention and treatment of PBI within the first 7 days after surgery may improve short-term survival.

Keywords: Bacterial infection; Lung transplantation; Mortality; Pulmonary infection; Risk factors.

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Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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