Infectious Complications of Bronchial Stenosis in Lung Transplant Recipients. (4th October 2017)

• Record Type: Journal Article
• Authors: Jablonski, Lindsay; Moss, Sean; Fallis, Rebecca; Axelrod, Peter; Clauss, Heather
• Is Part Of: Open forum infectious diseases. Volume 4(2017)Supplement 1
• Page Start: S698
• Page End: S698
• Publication Date: 2017-10-04
• Subjects: Communicable diseases -- Periodicals; Medical microbiology -- Periodicals; Infection -- Periodicals; 616.9
• DOI: 10.1093/ofid/ofx163.1874
• Languages: English
• ISSNs: 2328-8957

Abstract

Abstract: Background: Bronchial stenosis is a known complication in lung transplant recipients. We have noted anecdotally at our institution that these patients are frequently treated for pneumonia, and are frequently hospitalized. Our objective was to evaluate whether lung transplant recipients diagnosed with bronchial stenosis develop more infectious complications than lung transplant recipients without bronchial stenosis. Methods: The study population included two subsets of lung transplant recipients at Temple University Hospital who received organs between January 1, 2011 and September 29, 2016: A) patients diagnosed with bronchial stenosis, and B) a random sample of lung transplant recipients without bronchial stenosis. Charts were reviewed retrospectively to collect donor and recipient demographic information, bronchial stenosis treatments, respiratory culture data, and episodes of pneumonia and tracheobronchitis (diagnosed using CDC-NNIS criteria). Patients were followed up to one year after transplant. Results: We identified 35 patients who had been diagnosed with bronchial stenosis following transplant and 35 control patients. Stenosis occurred a median of 54 days after transplant (range 5–365 days). Patients with bronchial stenosis spent more time in the hospital (87.4 vs 46.8 days, P = 0.011) and had more total hospitalizations (4.54 vs 2.37, P = 0.00009). The relative risk of pneumonia among cases vs controls was 3.97 (95% CI 2.17–7.26, P = 0.000001) and purulent tracheobronchitis 3.10 (95% CI 1.58–6.08, P = 0.000443). Patients with bronchial stenosis were significantly more likely to have respiratory cultures with Staphylococcus aureus (RR 5.0; P = 0.001) and Pseudomonas aeruginosa (RR 2.1, P = 0.026). Mortality within the first year following transplant was equal in both groups (14.3% vs 14.3%). Conclusion: There was no significant increase in one year mortality in patients who developed bronchial stenosis following lung transplant. However, patients with bronchial stenosis had significantly higher risks of pneumonia and tracheobronchitis, and spent more days in the hospital than transplant recipients without bronchial stenosis. Disclosures: All authors: No reported disclosures.