Epidemiology and Immediate Indirect Effects of Respiratory Viruses in Lung Transplant Recipients: A 5‐Year Prospective Study |
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| Authors: | M Peghin H H Hirsch Ó Len G Codina C Berastegui B Sáez J Solé E Cabral A Solé F Zurbano F López‐Medrano J Gavaldá |
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| Institution: | 1. Department of Infectious Diseases, Hospital Universitari de la Vall d'Hebron, Barcelona, Spain;2. Spanish Network for Research in Infectious Diseases (REIPI), Seville, Spain;3. Transplantation & Clinical Virology, Department Biomedicine (Haus Petersplatz), University of Basel, Basel, Switzerland;4. Division Infection Diagnostics, Department Biomedicine (Haus Petersplatz), University of Basel, Basel, Switzerland;5. Infectious Diseases & Hospital Epidemiology, University Hospital Basel, Basel, Switzerland;6. Department of Microbiology, Hospital Universitari de la Vall d'Hebron, Barcelona, Spain;7. Department of Pulmonology and Lung Transplant Unit, Hospital Universitari de la Vall d'Hebron, Barcelona, Spain;8. CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain;9. Department of Thoracic Surgery, Hospital Universitari de la Vall d'Hebron, Barcelona, Spain;10. Lung Transplant Unit, Hospital Universitario y Politécnico La Fe, Valencia, Spain;11. Division of Pneumology, Hospital Universitario Marqués de Valdecilla, IDIVAL, University of Cantabria, Santander, Spain;12. Department of Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain;13. Spanish Network for Research in Infectious Diseases (REIPI), Seville, SpainCoordinators of the project. |
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| Abstract: | The epidemiology of respiratory viruses (RVs) in lung transplant recipients (LTRs) and the relationship of RVs to lung function, acute rejection (AR) and opportunistic infections in these patients are not well known. We performed a prospective cohort study (2009–2014) by collecting nasopharyngeal swabs (NPSs) from asymptomatic LTRs during seasonal changes and from LTRs with upper respiratory tract infectious disease (URTID), lower respiratory tract infectious disease (LRTID) and AR. NPSs were analyzed by multiplex polymerase chain reaction. Overall, 1094 NPSs were collected from 98 patients with a 23.6% positivity rate and mean follow‐up of 3.4 years (interquartile range 2.5–4.0 years). Approximately half of URTIDs (47 of 97, 48.5%) and tracheobronchitis cases (22 of 56, 39.3%) were caused by picornavirus, whereas pneumonia was caused mainly by paramyxovirus (four of nine, 44.4%) and influenza (two of nine, 22.2%). In LTRs with LRTID, lung function changed significantly at 1 mo (p = 0.03) and 3 mo (p = 0.04). In a nested case–control analysis, AR was associated with RVs (hazard ratio HR] 6.54), Pseudomonas aeruginosa was associated with LRTID (HR 8.54), and cytomegalovirus (CMV) replication or disease was associated with URTID (HR 2.53) in the previous 3 mo. There was no association between RVs and Aspergillus spp. colonization or infection (HR 0.71). In conclusion, we documented a high incidence of RV infections in LTRs. LRTID produced significant lung function abnormalities. Associations were observed between AR and RVs, between P. aeruginosa colonization or infection and LRTID, and between CMV replication or disease and URTID. |
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| Keywords: | clinical research/practice infectious disease lung transplantation/pulmonology complication: infectious infection and infectious agents viral infection and infectious agents viral: influenza lung disease: infectious rejection: acute |
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