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Incidenceandriskfactorsforrespiratorytractbacterialcolonizationandinfectioninlungtransplantrecipient

LPaglicci1,VBorgo1,NLanzarone2,MFabbiani1,CCassol13,MGCusi34,MValassina4,SScolletta5,EBargagli2,LMarchetti6,PPaladini7,LLuzzi7,AFossi2,DBennett2,FMontagnani89

1DepartmentofMedicalSciences,InfectiousandTropicalDiseasesUnit,SienaUniversityHospital,Siena,Italy

2DepartmentofMedicalandSurgicalSciencesNeurosciences,RespiratoryDiseasesandLungTransplantationUnit,SienaUniversityHospital,Siena,Italy

3DepartmentofMedicalBiotechnologies,UniversityofSiena,Siena,Italy

4DepartmentofInnovation,ExperimentationandClinicalResearch,MicrobiologyandVirologyUnit,SienaUniversityHospital,Siena,Italy

5DepartmentofEmergencyandUrgency,Medicine,SurgeryandNeurosciences,UnitofIntensiveCareMedicine,SienaUniversityHospital,Siena,Italy

6Cardio-Thoracic-VascularDepartment,AnesthesiaandCardio-Thoracic-VascularIntensiveCareUnit,SienaUniversityHospital,Siena,Italy

7Cardio-Thoracic-VascularDepartment,ThoracicSurgeryUnit,SienaUniversityHospital,Siena,Italy

Abstract

Toevaluateincidenceofandriskfactorsforrespiratorybacterialcolonizationandinfectionswithin30daysfromlungtransplantation(LT).Weretrospectivelyanalyzedmicrobiologicalandclinicaldatafrom94patientstransplantedforindicationsotherthancysticfibrosis,focusingontheoccurrenceofbacterialrespiratorycolonizationorinfectionduring1monthoffollow-upafterLT.Thirty-threepercentofpatientsdevelopedlowerrespiratorybacterialcolonization.BilateralLTandchronicheartdiseaseswereindependentlyassociatedtoahigherriskofoverallbacterialcolonization.Pepticdiseasesconferredahigherriskofmulti-drugresistant(MDR)colonization,whilelongerdurationofaerosolprophylaxiswasassociatedwithalowerrisk.Overall,35%oflungrecipientsdevelopedbacterialpneumonia.COPD(when