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Chlamydia pneumoniae infection after lung transplantation
Allan R Glanville1, Mesut Gencay, Michael Tamm
1Lung Transplant Unit, St. Vincent's Hospital, Sydney, Australia. aglanville@stvincents.com.au
Summary
Chlamydia pneumoniae infection after lung transplantation is linked to early mortality and airway disease. Early detection and treatment may improve outcomes for lung transplant recipients.
Area of Science:
- Pulmonology
- Infectious Diseases
- Transplantation Immunology
Background:
- Chlamydia pneumoniae is a known respiratory pathogen linked to asthma and COPD.
- Airway disease significantly impacts lung transplant recipient outcomes.
- The role of C. pneumoniae post-lung transplantation requires further investigation.
Purpose of the Study:
- To investigate the role of Chlamydia pneumoniae as a pulmonary pathogen in lung transplant recipients.
- To determine the association between C. pneumoniae infection and post-transplant airway disease and mortality.
Main Methods:
- Eighty lung transplant recipients were monitored over one year.
- 232 bronchoscopies with bronchoalveolar lavage and/or biopsies were performed for surveillance and clinical indications.
- Nested polymerase chain reaction (PCR) was used to detect C. pneumoniae.
Main Results:
- C. pneumoniae was detected in 25% of recipients within 30 days post-transplant; 3 of these died from airway disease.
- Recipients negative for C. pneumoniae survived over one year.
- Post-30 days, C. pneumoniae was found in 25% of recipients, associated with pneumonia, bronchiolitis obliterans syndrome, and acute rejection.
Conclusions:
- Persistent C. pneumoniae infection is detrimental to pulmonary allograft function.
- C. pneumoniae infection is associated with increased early mortality, rejection, and bronchiolitis obliterans syndrome.
- Empiric antibiotic therapy for C. pneumoniae may be beneficial in preventing progressive airway disease.