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Procalcitonin serum concentration in lung transplant recipients during mold colonization or infection
S Zegleń1, M Sioła, E Woźniak-Grygiel
1Departament and Clinic of Cardiac Surgery and Transplantology, Silesian Centre for Heart Diseases, Zabrze, Poland. slawekzeglen@poczta.onet.pl
Background:
This publication attempted to evaluate the frequency of mold colonization and infection and the procalcitonin serum concentrations (PCT) among lung transplant recipients.
Methods And Materials:
We included 49 patients (36 males and 13 females) of mean age at transplantation of 47.1±13.6 years. Molds were isolated using routine microbiologic methods. PCT (ng/mL) was measured using an immunoluminescence assay with values below 0.5 showing no probability of infection, 0.5 to 2.0, a moderate infection risk; 2.0 to 10, a high infection risk; and above 10 high sepsis risk.
Results:
Twenty-four (49%) patients revealed the presence of molds in material from the lower respiratory tract (sputum, tracheal, or tracheobronchial aspirate), mini-bronchoalveolar lavage. Aspergillus species was isolated in 14 (28.6%) patients, Penicillium in 7 (14.3%) patients, and Zygomycetes fungi in 9 (18.4%) patients. The average PCT value from 61 examinations of PCT during fungal isolation was 0.5±0.7 ng/mL. However, when the studied group was categorized according to the PCT range, the rates for the groups were no infection (n=30; 49.2%), moderate (n=20; 32.8%), high (n=9; 14.8%) and high sepsis risk (n=2; 3.3%).
Conclusions:
The mold colonization of transplanted lung is a frequent complication and should be considered even in the case of proper prophylaxis. Procalcitonin might be the marker helpful in mold infection diagnosis.
Insights
Mold colonization is common in lung transplant recipients. Procalcitonin (PCT) levels may help diagnose mold infections, even with prophylaxis.
Area of Science:
- Medical Mycology
- Transplant Surgery
- Infectious Diseases
Background:
- Lung transplant recipients face a high risk of mold colonization and infection.
- Evaluating the frequency of mold presence and serum procalcitonin (PCT) concentrations is crucial in this patient population.
Purpose of the Study:
- To determine the incidence of mold colonization and infection in lung transplant recipients.
- To assess the utility of procalcitonin (PCT) serum concentrations as a diagnostic marker for mold infections.
Main Methods:
- A cohort of 49 lung transplant recipients was studied.
- Molds were identified using standard microbiological techniques.
- Procalcitonin (PCT) levels were measured via immunoluminescence assay, with defined ranges for infection risk.
Main Results:
- Mold presence in lower respiratory tract samples was observed in 49% of patients.
- Aspergillus, Penicillium, and Zygomycetes were the most common molds identified.
- The average PCT level was 0.5±0.7 ng/mL, with varying PCT ranges correlating to infection risk categories.
Conclusions:
- Mold colonization is a frequent complication following lung transplantation, necessitating vigilance despite prophylaxis.
- Procalcitonin shows potential as a valuable biomarker for diagnosing mold infections in lung transplant patients.
