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426
Association between pre-transplant Staphylococcus aureus colonisation and post-transplant S. aureus infection among cystic fibrosis lung transplant recipients

Session: Poster Abstract Session: Transplant Infectious Diseases
Thursday, October 9, 2014
Room: The Pennsylvania Convention Center: IDExpo Hall BC
Posters
  • Poster IDweek 2014.pdf (969.5 kB)
  • Background: Cystic fibrosis (CF) patients are frequently colonized with Staphylococcus aureus. However the impact of S. aureus colonization on post-transplant outcome among CF patients undergoing lung transplantation is unknown.

    Methods: We conducted a 5-year retrospective cohort study of all CF patients undergoing lung transplantation to determine the impact of pre-transplant S. aureus infection on the incidence of S. aureus infection after transplantation. All patients were followed up to one year after transplantation.

    Results:  In total, 74 patients with CF underwent lung transplantation at our center. Thirty-seven patients (50%) were colonized with S. aureus prior to transplantation, 26 (35%) with MSSA, 6 (8%) with MRSA and 5 (7%) with both MSSA and MRSA. Nineteen (26%) patients had post-transplant S. aureus respiratory infections, 10 (14%) of which were pneumonia, 6 (8%) bronchitis and 3 (4%) received therapy without meeting the CDC criteria for respiratory tract infection. In a univariable analysis, pre-transplant S. aureus colonization was associated with an increased risk for post-transplant S. aureus infection (OR 4.46, 95%CI1.30–15.41; p=0.01). However, there was no difference in length of ICU or hospital stay. In a multivariable model controlling for age > 30, gender, pre-transplant Pseudomonas colonization, pre-transplant S. aureus colonization remained independently associated with an increased risk for post-transplant S. aureus infection (OR 4.4770, 1.34-16.54; p=0.01). There was no evidence for a difference in mortality between patients with (2; 5.4%) and those without pre-transplant S. aureus colonization (3; 8.1%) (p=0.64).

    Conclusion: Our study suggests that pre-transplant S. aureus infection among CF patients undergoing lung transplant increases the risk of post-transplant S. aureus infection but does not negatively impact on post transplant one year survival.

    Jessica St-Pierre, MD1, Charles Poirier, MD2, Jean Chalaoui, MD3, Pasquale Ferraro, MD4, Valérie Martel-Laferrière, MD1, Gavin Koh, MD5 and Me-Linh Luong, MD1, (1)Microbiology, University of Montreal Health Center, Montreal, QC, Canada, (2)Respirology, University of Montreal Health Center, Montreal, QC, Canada, (3)Radiology, University of Montreal Health Center, Montreal, QC, Canada, (4)Thoracic Surgery, University of Montreal Health Center, Montreal, QC, Canada, (5)Infectious Diseases, University of Warwick, Birmingham, United Kingdom

    Disclosures:

    J. St-Pierre, None

    C. Poirier, None

    J. Chalaoui, None

    P. Ferraro, None

    V. Martel-Laferrière, None

    G. Koh, None

    M. L. Luong, None

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