Association between pre-transplant Staphylococcus aureus colonisation and post-transplant S. aureus infection among cystic fibrosis lung transplant recipients
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.
J. Chalaoui, None
P. Ferraro, None
V. Martel-Laferrière, None
G. Koh, None
M. L. Luong, None