Risk factors, management, and clinical outcomes of invasive Mycoplasma and Ureaplasma infections after lung transplantation

Resource type
Journal Article
Authors/contributors
Title
Risk factors, management, and clinical outcomes of invasive Mycoplasma and Ureaplasma infections after lung transplantation
Abstract
Mollicute infections, caused by Mycoplasma and Ureaplasma species, are serious complications after lung transplantation; however, understanding of the epidemiology and outcomes of these infections remains limited. We conducted a single-center retrospective study of 1156 consecutive lung transplants performed from 2010-2019. We used log-binomial regression to identify risk factors for infection and analyzed clinical management and outcomes. In total, 27 (2.3%) recipients developed mollicute infection. Donor characteristics independently associated with recipient infection were age ≤40 years (prevalence rate ratio [PRR] 2.6, 95% CI 1.0-6.9), White race (PRR 3.1, 95% CI 1.1-8.8), and purulent secretions on donor bronchoscopy (PRR 2.3, 95% CI 1.1-5.0). Median time to diagnosis was 16 days posttransplant (IQR: 11-26 days). Mollicute-infected recipients were significantly more likely to require prolonged ventilatory support (66.7% vs 21.4%), undergo dialysis (44.4% vs 6.3%), and remain hospitalized ≥30 days (70.4% vs 27.4%) after transplant. One-year posttransplant mortality in mollicute-infected recipients was 12/27 (44%), compared to 148/1129 (13%) in those without infection (P <.0001). Hyperammonemia syndrome occurred in 5/27 (19%) mollicute-infected recipients, of whom 3 (60%) died within 10 weeks posttransplant. This study highlights the morbidity and mortality associated with mollicute infection after lung transplantation and the need for better screening and management protocols.
Publication
American Journal of Transplantation: Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons
Volume
24
Issue
4
Pages
641-652
Date
2024-04
Journal Abbr
Am J Transplant
Language
eng
ISSN
1600-6143
Library Catalog
PubMed
Extra
PMID: 37657654 PMCID: PMC10902193
Citation
Tam, P. C. K., Hardie, R., Alexander, B. D., Yarrington, M. E., Lee, M. J., Polage, C. R., Messina, J. A., Maziarz, E. K., Saullo, J. L., Miller, R., Wolfe, C. R., Arif, S., Reynolds, J. M., Haney, J. C., Perfect, J. R., & Baker, A. W. (2024). Risk factors, management, and clinical outcomes of invasive Mycoplasma and Ureaplasma infections after lung transplantation. American Journal of Transplantation: Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 24(4), 641–652. https://doi.org/10.1016/j.ajt.2023.08.019
ATC 2024 Top Papers in TID
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