Paglicci et al reported risk factors for a lung transplant recipient developing respiratory tract colonization and infection. These can help to identify a patient who may benefit from more aggressive management. The authors are from Siena University and Hospital in Italy.
Patient selection: lung transplant recipient
Outcome: 30-day risk of respiratory tract colonization and/or infection post-transplant
Frequency of pneumonia: 35%
Risk factors respiratory tract colonization:
(1) bilateral transplant (aOR 3.6)
(2) chronic heart failure (aOR 6.7)
Colonization by a multi-drug resistant bacteria was increased in patients with peptic disease (aOR 7.7).
Colonization by bacteria was reduced by longer duration of aerosol prophylaxis (aOR 0.95 per day).
Risk factors for pneumonia:
(1) COPD (aOR 0.17 vs IPF)
(2) lean body weight (higher BMI protective, aOR 0.87 per kg per sq m)
Risk factors for pneumonia with a multi-drug resistant organism:
(1) idiopathic pulmonary fibrosis (IPF; aOR 0.07 for COPD and 0.17 for other vs IPF)
(2) pre-transplant colonization and/or infection (aOR 5.4 for colonization; aOR 16.9 for infection)
