Gastroparesis following lung transplantation: Risk factor for pneumonia

Riera, Jordi; Baldirà, Jaume; Ramirez-Estrada, Sergio; Mazo, Cristopher; Maldonado, Carmen; Sáez-Giménez, Berta; Bello, Irene; Pont, T.; Rello, Jordi

doi:10.1183/13993003.congress-2015.pa2644

Cited by 1 publication

(2 citation statements)

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“…Tracheobronchitis occurred before bacterial pneumonia in 90% of cases in one cohort study (105). Gastroparesis and aspiration increase the risk for both tracheobronchitis and pneumonia in mechanically ventilated patients, and ventilator-associated tracheobronchitis has been associated with longer duration of ventilation and length of stay (107,127).…”

Section: Tracheobronchitismentioning

confidence: 99%

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Bacterial infections in lung transplantation

McCort¹,

MacKenzie²,

Pursell³

et al. 2021

J Thorac Dis

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Lung transplantation has lower survival rates compared to other than other solid organ transplants (SOT) due to higher rates of infection and rejection-related complications, and bacterial infections (BI) are the most frequent infectious complications. Excess morbidity and mortality are not only a direct consequence of these BI, but so are subsequent loss of allograft tolerance, rejection, and chronic lung allograft dysfunction due to bronchiolitis obliterans syndrome (BOS). A wide variety of pathogens can cause infections in lung transplant recipients (LTRs), including a number of nosocomial pathogens and other multidrug-resistant (MDR) pathogens. Although pneumonia and intrathoracic infections predominate, LTRs are at risk of a number of types of infections. Risk factors include altered anatomy and function of airways, impaired immunity, the microbial flora of the donor and recipient, underlying medical conditions, and genetic factors. Further work on immune monitoring has the potential to improve outcomes. The infecting agents can be derived from the donor lung, pre-existing recipient flora, or acquired from the environment over time. Certain infections may preclude lung transplantation, but this varies from center to center, and more recent studies suggest fewer patients should be disqualified. New molecular methods allow microbiome studies of the lung, gut, and other sites that may further our knowledge of how airway colonization can result in infection and allograft loss. Surveillance, early diagnosis, and aggressive antimicrobial therapy of BI is critical in LTRs. Antibiotic resistance is a major barrier to successful management of these infections. The availability of new agents for MDR Gram-negatives may improve outcomes. Other new therapies, such as bacteriophage therapy, show promise for the future. Finally, it is important to prevent infections through peri-transplant prophylaxis, vaccination, and infection control measures.

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Section: Tracheobronchitismentioning

confidence: 99%

“…The majority of respiratory infections were bacterial (83.6%), most frequently due to GNRs with PsAR being the single most commonly isolated pathogen. Early post-transplant bacterial colonization and pneumonia may also be related to aspiration events, and gastroparesis plays a role as well (107).…”

Section: Early-onset Pneumoniamentioning

confidence: 99%