Microbiological findings in bronchoalveolar lavage fluid from lung transplant patients in Sweden.
BACKGROUND
Lung transplant patients experience a high risk of airway infections and microbial colonization of the lung due to constant exposure to the environment through inhaled microorganisms, denervation, reduced ciliary transport, and decreased cough.


METHODS
In this nationwide prospective study on Swedish lung transplant patients, we evaluated the microbiological panorama of bacteria, fungi, and virus found in bronchoalveolar lavage fluid (BALF) obtained the first year after lung transplantation (LTx). Differences in microbiological findings depending of concomitant signs of infection and background factors were assessed.


RESULTS
A total of 470 bronchoscopies from 126 patients were evaluated. Sixty-two percent (n = 293) of BALF samples had positive microbiological finding(s). Forty-six percent (n = 217) had bacterial growth, 29% (n = 137) fungal growth, and 9% (n = 43) were positive in viral PCR. In 38% of BALF samples (n = 181), a single microbe was found, whereas a combination of bacteria, fungi or virus was found in 24% (n = 112) of bronchoscopies. The most common microbiological findings were Candida albicans, Pseudomonas aeruginosa and coagulase negative Staphylococcus (in 42 (33%), 36 (29%), and 25 (20%) patients, respectively). Microbiological findings were similar in BALF from patients with and without signs of lung infection and the frequency of multidrug resistant (MDR) bacteria was low. No significant association was found between background factors and time to first lung infection.


CONCLUSION
This study gives important epidemiologic insights and reinforces that microbiological findings have to be evaluated in the light of clinical symptoms and endobronchial appearance in the assessment of lung infections in lung transplant patients.
['Stjärne Aspelund|Anna|A|http://orcid.org/0000-0002-7391-268X', 'Hammarström|Helena|H|', 'Inghammar|Malin|M|', 'Larsson|Hillevi|H|', 'Hansson|Lennart|L|', 'Riise|Gerdt C|GC|', 'Friman|Vanda|V|', 'Christensson|Bertil|B|', 'Påhlman|Lisa I|LI|']
D000328:Adult D000368:Aged D001992:Bronchoalveolar Lavage Fluid D001999:Bronchoscopy D002176:Candida albicans D024901:Drug Resistance, Multiple, Bacterial D005260:Female D006801:Humans D016040:Lung Transplantation D008297:Male D008875:Middle Aged D011014:Pneumonia D011446:Prospective Studies D011550:Pseudomonas aeruginosa D013210:Staphylococcus D013548:Sweden D055815:Young Adult
microbiology bronchoalveolar lavage fluid lung transplantation lung infections