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Risk Factors for and Outcomes Following Early Acquisition of Mycobacterium abscessus Complex After Lung Transplantation.

Publication ,  Journal Article
Nick, SE; Yarrington, ME; Reynolds, JM; Anderson, DJ; Baker, AW
Published in: Open Forum Infect Dis
May 2024

BACKGROUND: Lung transplant recipients are at increased risk of Mycobacterium abscessus complex (MABC) acquisition and invasive infection. We analyzed risk factors and outcomes of early post-lung transplant MABC acquisition. METHODS: We conducted a retrospective matched case-control study of patients who underwent lung transplant from 1/1/2012 to 12/31/2021 at a single large tertiary care facility. Cases had de novo MABC isolation within 90 days post-transplant. Controls had no positive MABC cultures and were matched 3:1 with cases based on age and transplant date. Recipient demographics and pre-/peri-operative characteristics were analyzed, and a regression model was used to determine independent risk factors for MABC acquisition. We also assessed 1-year post-transplant outcomes, including mortality. RESULTS: Among 1145 lung transplants, we identified 79 cases and 237 matched controls. Post-transplant mechanical ventilation for >48 hours was independently associated with MABC acquisition (adjusted odds ratio, 2.46; 95% CI, 1.29-4.72; P = .007). Compared with controls, cases required more days of hospitalization after the MABC index date (28 vs 12 days; P = .01) and had decreased 1-year post-transplant survival (78% vs 89%; log-rank P = .02). One-year mortality appeared highest for cases who acquired M. abscessus subsp. abscessus (31% mortality) or had extrapulmonary infections (43% mortality). CONCLUSIONS: In this large case-control study, prolonged post-transplant ventilator duration was associated with early post-lung transplant MABC acquisition, which in turn was associated with increased hospital-days and mortality. Further studies are needed to determine the best strategies for MABC prevention, surveillance, and management.

Duke Scholars

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Published In

Open Forum Infect Dis

DOI

ISSN

2328-8957

Publication Date

May 2024

Volume

11

Issue

5

Start / End Page

ofae209

Location

United States

Related Subject Headings

  • 3207 Medical microbiology
  • 3202 Clinical sciences
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Nick, S. E., Yarrington, M. E., Reynolds, J. M., Anderson, D. J., & Baker, A. W. (2024). Risk Factors for and Outcomes Following Early Acquisition of Mycobacterium abscessus Complex After Lung Transplantation. Open Forum Infect Dis, 11(5), ofae209. https://doi.org/10.1093/ofid/ofae209
Nick, Sophie E., Michael E. Yarrington, John M. Reynolds, Deverick J. Anderson, and Arthur W. Baker. “Risk Factors for and Outcomes Following Early Acquisition of Mycobacterium abscessus Complex After Lung Transplantation.Open Forum Infect Dis 11, no. 5 (May 2024): ofae209. https://doi.org/10.1093/ofid/ofae209.
Nick SE, Yarrington ME, Reynolds JM, Anderson DJ, Baker AW. Risk Factors for and Outcomes Following Early Acquisition of Mycobacterium abscessus Complex After Lung Transplantation. Open Forum Infect Dis. 2024 May;11(5):ofae209.
Nick, Sophie E., et al. “Risk Factors for and Outcomes Following Early Acquisition of Mycobacterium abscessus Complex After Lung Transplantation.Open Forum Infect Dis, vol. 11, no. 5, May 2024, p. ofae209. Pubmed, doi:10.1093/ofid/ofae209.
Nick SE, Yarrington ME, Reynolds JM, Anderson DJ, Baker AW. Risk Factors for and Outcomes Following Early Acquisition of Mycobacterium abscessus Complex After Lung Transplantation. Open Forum Infect Dis. 2024 May;11(5):ofae209.
Journal cover image

Published In

Open Forum Infect Dis

DOI

ISSN

2328-8957

Publication Date

May 2024

Volume

11

Issue

5

Start / End Page

ofae209

Location

United States

Related Subject Headings

  • 3207 Medical microbiology
  • 3202 Clinical sciences