Infections in lung transplanted patients: A review

• Published in: Pulmonology 2024-05, Vol.30 (3), p.287-304
• Main Authors: Dettori, M., Riccardi, N., Canetti, D., Antonello, R.M., Piana, A.F., Palmieri, A., Castiglia, P., Azara, A.A., Masia, M.D., Porcu, A., Ginesu, G.C., Cossu, M.L., Conti, M., Pirina, P., Fois, A., Maida, I., Madeddu, G., Babudieri, S., Saderi, L., Sotgiu, G.
• Format: Article
• Language: English
• Subjects: Bacteria; Bacterial Infections - epidemiology; Cross Infection - epidemiology; Fungi; Humans; Infections; Lung Transplantation - adverse effects; Lungs; Postoperative Complications - epidemiology; Postoperative Complications - microbiology; Risk Factors; Transplant; Virus Diseases - epidemiology; Virus Diseases - etiology; Viruses
• ISSN: 2531-0437; 2531-0437
• DOI: 10.1016/j.pulmoe.2022.04.010

Lung transplantation can improve the survival of patients with severe chronic pulmonary disorders. However, the short- and long-term risk of infections can increase morbidity and mortality rates. A non-systematic review was performed to provide the most updated information on pathogen, host, and environment-related factors associated with the occurrence of bacterial, fungal, and viral infections as well as the most appropriate therapeutic options. Bacterial infections account for about 50% of all infectious diseases in lung transplanted patients, while viruses represent the second cause of infection accounting for one third of all infections. Almost 10% of patients develop invasive fungal infections during the first year after lung transplant. Pre-transplantation comorbidities, disruption of physical barriers during the surgery, and exposure to nosocomial pathogens during the hospital stay are directly associated with the occurrence of life-threatening infections. Empiric antimicrobial treatment after the assessment of individual risk factors, local epidemiology of drug-resistant pathogens and possible drug-drug interactions can improve the clinical outcomes.