Pneumonia after heart transplantation:: A multiinstitutional study

被引:72
作者
Cisneros, JM [1 ]
Muñoz, P
Torre-Cisneros, J
Gurgui, M
Rodriguez-Hernandez, MJ
Aguado, JM
Echaniz, A
机构
[1] Hosp Univ Virgen del Rocio, Unidad Enfermedades Infecciosas, Seville 41013, Spain
[2] Hosp Gen Gregorio Maranon, E-28007 Madrid, Spain
[3] Hosp 12 Octubre, E-28041 Madrid, Spain
[4] Hosp Reina Sofia, Cordoba, Spain
[5] Hosp Santa Creu & Sant Pau, E-08025 Barcelona, Spain
[6] Hosp Juan Canalejo, La Coruna, Spain
关键词
D O I
10.1086/514649
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
A multiinstitutional study of 307 heart transplant recipients was carried out to determine the clinical, radiographic, and prognostic characteristics, the incidence, and the etiology of pneumonias in the first year after transplantation. There were 21.1 cases of pneumonia per 100 heart transplantations. Seventy-five percent of the cases occurred in the first trimester. Eighty-two causal agents were identified, of which 60% were opportunistic, 25% were nosocomial, and 15% were community-acquired. The most frequent isolates were cytomegalovirus (20), Aspergillus species (13), and Pneumocystis carinii (11). Hemoptysis occurred more frequently in aspergillus pneumonias than in other pneumonias (54% vs. 6%, respectively; P < .05); aspergillus pneumonia was the only type of pneumonia during which cavitated nodules were noted on thoracic radiographs. The overall mortality rate was 30.8%; the independent factors of a poor prognosis were aspergillus infection (relative risk [RR], 7.4; 95% confidence interval [CI], 5.8-9.1) and bilateral pulmonary infiltrates (RR, 10; 95% CI, 8.5-11.4).
引用
收藏
页码:324 / 331
页数:8
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