RELATIONSHIP BETWEEN CYTOMEGALOVIRUS AND COLONIZATION OF THE OROPHARYNX BY GRAM-NEGATIVE BACILLI FOLLOWING RENAL-TRANSPLANTATION

被引:16
作者
MACKOWIAK, PA
GOGGANS, M
TORRES, W
DALNOGARE, A
LUBY, JP
HELDERMAN, H
机构
[1] VET ADM MED CTR,DALLAS,TX 75216
[2] UNIV TEXAS,HLTH SCI CTR,SW MED SCH,SW MED CTR,DEPT INTERNAL MED,DALLAS,TX 75235
关键词
D O I
10.1017/S0950268800049050
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Numerous investigators have reported an increased incidence of pneumonia caused by Gram-negative bacilli and other secondary pathogens in transplant recipients infected by cytomegalovirus (CMV). To determine if CMV infections are related to colonization of the upper respiratory tract by Gram-negative bacilli, we examined prospectively 22 renal transplant recipients with sequential bacteriological, virological and biochemical examinations performed just prior to and at various times after transplantation. Only 11% of subjects had Gram-negative bacilli isolated from gargle specimens prior to transplantation, as compared to 54% after transplantation. More importantly, after transplantation, subjects with active CMV infections were more likely to have prolonged oropharyngeal carriage of Gram-negative bacilli than subjects without CMV infections (36% v. 25%). During active CMV infections, the rate at which Gram-negative bacilli were isolated from gargle specimens rose from 28 to 47%. During culture-positive CMV infections, the isolation rate reached 57% and was significantly different from that of CMV-negative samples (P < 0.01). The increased rate of Gram-negative bacillary isolation from gargle specimens during (CMV infections was not a function of type of immunosuppressive agents used, rejection episodes, antibiotic administration, concomitant hepatitis B, Epstein-Barr (EBV) virus, or herpes simplex virus infections, or alterations in salivary fibronectin concentrations.
引用
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页码:411 / 420
页数:10
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