Lung Transplantation in a Patient with Pre-transplant Colonization of Extensively Drug-resistant Acinetobacter baumannii
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Colonization of the pre-transplant lung by multidrug-resistant bacteria affects short- and long-term outcomes of lung transplantation. However, there are no case reports on the colonization of a pre-transplant lung by drug-resistant Acinetobacter baumannii. We report a case of extensively drug resistant (XDR) A. baumannii colonization in the tracheobronchial tree that caused severe infectious complications after bilateral lung transplantation. A 23-year-old man diagnosed with bronchiolitis obliterans syndrome (BOS) 4 years earlier with a history of allogenic bone marrow transplantation for acute lymphoblastic leukemia was admitted to the hospital with dyspnea. Due to progressive hypercapnic respiratory failure, long-term mechanical ventilation was started after a tracheostomy was performed, and the patient underwent a bilateral lung transplantation to treat end-stage BOS. After the transplantation, the colonization of XDR A. baumannii caused severe bacterial pneumonia in the early postoperative period. Combined treatment with colistin and meropenem led to recovery from the pneumonia but caused drug-induced renal failure. Because many centers are willing to transplant candidates who are on mechanical ventilation or extracorporeal life support, the incidence of XDR A. baumannii colonization of pretransplant lungs is expected to increase. Further studies are needed to examine pre-transplant management strategies in patients colonized with XDR A. baumannii.
Abstract
Colonization of the pre-transplant lung by multidrug-resistant bacteria affects short- and long-term outcomes of lung transplantation. However, there are no case reports on the colonization of a pre-transplant lung by drug-resistant Acinetobacter baumannii. We report a case of extensively drug resistant (XDR) A. baumannii colonization in the tracheobronchial tree that caused severe infectious complications after bilateral lung transplantation. A 23-year-old man diagnosed with bronchiolitis obliterans syndrome (BOS) 4 years earlier with a history of allogenic bone marrow transplantation for acute lymphoblastic leukemia was admitted to the hospital with dyspnea. Due to progressive hypercapnic respiratory failure, long-term mechanical ventilation was started after a tracheostomy was performed, and the patient underwent a bilateral lung transplantation to treat end-stage BOS. After the transplantation, the colonization of XDR A. baumannii caused severe bacterial pneumonia in the early postoperative period. Combined treatment with colistin and meropenem led to recovery from the pneumonia but caused drug-induced renal failure. Because many centers are willing to transplant candidates who are on mechanical ventilation or extracorporeal life support, the incidence of XDR A. baumannii colonization of pretransplant lungs is expected to increase. Further studies are needed to examine pre-transplant management strategies in patients colonized with XDR A. baumannii.
참고문헌 (20)
- Holm AM, "Lung transplantation for bronchiolitis obliterans after allogeneic hematopoietic stem cell transplantation: unresolved questions", Transplantation, 96, pp.e21~e22 (2013)
- 김유리, "Lung Transplantation for Bronchiolitis Obliterans after Allogeneic Hematopoietic Stem Cell Transplantation", Yonsei Medical Journal, 53(5), pp.1054~1057 (2012), 연세대학교의과대학[DOI]
- Soubani AO, "Lung transplantation following hematopoietic stem cell transplantation: report of two cases and systematic review of literature", Clin Transplant, 28, pp.776~782 (2014)
- Orens JB, "International guidelines for the selection of lung transplant candidates: 2006 update--a consensus report from the Pulmonary Scientific Council of the International Society for Heart and Lung Transplantation", J Heart Lung transplant, 25, pp.745~755 (2006)
- Fournier PE, "The epidemiology and control of Acinetobacter baumannii in health care facilities", Clin Infect Dis, 42, pp.692~699 (2006)
- Nunley DR, "Mortality associated with Acinetobacter baumannii infections experienced by lung transplant recipients", Lung, 188, pp.381~385 (2010)
- Shields RK, "High mortality rates among solid organ transplant recipients infected with extensively drug-resistant Acinetobacter baumannii:using in vitro antibiotic combination testing to identify the combination of a carbapenem and colistin as an effective treatment regimen", Diagn Microbiol Infect Dis, 70, pp.246~252 (2011)
- Shoham S, "Impact of multidrug-resistant organisms on patients considered for lung transplantation", Infect Dis Clin North Am, 27, pp.343~358 (2013)
- Bonvillain RW, "Post-operative infections in cystic fibrosis and non-cystic fibrosis patients after lung transplantation", J Heart Lung transplant, 26, pp.890~897 (2007)
- Palmer SM, "Significance of blood stream infection after lung transplantation: analysis in 176 consecutive patients", Transplantation, 69, pp.2360~2366 (2000)
- Vos R, "Pseudomonal airway colonisation: risk factor for bronchiolitis obliterans syndrome after lung transplantation?", Eur Respir J, 31, pp.1037~1045 (2008)
- Murray S, "Impact of burkholderia infection on lung transplantation in cystic fibrosis", Am J Respir Crit Care Med, 178, pp.363~371 (2008)
- Kennedy MP, "Burkholderia gladioli: five year experience in a cystic fibrosis and lung transplantation center", J Cyst Fibros, 6, pp.267~273 (2007)
- Sopirala MM, "Multidrug-resistant Acinetobacter baumannii pneumonia in lung transplant recipients", J Heart Lung Transplant, 27, pp.804~807 (2008)
- Martins N, "Severe infection in a lung transplant recipient caused by donor-transmitted carbapenem-resistant Acinetobacter baumannii", Transpl Infect Dis, 14, pp.316~320 (2012)
- Michalopoulos A, "Treatment of Acinetobacter infections", Expert Opin Pharmacother, 11, pp.779~788 (2010)
- Petrosillo N, "Colistin monotherapy vs. combination therapy: evidence from microbiological, animal and clinical studies", Clin Microbiol Infect, 14, pp.816~827 (2008)
- Gordon NC, "A review of clinical and microbiological outcomes following treatment of infections involving multidrug-resistant Acinetobacter baumannii with tigecycline", J Antimicrob Chemother, 63, pp.775~780 (2009)
- Gallagher JC, "Tigecycline for the treatment of Acinetobacter infections: a case series", Ann Pharmacother, 42, pp.1188~1194 (2008)
- Falagas ME, "Toxicity of polymyxins: a systematic review of the evidence from old and recent studies", Crit Care, 10, pp.R27~ (2006)