Risk factors for survival after lung transplantation in cystic fibrosis: impact of colonization with multidrug-resistant strains of Pseudomonas aeruginosa.
Background: Lung transplantation is the ultimate treatment option for patients with advanced cystic fibrosis. Chronic colonization of these recipients with multidrug-resistant (MDR) pathogens may constitute a risk factor for an adverse outcome. We sought to analyze whether colonization with MDR path...
| Publicado en: | Infection Vol. 53; no. 5; pp. 1677 - 1685 |
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| Autores principales: | , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Springer Nature
Oct2025
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=188243047&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 188243047 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 03008126 NXO jtl: Infection issn: 03008126 maglogo: N pubinfo: dt: Oct2025 vid: 53 iid: 5 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 188243047 182560328 188243047 188243047 10.1007/s15010-025-02478-z 188243047 ppf: 1677 ppct: 8 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Risk factors for survival after lung transplantation in cystic fibrosis: impact of colonization with multidrug-resistant strains of Pseudomonas aeruginosa. aug: au: Weingard, Bettina Becker, Sören L. Schneitler, Sophie Trudzinski, Franziska C. Bals, Robert Wilkens, Heinrike Langer, Frank affil: https://ror.org/01jdpyv68 Internal Medicine V, Saarland University, 66421, Homburg/Saar, Germany sug: subj: Cystic Fibrosis Surgery Lung Transplantation Adverse Effects Lung Transplantation Mortality Drug Resistance, Microbial Pseudomonas Infections Microbiology Bacterial Colonization Cystic Fibrosis Mortality Pseudomonas Infections Mortality Mortality Risk Factors Risk Assessment Human Male Female Child Adolescence Adult Retrospective Design Record Review Germany Comparative Studies Descriptive Statistics Surgical Patients Pseudomonas Drug Effects Survival Analysis T-Tests Mann-Whitney U Test Fisher's Exact Test Kaplan-Meier Estimator Log-Rank Test Cox Proportional Hazards Model Multiple Regression Child: 6-12 years Adolescent: 13-18 years Adult: 19-44 years Male Female ab: Background: Lung transplantation is the ultimate treatment option for patients with advanced cystic fibrosis. Chronic colonization of these recipients with multidrug-resistant (MDR) pathogens may constitute a risk factor for an adverse outcome. We sought to analyze whether colonization with MDR pathogens, as outlined in the German classification of multiresistant Gram-negative bacteria (MRGN), was associated with the success of lung transplantation. Methods: We performed a monocentric retrospective analysis of 361 lung transplantations performed in Homburg, Germany, between 1995 and 2020. All recipients with a main diagnosis of cystic fibrosis (n = 69) were stratified into two groups based on colonization with Pseudomonas aeruginosa in view of MRGN before transplantation: no colonization and colonization without (n = 23) or with (n = 46) resistance to three or four antibiotic groups (3MRGN/4MRGN). Multivariable analyses were performed including various clinical parameters (preoperative data, postoperative data). Results: CF patients colonized with multidrug-resistant pathogens (Pseudomonas aeruginosa) classified as 3MRGN/4MRGN had poorer survival (median survival 16 years (without MRGN) versus 8 years (with MRGN), P = 0.048). Extracorporeal support (P = 0.014, HR = 2.929), re-transplantation (P = 0.023, HR = 2.303), female sex (P = 0.019, HR = 2.244) and 3MRGN/4MRGN (P = 0.036, HR = 2.376) were predictors of poor outcomes in the multivariate analysis. Co-colonization with the mold Aspergillus fumigatus was further associated with mortality risk in the 3MRGN/4MRGN group (P = 0.037, HR = 2.150). Conclusion: Patients with cystic fibrosis and MDR colonization (Pseudomonas aeruginosa) are risk candidates for lung transplantation, targeted diagnostics and tailored anti-infective strategies are essential for survival after surgery. MDR colonization as expressed by MRGN may help to identify patients at increased risk to improve the organ allocation process. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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