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Risk of Bronchial Dehiscence in Lung Transplant Recipients With Carbapenemase-producing Klebsiella

Authors
 Jee Won Suh  ;  Jin Gu Lee  ;  Su Jin Jeong  ;  Moo Suk Park  ;  Song Yee Kim  ;  Hyo Chae Paik 
Citation
 ANNALS OF THORACIC SURGERY, Vol.110(1) : 265-271, 2020-07 
Journal Title
 ANNALS OF THORACIC SURGERY 
ISSN
 0003-4975 
Issue Date
2020-07
MeSH
Aged ; Bacterial Proteins ; Bronchial Diseases / diagnosis ; Bronchial Diseases / epidemiology* ; Bronchial Diseases / microbiology ; Bronchoscopy ; Female ; Humans ; Incidence ; Klebsiella Infections / diagnosis ; Klebsiella Infections / epidemiology* ; Klebsiella pneumoniae* ; Lung Diseases / surgery* ; Lung Transplantation / adverse effects* ; Male ; Middle Aged ; Surgical Wound Dehiscence / diagnosis ; Surgical Wound Dehiscence / epidemiology* ; Surgical Wound Dehiscence / microbiology ; beta-Lactamases
Abstract
Background: Klebsiella pneumoniae is commonly isolated after lung transplantation. This study observed an increase in bronchial complications after an outbreak of Klebsiella pneumoniae carbapenemase-producing Klebsiella (KPC-KP). Methods: The study enrolled 173 patients who had undergone bilateral lung transplantation between 2012 and 2018 to examine the association between bronchial complications after lung transplantation and KPC-KP. The KPC-KP group was defined as patients whose isolates from sputum or bronchoalveolar lavage fluid were positive for KPC-KP. The presence of bronchial complications was defined as a positive finding on bronchoscopy in accordance with the criteria of the International Society for Heart and Lung Transplantation. Risk factors for bronchial complications were analyzed. Results: KPC-KP was identified in 29 patients (16.8%), and bronchial dehiscence was observed in 13 patients (7.5%). Smoking (odds ratio [OR], 5.690; 95% confidence interval [CI], 1.106- to 9.260; P = .037), the presence of KPC-KP (OR, 5.360; 95% CI, 1.380 to 20.810; P = .015), and bronchial necrosis (OR, 7.009; 95% CI, 1.811 to 27.124; P = .005) were associated with bronchial dehiscence in a multivariate logistic regression model. Conclusions: The presence of KPC-KP in lung-transplant recipients significantly increased the risk of bronchial dehiscence, independent of bronchial necrosis. Thus, patients with KPC-KP require greater surveillance and follow-up bronchoscopy, irrespective of the presence or absence of bronchial necrosis or the overall patient condition.
Full Text
https://www.sciencedirect.com/science/article/pii/S0003497520303465
DOI
10.1016/j.athoracsur.2020.01.076
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Song Yee(김송이) ORCID logo https://orcid.org/0000-0001-8627-486X
Park, Moo Suk(박무석) ORCID logo https://orcid.org/0000-0003-0820-7615
Paik, Hyo Chae(백효채) ORCID logo https://orcid.org/0000-0001-9309-8235
Suh, Jee Won(서지원) ORCID logo https://orcid.org/0000-0003-0287-0651
Lee, Jin Gu(이진구)
Jeong, Su Jin(정수진) ORCID logo https://orcid.org/0000-0003-4025-4542
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/180233
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