Risk factors and outcomes of non-tuberculous mycobacteria infection in lung transplant recipients: A systematic review and meta-analysis

Marty, Paige K.; Yetmar, Zachary A.; Gerberi, Dana; Escalante, Patricio; Pennington, Kelly; Mahmood, Maryam

doi:10.1016/j.healun.2022.10.004

Cited by 11 publications

(2 citation statements)

References 41 publications

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“…Published data are otherwise absent and current guidelines do not comment on management in this clinical context 19 . There is precedent for other pretransplant infections, such as nontuberculous mycobacteria and Mycobacterium abscessus specifically, being associated with recurrent infection and poor posttransplant outcomes 20–22 . As such, we aimed to review outcomes of patients with growth of Nocardia from a pretransplant clinical specimen who subsequently underwent SOT or HSCT.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of transplant recipients with pretransplant Nocardia colonization or infection

Yetmar

Chesdachai

Khodadadi

et al. 2023

Transplant Infectious Dis

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BackgroundSpecific pretransplant infections have been associated with poor posttransplant outcomes. However, the impact of pretransplant Nocardia isolation has not been studied.MethodsWe performed a retrospective study from three centers in Arizona, Florida, and Minnesota of patients with Nocardia infection or colonization who subsequently underwent solid organ or hematopoietic stem cell transplantation from November 2011 through April 2022. Outcomes included posttransplant Nocardia infection and mortality.ResultsNine patients with pretransplant Nocardia were included. Two patients were deemed colonized with Nocardia, and the remaining seven had nocardiosis. These patients underwent bilateral lung (N = 5), heart (N = 1), heart‐kidney (N = 1), liver‐kidney (N = 1), and allogeneic stem cell transplantation (N = 1) at a median of 283 (interquartile range [IQR] 152–283) days after Nocardia isolation. Two (22.2%) patients had disseminated infection, and two were receiving active Nocardia treatment at the time of transplantation. One Nocardia isolate was resistant to trimethoprim‐sulfamethoxazole (TMP‐SMX) and all patients received TMP‐SMX prophylaxis posttransplant, often for extended durations. No patients developed posttransplant nocardiosis during a median follow‐up of 1.96 (IQR 0.90–6.33) years. Two patients died during follow‐up, both without evidence of nocardiosis.ConclusionsThis study did not identify any episodes of posttransplant nocardiosis among nine patients with pretransplant Nocardia isolation. As patients with the most severe infections may have been denied transplantation, further studies with larger sample sizes are needed to better analyze any impact of pretransplant Nocardia on posttransplant outcomes. However, among patients who receive posttransplant TMP‐SMX prophylaxis, these data suggest pretransplant Nocardia isolation may not impart a heightened risk of posttransplant nocardiosis. image

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Section: Introductionmentioning

confidence: 99%

Outcomes of transplant recipients with pretransplant Nocardia colonization or infection

Yetmar

Chesdachai

Khodadadi

et al. 2023

Transplant Infectious Dis

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“…In many patients, M. abscessus causes progressive lung function decline with reduced quality of life [ 2 ] and it can be fatal [ 3 ], with a 15-year cumulative mortality rate of 51% [ 4 ]. It is a contraindication for lung transplantation and associated with worse post-lung treatment outcomes [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Clinical and Experimental Determination of Protection Afforded by BCG Vaccination against Infection with Non-Tuberculous Mycobacteria: A Role in Cystic Fibrosis?

Warner,

Blaxland,

Counoupas

et al. 2023

Vaccines

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Mycobacterium abscessus is a nontuberculous mycobacterium (NTM) of particular concern in individuals with obstructive lung diseases such as cystic fibrosis (CF). Treatment requires multiple drugs and is characterised by high rates of relapse; thus, new strategies to limit infection are urgently required. This study sought to determine how Bacille Calmette-Guérin (BCG) vaccination may impact NTM infection, using a murine model of Mycobacterium abscessus infection and observational data from a non-BCG vaccinated CF cohort in Sydney, Australia and a BCG-vaccinated CF cohort in Cape Town, South Africa. In mice, BCG vaccination induced multifunctional antigen-specific CD4+ T cells circulating in the blood and was protective against dissemination of bacteria to the spleen. Prior infection with M. abscessus afforded the highest level of protection against M. abscessus challenge in the lung, and immunity was characterised by a greater frequency of pulmonary cytokine-secreting CD4+ T cells compared to BCG vaccination. In the clinical CF cohorts, the overall rates of NTM sampling during a three-year period were equivalent; however, rates of NTM colonisation were significantly lower in the BCG-vaccinated (Cape Town) cohort, which was most apparent for M. abscessus. This study provides evidence that routine BCG vaccination may reduce M. abscessus colonisation in individuals with CF, which correlates with the ability of BCG to induce multifunctional CD4+ T cells recognising M. abscessus in a murine model. Further research is needed to determine the optimal strategies for limiting NTM infections in individuals with CF.

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Fibrotic progression from acute cellular rejection is dependent on secondary lymphoid organs in a mouse model of chronic lung allograft dysfunction

Mineura,

Tanaka,

Goda

et al. 2024

American Journal of Transplantation

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Risk factors and outcomes of non-tuberculous mycobacteria infection in lung transplant recipients: A systematic review and meta-analysis

Cited by 11 publications

References 41 publications

Outcomes of transplant recipients with pretransplant Nocardia colonization or infection

Outcomes of transplant recipients with pretransplant Nocardia colonization or infection

Clinical and Experimental Determination of Protection Afforded by BCG Vaccination against Infection with Non-Tuberculous Mycobacteria: A Role in Cystic Fibrosis?

Fibrotic progression from acute cellular rejection is dependent on secondary lymphoid organs in a mouse model of chronic lung allograft dysfunction

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