Transplantation infectionMycobacterium abscessus Infections in Lung Transplant Recipients: The International Experience
Section snippets
Methods
In November 2003, a questionnaire was sent by e-mail or regular mail to 62 transplant centers affiliated with the International Society of Heart and Lung Transplantation registry (Appendix A). As M abscessus was sub-speciated from M chelonae after 1992, only those patients who received transplants after 1992 were included.4 The 2-page questionnaire addressed total program activity and total number of cases of M abscessus infection. Each program used its own procedures to identify cases of M
Survey Response and Incidence
Thirty-one centers (50%) responded (Appendix B). Of a total of 5,200 transplantations performed, 17 patients were identified with M abscessus for a cumulative incidence of 0.33%. Most centers did not report any cases (n = 24), whereas 5 centers reported 1 patient, 1 center reported 4 patients, and our center reported 8 patients. Eleven patients were from North America, 2 were from Europe, and 4 were from Australia. Four of these cases have previously been reported.2, 3 The cumulative incidence
Discussion
This study is, to our knowledge, the first worldwide survey of M abscessus infections in lung transplant recipients. Non-tuberculous mycobacteria (NTM) are ubiquitous environmental organisms that rarely cause disease in immunocompetent individuals. Contact tracing has been deemed unnecessary, as human-to-human transmission is rare.5, 6, 7 As a result, the exact incidence and prevalence of NTM remains unknown. Like several other NTM, M abscessus is generally found in patients with pre-existing
Conclusion
M abscessus is a rare and challenging pathogen in lung transplant recipients. With prolonged combination antimicrobial therapy coupled with surgical débridement for cutaneous lesions, treatment can be successful. Co-existent infections are common, however, and potentially fatal in this vulnerable population.
References (19)
- et al.
Cutaneous nodules of Mycobacterium chelonae in an immunosuppressed patient with preexisting pulmonary colonization
J Am Acad Dermatol
(1993) - et al.
Mycobacterium abscessus empyema in a lung transplant recipient
J Heart Lung Transplant
(2002) - et al.
Mycobacterial infections in lung transplant recipients
Chest
(1999) Bronchiolitis obliterans: pathogenesis, prevention, and management
Am J Med Sci
(1998)- et al.
Fatal pulmonary infection due to multidrug-resistant Mycobacterium abscessus in a patient with cystic fibrosis
J Clin Microbiol
(2001) - et al.
The spectrum of mycobacterial infection after lung transplantation
Am J Respir Crit Care Med
(1999) - et al.
Comparison of methods for Identification of Mycobacterium abscessus and M chelonae isolates
J Clin Microbiol
(2001) - et al.
Nontuberculous mycobacterial pulmonary diseases in immunocompetent patients
Korean J Radiol
(2002) Diagnosis and treatment of disease caused by nontuberculous mycobacteria
Am J Respir Crit Care Med
(1997)
Cited by (95)
Cystic Fibrosis-Related Nontuberculous Mycobacterial Pulmonary Disease
2023, Clinics in Chest MedicineRisk factors and outcomes of non-tuberculous mycobacteria infection in lung transplant recipients: A systematic review and meta-analysis
2023, Journal of Heart and Lung TransplantationCitation Excerpt :These organisms have a predilection for causing pulmonary infection in patients with structural lung disease, particularly cystic fibrosis (CF) and other diseases associated with bronchiectasis.2,3 Immunocompromised individuals are also at risk of multiple forms of NTM infection, including pulmonary infection, soft tissue infection, and disseminated disease.4–6 A case-control study examining associations of NTM disease in solid organ transplant recipients found lung transplant recipients (LTR) to be at the highest risk.7
Thoracic Infections in Solid Organ Transplants: Radiological Features and Approach to Diagnosis
2022, Radiologic Clinics of North AmericaNontuberculous and tuberculous Mycobacterium
2020, Pediatric Transplant and Oncology Infectious DiseasesFirst multicenter study of nontuberculous mycobacteria and/or Aspergillus infections in lung transplant recipients in Japan
2018, Respiratory Investigation