Assessment of Staphylococcus aureus colonisation post lung transplantation

Abstract number: r2232

Archer  L., Fisher  A., Botha  P., Gould  K.

Colonisation with potentially pathogenic bacteria following lung transplantation may reflect some underlying disease process. We reviewed our transplant database for both Cystic Fibrosis (CF) and non-CF recipients for the incidence of S. aureus post-transplant. 213 lung transplants were carried out at this centre in 6 years to 2003. 85(40%) were CF patients and 128 (60%) were non-CF. Routine Bronchoalveolar Lavage (BAL) is performed at 1 week, then 1, 3, 6 and 12 months post-transplant, with other routine respiratory specimens being submitted for culture as necessary. Of 85 CF patients transplanted only 8 (8.2%) had S. aureus isolated at time of transplant, 1 patient remained colonised at week 1, 2 patients at 1 month, there was no increase by 3 months, 4 patients at 6 months and the same number at 1 year post-transplant. There were 6 patients who had S. aureus isolated from other respiratory specimens and the remaining 1 patient never grew S. aureus again. Of the 78 (91.8%) patients who did not grow S. aureus at time of transplant, only 23 (27%) had positive cultures with S. aureus. Of these 23 patients 3 (13%) grew S. aureus at 1 week, 5 (22%) by 1 month and 8 (34%), 15 (65%), 17 (74%) by 3.6 and 12 months respectively. S. aureus was isolated from other respiratory samples of the remaining 6 patients post transplant. 128 non-CF patients were transplanted in the same period. 36 (28.1%) were colonised with S. aureus post-transplant. Only 4 (3.1%) however had S. aureus at time of transplant, and of these 4 patients only 1 patient grew the organism again. In the 32 patients who grew S. aureus post transplant only, 5 (15.6%) were isolated at 1 week, 14 (43.7%), 15 (46.8%), 17 (53.1%) at 1, 3 and 6 months with no increase by 1 year. The remaining 15 patients had S. aureus isolated from routine respiratory specimens only.

Conclusion: 

S. aureus colonisation occurs at a similar rate in CF and non-CF transplant recipients. Further study is required to determine whether or not there is any underlying lung pathology.