Chronic rhinoviral infection in lung transplant recipients
Chronic rhinoviral infection in lung transplant recipients
复制标题
DOI：
10.1164/rccm.200604-489oc
复制
发表时间：
2006-12-15
影响因子：
24.7
通讯作者：
Soccal, Paola M.
中科院分区：
文献类型：
--
作者：
Kaiser, Laurent;Aubert, John-David;Soccal, Paola M.
基本原理：肺移植受者特别容易发生鼻病毒并发症，鼻病毒是社区中最常见的呼吸道病毒。目的：确定肺移植受者是否会慢性感染鼻病毒及其潜在的临床影响。方法：我们首先确定了一个索引病例，其中鼻病毒被反复分离出来，并进行了详细的分子分析，以确定这是否与一个独特的菌株或再感染事件。经支气管活检用于评估肺实质中鼻病毒的存在。慢性鼻病毒感染的发病率和潜在的临床影响进行了前瞻性评估，在一个队列的68例肺移植受者在19个月的筛选支气管肺泡lavages. Measures和主要结果：我们描述了3个肺移植受者与移植功能障碍，鼻病毒被确定在上，下呼吸道标本的逆转录-聚合酶链反应超过12个月的时间。在两个病例中，鼻病毒在培养物中反复分离。通过5 'NCR和VP 1基因的序列分析证实了每种情况下独特菌株的持久性。在指示病例中，在下呼吸道实质中检测到鼻病毒。在肺移植受者的队列中，鼻病毒感染记录在支气管肺泡灌洗标本的10个收件人，和2提出了一个持续性infection.Conclusions：鼻病毒感染可以是持久的肺移植受者与移植物功能障碍，和病毒可以检测到肺实质。考虑到潜在的临床影响，肺移植受者需要考虑慢性鼻病毒感染。
Rationale: Lung transplant recipients are particularly at risk of complications from rhinovirus, the most frequent respiratory virus circulating in the community.Objectives: To determine whether lung transplant recipients can be chronically infected by rhinovirus and the potential clinical impact.Methods: We first identified an index case, in which rhinovirus was isolated repeatedly, and conducted detailed molecular analysis to determine whether this was related to a unique strain or to reinfection episodes. Transbronchial biopsies were used to assess the presence of rhinovirus in the lung parenchyma. The incidence of chronic rhinoviral infections and potential clinical impact was assessed prospectively in a cohort of 68 lung transplant recipients during 19 mo by screening of bronchoalveolar lavages.Measurements and Main Results: We describe 3 lung transplant recipients with graft dysfunctions in whom rhinovirus was identified by reverse transcriptase-polymerase chain reaction in upper and lower respiratory specimens over a 12-mo period. In two cases, rhinovirus was repeatedly isolated in culture. The persistence of a unique strain in each case was confirmed by sequence analysis of the 5'NCR and VP1 gene. In the index case, rhinovirus was detected in the lower respiratory parenchyma. In the cohort of lung transplant recipients, rhinoviral infections were documented in bronchoalveolar lavage specimens of 10 recipients, and 2 presented with a persistent infection.Conclusions: Rhinoviral infection can be persistent in lung transplant recipients with graft dysfunction, and the virus can be detected in the lung parenchyma. Given the potential clinical impact, chronic rhinoviral infection needs to be considered in lung transplant recipients.