Osmani, Morsal

AbstractPurposeTo evaluate our institutional experience withMycobacterium abscessusinfections occurring in lung transplant recipients (LTR).MethodsWe retrospectively reviewed our prospectively collected institutional adult lung transplant database from 2001 to 2015 to identify patients withM. abscessusorMycobacterium chelonae/abscessusinfection before or after transplantation. Untreated, colonized patients were excluded from the study. Electronic health records of nine out of 516 lung recipients (1.74%) with clinical infection were reviewed to determine outcomes.ResultsSeven patients acquired the infection after transplantation. Indications for transplantation were: idiopathic pulmonary fibrosis (in 6), chronic obstructive pulmonary disease (in 2), and cystic fibrosis (in 1). Five patients (55.5%) underwent bilateral lung transplantation; one patient required bilateral re‐transplantation for complications from infection.M. abscessuswas isolated from the respiratory tract with a median time of 7.5 months (range: 3 days to 13 months) from transplantation. All patients were treated using a multidrug regimen, with durations ranging from 3 days to 12 months. Complications from infection included death in one patient, bronchial anastomotic dehiscence in one patient, delayed bronchial occlusions in two patients, and osteomyelitis of the knee in one patient. Median survival time from transplantation was 39 months (range: 11‐96 months) and from the date of first positive culture was 58 months (range: 3‐91 months). Five patients (55.5%) were cured but two had re‐infections >1 year later.ConclusionsMycobacterium abscessusinfection inLTRis rare and can lead to severe complications. Eradication is difficult and usually requires prolonged combination antibiotic therapy and occasionally surgical management.