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Relationship between cytomegalovirus and colonization of the oropharynx by Gram-negative bacilli following renal transplantation

Published online by Cambridge University Press:  15 May 2009

P. A. Mackowiak ,
M. Goggans ,
W. Torres ,
A. Dal Nogare ,
J. P. Luby  and
H. Helderman
P. A. Mackowiak
Affiliation:
V. A. Medical Center and Department of Internal Medicine, University of Texas Southwestern Medical Center at Dallas, Southwestern Medical School, Dallas, Texas
M. Goggans
Affiliation:
V. A. Medical Center and Department of Internal Medicine, University of Texas Southwestern Medical Center at Dallas, Southwestern Medical School, Dallas, Texas
W. Torres
Affiliation:
V. A. Medical Center and Department of Internal Medicine, University of Texas Southwestern Medical Center at Dallas, Southwestern Medical School, Dallas, Texas
A. Dal Nogare
Affiliation:
V. A. Medical Center and Department of Internal Medicine, University of Texas Southwestern Medical Center at Dallas, Southwestern Medical School, Dallas, Texas
J. P. Luby
Affiliation:
V. A. Medical Center and Department of Internal Medicine, University of Texas Southwestern Medical Center at Dallas, Southwestern Medical School, Dallas, Texas
H. Helderman
Affiliation:
V. A. Medical Center and Department of Internal Medicine, University of Texas Southwestern Medical Center at Dallas, Southwestern Medical School, Dallas, Texas
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Summary

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Numerous investigators have reported an increased incidence of pneumonia caused by Gram-negative bacilli and other secondary pathogens in transplant recipients infected by cytomegalovirus (CMV). To determine if CMV infections are related to colonization of the upper respiratory tract by Gram-negative bacilli, we examined prospectively 22 renal transplant recipients with sequential bacteriological, virological and biochemical examinations performed just prior to and at various times after transplantation. Only 11% of subjects had Gram-negative bacilli isolated from gargle specimens prior to transplantation, as compared to 54% after transplantation. More importantly, after transplantation, subjects with active CMV infections were more likely to have prolonged oropharyngeal carriage of Gram-negative bacilli than subjects without CMV infections (36% v.. 25%). During active CMV infections, the rate at which Gram-negative bacilli were isolated from gargle specimens rose from 28 to 47%. During culture-positive CMV infections, the isolation rate reached 57% and was significantly different from that of CMV-negative samples (P < 0·01). The increased rate of Gram-negative bacillary isolation from gargle specimens during CMV infections was not a function of type of immunosuppresive agents used, rejection episodes, antibiotic administration, concomitant hepatitis B, Epstein–Barr (EBV) virus, or herpes simplex virus infections, or alterations in salivary fibronectin concentrations.

Type
Research Article
Information
Epidemiology & Infection , Volume 107 , Issue 2 , October 1991 , pp. 411 - 420
Copyright
Copyright © Cambridge University Press 1991

References

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