Chlamydia pneumoniae infection after lung transplantation

J Heart Lung Transplant. 2005 Feb;24(2):131-6. doi: 10.1016/j.healun.2003.09.042.


Background: Chlamydia pneumoniae is established as a common agent of acute respiratory tract infection and has been implicated in the pathogenesis of asthma and chronic obstructive pulmonary disease. Airway disease is a prominent cause of morbidity and mortality after lung transplantation. We investigated the role of C pneumoniae as a pulmonary pathogen after lung transplantation.

Methods: Eighty lung transplant recipients underwent 232 bronchoscopies with bronchoalveolar lavage with or without transbronchial lung biopsy during 1 year for surveillance of rejection and infection, or where clinically indicated.

Results: C pneumoniae was detected using nested polymerase chain reaction in 9 of 36 (25%) recipients studied within 30 days of lung transplantation, 3 of whom remained positive on repeat lavage and died from airway disease in the first year post-operatively. By comparison, all 27 recipients with negative lavage survived >1 year. Lavage was positive for C pneumoniae in 18 of 71 (25%) recipients studied >30 days after lung transplantation, 5 of whom had pneumonia and 8 of whom had bronchiolitis obliterans syndrome. Eleven also had acute pulmonary allograft rejection.

Conclusions: Persistent infection with C pneumoniae (whether donor-derived, de novo or re-activated) appears deleterious to pulmonary allograft function and is associated with early mortality, rejection and bronchiolitis obliterans syndrome after lung transplantation. A trial of empiric antibiotic therapy for C pneumoniae may therefore be warranted in the attempt to prevent progressive inflammatory airway disease.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Bronchiolitis Obliterans / etiology*
  • Bronchoalveolar Lavage
  • Chlamydophila Infections / etiology*
  • Chlamydophila Infections / mortality
  • Chlamydophila pneumoniae* / genetics
  • Female
  • Follow-Up Studies
  • Graft Rejection
  • Humans
  • Lung Transplantation*
  • Male
  • Middle Aged
  • Pneumonia, Bacterial / etiology*
  • Pneumonia, Bacterial / mortality
  • Polymerase Chain Reaction
  • Postoperative Complications / etiology*
  • Postoperative Complications / mortality
  • Survival Analysis
  • Treatment Outcome