Procalcitonin serum concentration in lung transplant recipients during mold colonization or infection

Transplant Proc. 2011 Oct;43(8):3089-91. doi: 10.1016/j.transproceed.2011.08.057.

Abstract

Background: This publication attempted to evaluate the frequency of mold colonization and infection and the procalcitonin serum concentrations (PCT) among lung transplant recipients.

Methods and materials: We included 49 patients (36 males and 13 females) of mean age at transplantation of 47.1±13.6 years. Molds were isolated using routine microbiologic methods. PCT (ng/mL) was measured using an immunoluminescence assay with values below 0.5 showing no probability of infection, 0.5 to 2.0, a moderate infection risk; 2.0 to 10, a high infection risk; and above 10 high sepsis risk.

Results: Twenty-four (49%) patients revealed the presence of molds in material from the lower respiratory tract (sputum, tracheal, or tracheobronchial aspirate), mini-bronchoalveolar lavage. Aspergillus species was isolated in 14 (28.6%) patients, Penicillium in 7 (14.3%) patients, and Zygomycetes fungi in 9 (18.4%) patients. The average PCT value from 61 examinations of PCT during fungal isolation was 0.5±0.7 ng/mL. However, when the studied group was categorized according to the PCT range, the rates for the groups were no infection (n=30; 49.2%), moderate (n=20; 32.8%), high (n=9; 14.8%) and high sepsis risk (n=2; 3.3%).

Conclusions: The mold colonization of transplanted lung is a frequent complication and should be considered even in the case of proper prophylaxis. Procalcitonin might be the marker helpful in mold infection diagnosis.

MeSH terms

  • Adult
  • Biomarkers / blood
  • Calcitonin / blood*
  • Calcitonin Gene-Related Peptide
  • Female
  • Humans
  • Invasive Pulmonary Aspergillosis / blood
  • Invasive Pulmonary Aspergillosis / etiology
  • Lung Diseases, Fungal / blood*
  • Lung Diseases, Fungal / etiology*
  • Lung Diseases, Fungal / microbiology
  • Lung Transplantation / adverse effects*
  • Lung Transplantation / physiology
  • Male
  • Middle Aged
  • Penicillium / isolation & purification
  • Postoperative Complications / blood*
  • Postoperative Complications / etiology*
  • Postoperative Complications / microbiology
  • Protein Precursors / blood*
  • Zygomycosis / blood
  • Zygomycosis / etiology

Substances

  • Biomarkers
  • CALCA protein, human
  • Protein Precursors
  • Calcitonin
  • Calcitonin Gene-Related Peptide