Hostname: page-component-848d4c4894-xfwgj Total loading time: 0 Render date: 2024-06-17T17:58:38.311Z Has data issue: false hasContentIssue false
  • English
  • Français

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
Rights & Permissions [Opens in a new window]

Summary

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

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

REFERENCES

1.Fiala, M, Payne, JE, Berne, TV, et al. Epidemiology of cytomegalovirus infection after transplantation and immunosuppression. J Infect Dis 1975; 132: 421–33.CrossRefGoogle ScholarPubMed
2.Onorato, IM, Morens, DM, Martone, WJ, Stansfield, SK. Epidemiology of cytomegaloviral infections: recommendations for prevention and control. Rev Infect Dis 1985; 7: 479–96.CrossRefGoogle ScholarPubMed
3.Rubin, RH, Cosimi, AB, Tolkoff-Rubin, NE, Russell, PS, Hirsch, MS. Infectious disease syndromes attributable to cytomegalovirus and their significance among renal transplant recipients. Transplantation 1977; 24: 458–64.CrossRefGoogle ScholarPubMed
4.Rand, KH, Pollard, RB, Merigan, TC. Increased pulmonary superinfections in cardiac transplant patients undergoing primary cytomegalovirus infection. N Engl J Med 1978; 198: 951–3.CrossRefGoogle Scholar
5.Chatterjee, SN, Fiala, M, Weiner, J, Steward, JA, Stacy, B, Warner, N. Primary cytomegalovirus and opportunistic infections. Incidence in renal transplant recipients. JAMA 1978; 240: 2446–9.CrossRefGoogle ScholarPubMed
6.Osborn, JR, Blazkovec, AA, VValker, DL. Immunosuppression during acute murine cytomegalovirus infection. J Immunol 1968; 100: 835–44.CrossRefGoogle ScholarPubMed
7.Howard, RJ, Najarian, JS. Cytomegalovirus-induced immune suppression. I. Humoral immunity. Clin Exp Immunol 1974; 18: 109–18.Google ScholarPubMed
8.Oill, PA, Fiala, M, Schofferman, J, et al. Cytomegalovirus mononucleosis in a healthy adult. Am J Med 1977; 62: 413–17.CrossRefGoogle Scholar
9.Ho, M. Cytomegalovirus. Biology and Infection. New York: Plenum Medical Book Co., 1982: Chapters 7 and 9.CrossRefGoogle Scholar
10.Johanson, WB, Pierce, AK, Sanford, JP. Changing pharyngeal bacterial flora of hospitalized patients. N Engl J Med 1969; 281: 1137–40.CrossRefGoogle ScholarPubMed
11.Gibbons, RJ, Van Houte, J. Selective bacterial adherence to oral epithelial surfaces and its role as an ecological determinant. Infected Immun 1971; 3: 567–73.CrossRefGoogle ScholarPubMed
12.Dal Nogare, AR, Toews, GB, Pierce, AK. Increased salivary elastase precedes Gram-negative bacillary colonization in postoperative patients. Am Rev Respir Dis 1987; 135: 671–5.Google ScholarPubMed
13.Spijkervet, FKL, Van Saene, HKF, Panders, AK, Vermey, A. Colonisation Index of the oral cavity: a novel technique for monitoring colonisation defence. Microb Ecol health Dis 1989; 2: 145–51.Google Scholar
14.Craighead, JE, Hanshaw, JB, Carpenter, CB. Cytomegalovirus infection after renal allotransplantation. JAMA 1967; 201: 99–102.CrossRefGoogle ScholarPubMed
15.Naraqi, S, Jackson, GG, Jonasson, O, Yamashiroya, HM. Prospective study of prevalence, incidence, and source of herpesvirus infections in patients with renal allografts. J Infect Dis 1977; 136: 531–40.CrossRefGoogle ScholarPubMed
16.Betts, RF, Freeman, RB, Douglas, RG, Talley, TE. Clinical manifestations of renal allograft derived primary cytomegalovirus infection. Am J Dis Child 1977; 131: 759–63.Google ScholarPubMed
17.Walker, DP, Longson, M, Mallick, NP, Johnson, RWG. A prospective study of cytomegalovirus and herpes simplex virus disease in renal transplant recipients. J Clin Pathol 1982; 35: 1190–3.CrossRefGoogle ScholarPubMed
18.Mackowiak, PA, Martin, RM, Jones, SR, Smith, JW. Pharyngeal colonization of aspiration-prone persons by Gram-negative bacilli and other potential pathogens. Arch Intern Med 1978; 138: 1224–7.CrossRefGoogle Scholar
19.Sprunt, K, Redman, W. Evidence suggesting importance of role in interbacterial inhibition in maintaining balance of normal flora. Ann Intern Med 1968; 68: 579–90.CrossRefGoogle ScholarPubMed
20.Johanson, WG Jr, Blackstock, R, Pierce, AK, Sanford, JP. The role of bacterial antagonism in pneumococcal colonization of the human pharynx. J Lab Clin Med 1970; 75: 946–52.Google ScholarPubMed
21.Sanders, E. Bacterial interference. I. Its occurrence among the respiratory tract flora and characterization of inhibitions of group A streptococci by viridans streptococci. J Infect Dis 1969; 120: 698–707.CrossRefGoogle Scholar
22.Woods, JDE, Straus, DC, Johnson, WG, Bass, JA. Role of fibronectin in the prevention of adherence of Pseudomonas aeruginosa to buccal cells. J Infect Dis 1981; 143: 784–90.CrossRefGoogle ScholarPubMed
23.Abraham, SM, Beachey, EH, Simpson, WA. Adherence of Streptococcus pyogenes, Escherichia coli, and Pseudomonas aeruginosa to fibronectin-coated and uncoated epithelial cells. Infect Immun 1983; 41: 1261–8.CrossRefGoogle ScholarPubMed
24.Woods, DE, Straus, DC, Johanson, WG, Bass, JA. Role of salivary protease activity in adherence of Gram-negative bacilli to mammalian buccal epithelial ceils in vivo. J Clin Invest 1981; 68: 1435–40.CrossRefGoogle Scholar
25.Woods, DE, Straus, DC, Johnson, WG, Bass, JA. Factors influencing the adherence of Pseudomonas aeruginosa to mammalian buccal epithelial cells. Rev Infect Dis 1983; 5 (Suppl): 846–51.CrossRefGoogle ScholarPubMed
26.Westmoreland, D, Watkins, JF. The IgG receptor induced by herpes simplex virus; studies using radioiodinated IgG. J Gen Virol 1974; 24: 167–78.CrossRefGoogle ScholarPubMed
27.Sakuma, S, Furokawa, T, Plotkin, SA. The characterization of the IgG receptor induced by human cytomegalovirus. Proc Soc Exp Biol Med 1977; 155: 168–72.CrossRefGoogle ScholarPubMed
28.Ogata, M, Shigeta, S. Appearance of immunoglobulin G Fc receptor in cultured human cells infected with varicella-zoster virus. Infect Immun 1977; 25: 770–4.Google Scholar
29.Mackowiak, PA, Marling-Cason, M, Smith, JW, Luby, JP. Antibody-mediated bacterial adhesion to cytomegalovirus-induced Fc receptors. Potential relationship to secondary infections complicating herpesvirus infections. J Clin Invest 1984; 73: 987–91.CrossRefGoogle ScholarPubMed