Incidence of nosocomial pneumonia and risk of recurrence after antimicrobial therapy in critically ill lung and heart–lung transplant patients

Little is known about the resolution of symptoms of nosocomial pneumonia ( N oso P ) after lung and heart–lung transplantation. The aim of this study was to describe the clinical response to antimicrobial therapy in ( ICU ) patients with N oso P after lung or heart–lung transplantation. Between January 2008 and A ugust 2010, 79 lung or heart–lung transplantations patients were prospectively studied. N oso P was confirmed by quantitative cultures of bronchoalveolar lavage or endotracheal aspirates. Clinical variables, sequential organ failure assessment ( SOFA ) score, and radiologic score were recorded from start of therapy until day 9. Thirty‐five patients (44%) experienced 64 episodes of N oso P in ICU . Fourteen patients (40%) had N oso P recurrence. Most frequently isolated organisms were E nterobacteriaceae (30%), P seudomonas aeruginosa (25%), and S taphylococcus aureus (20%). Sequential organ failure assessment ( SOFA ) score improved significantly at day 6 and C‐reactive protein level at day 9. SOFA and radiologic scores differed significantly between patients with and without NosoP recurrence at day 3 and 9. The ICU mortality rate did not differ between patients with and without N oso P recurrence, and free of N oso P (14.3%, 9.5%, 11.4%, respectively) (p = 0.91). Severities of illness and lung injury were the two major risk factors for N oso P recurrence. Occurrence of N oso P has no impact on ICU mortality.