Abstract | BACKGROUND: METHODS: A retrospective study of ganciclovir susceptibility testing of CMV isolates recovered from lung transplant recipients was performed. Patients with CMV isolates having partial (1<IC50<3 microg/ml) or full resistance (IC50> or =3 microg/ml) to ganciclovir determined by plaque reduction assay were included in a case-control study to identify risk factors for ganciclovir resistance. RESULTS: Between 2/91 and 5/98, 18 patients (5.2% of patients transplanted) were found to have CMV infections with some degree of ganciclovir resistance (4 partially, 14 fully resistant). More positive viral blood cultures (3.2+/-2.5 vs. 1.6+/-1.4 CMV positive cultures, P=0.02) and more episodes of CMV pneumonitis (0.24+/-0.23 vs. 0.10+/-0.17 episodes/bronchoscopy, P=0.02) occurring before the detection of resistance were seen among resistant patients than controls. Ganciclovir-resistant patients received more antithymocyte globulin during induction (70+/-44 vs. 45+/-39 mg/kg, P=0.03) and received ganciclovir for a greater number of days (79+/-52 vs. 64+/-53 days, P=0.005) before the detection of resistance than controls. Ganciclovir-resistant patients had a shorter survival and an earlier onset of bronchiolitis obliterans syndrome compared with patients in the transplant database at Washington University. CONCLUSIONS:
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Authors | R M Kruger, W D Shannon, M Q Arens, J P Lynch, G A Storch, E P Trulock |
Journal | Transplantation
(Transplantation)
Vol. 68
Issue 9
Pg. 1272-9
(Nov 15 1999)
ISSN: 0041-1337 [Print] United States |
PMID | 10573063
(Publication Type: Journal Article)
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Chemical References |
- Antilymphocyte Serum
- Antiviral Agents
- Ganciclovir
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Topics |
- Adult
- Aged
- Antilymphocyte Serum
(therapeutic use)
- Antiviral Agents
(therapeutic use)
- Cytomegalovirus Infections
(drug therapy)
- Drug Resistance, Microbial
- Female
- Ganciclovir
(therapeutic use)
- Graft Rejection
- Humans
- Lung Transplantation
(adverse effects, mortality)
- Male
- Middle Aged
- Retrospective Studies
- T-Lymphocytes
(immunology)
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