Pulmonary infections in renal transplant recipients from tertiary care hospital, SIUT Pakistan

<b>Introduction:</b> Renal transplant recipient are at a high risk of intricate pulmonary infections. The net state of immunosuppression also plays a role in atypical microbes like Pneumocystis Jirovecci, fungus, viruses and gram negative bacteria, therefore multiple factors are assessed for probable etiology of infection and choice of antibiotic. Aim of this study was to observe all cases of pulmonary infections in renal transplant recipients over two years. <b>Methods:</b> All transplant recipients with suspected chest infections were included in this retrospective study. Microbiological data of respiratory specimens was retrieved, patient’s records were evaluated for etiology, presentation, drug susceptibility, outcome and were saved on simple excel sheet. <b>Results:</b> From April2018 to April2020, 1015 cases of suspected pneumonia samples were analysed. Of these, 806 were sputum samples, 110 bronchial lavage and 99 tracheal aspirates. Haemophilus influenzae was the commonest organism in community aquired pneumonia, 94% sensitive to Co-amoxiclav and 72% sensitive to Quinolones, whereas in hospital aquired pneumonia Klebseilla being the commonest with 40% multi drug resistance. Aspergillus in about 10% and Pneumocystis Jirovecii in less than 5%. Almost 60% of sputum samples were negative while the yield from tracheal aspirate and bronchial lavage was 65% and 70% respectively. <b>Conclusion:</b> All pulmonary infections in transplant patients are potentially serious and all efforts should be made to isolate organisms. There is growing threat of resistant organisms and high mortality (20% in our study) in this population so aggressive and multidisciplinary approach can save lives.