Skip to main content
NCBI home page
Epidemiology and Infection logoLink to Epidemiology and Infection
. 1991 Oct;107(2):411–420. doi: 10.1017/s0950268800049050

Relationship between cytomegalovirus and colonization of the oropharynx by gram-negative bacilli following renal transplantation.

P A Mackowiak 1, M Goggans 1, W Torres 1, A Dal Nogare 1, J P Luby 1, H Helderman 1
PMCID: PMC2272072  PMID: 1657624

Abstract

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 less than 0.01). The increased rate of Gram-negative bacillary isolation from gargle specimens during CMV infections was not a function of type of immunosuppressive agents used, rejection episodes, antibiotic administration, concomitant hepatitis B, Epstein-Barr (EBV) virus, or herpes simplex virus infections, or alterations in salivary fibronectin concentrations.

Full text

PDF
411

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Abraham S. N., Beachey E. H., Simpson W. A. Adherence of streptococcus pyogenes, Escherichia coli, and Pseudomonas aeruginosa to fibronectin-coated and uncoated epithelial cells. Infect Immun. 1983 Sep;41(3):1261–1268. doi: 10.1128/iai.41.3.1261-1268.1983. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Betts R. F., Freeman R. B., Douglas R. G., Jr, Talley T. E. Clinical manifestations of renal allograft derived primary cytomegalovirus infection. Am J Dis Child. 1977 Jul;131(7):759–763. doi: 10.1001/archpedi.1977.02120200041010. [DOI] [PubMed] [Google Scholar]
  3. Chatterjee S. N., Fiala M., Weiner J., Stewart J. A., Stacey B., Warmer N. Primary cytomegalovirus and opportunistic infections. Incidence in renal transplant recipients. JAMA. 1978 Nov 24;240(22):2446–2449. [PubMed] [Google Scholar]
  4. Dal Nogare A. R., Toews G. B., Pierce A. K. Increased salivary elastase precedes gram-negative bacillary colonization in postoperative patients. Am Rev Respir Dis. 1987 Mar;135(3):671–675. doi: 10.1164/arrd.1987.135.3.671. [DOI] [PubMed] [Google Scholar]
  5. Fiala M., Payne J. E., Berne T. V., Moore T. C., Henle W., Montgomerie J. Z., Chatterjee S. N., Guze L. B. Epidemiology of cytomegalovirus infection after transplantation and immunosuppression. J Infect Dis. 1975 Oct;132(4):421–433. doi: 10.1093/infdis/132.4.421. [DOI] [PubMed] [Google Scholar]
  6. Gibbons R. J., van Houte J. Selective bacterial adherence to oral epithelial surfaces and its role as an ecological determinant. Infect Immun. 1971 Apr;3(4):567–573. doi: 10.1128/iai.3.4.567-573.1971. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Golbert T. M., Sanz C. J., Rose H. D., Leitschuh T. H. Comparative evaluation of treatments of alcohol withdrawal syndromes. JAMA. 1967 Jul 10;201(2):99–102. [PubMed] [Google Scholar]
  8. Howard R. J., Najarian J. S. Cytomegalovirus-induced immune suppression. I. Humoral immunity. Clin Exp Immunol. 1974 Sep;18(1):109–118. [PMC free article] [PubMed] [Google Scholar]
  9. Johanson W. G., Jr, Blackstock R., Pierce A. K., Sanford J. P. The role of bacterial antagonism in pneumococcal colonization of the human pharynx. J Lab Clin Med. 1970 Jun;75(6):946–952. [PubMed] [Google Scholar]
  10. Johanson W. G., Pierce A. K., Sanford J. P. Changing pharyngeal bacterial flora of hospitalized patients. Emergence of gram-negative bacilli. N Engl J Med. 1969 Nov 20;281(21):1137–1140. doi: 10.1056/NEJM196911202812101. [DOI] [PubMed] [Google Scholar]
  11. Mackowiak P. A., Marling-Cason M., Smith J. W., Luby J. P. Antibody-mediated bacterial adhesion to cytomegalovirus-induced Fc receptors. Potential relationship to secondary infections complicating herpesvirus infections. J Clin Invest. 1984 Apr;73(4):987–991. doi: 10.1172/JCI111324. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Mackowiak P. A., Martin R. M., Jones S. R., Smith J. W. Pharyngeal colonization by gram-negative bacilli in aspiration-prone persons. Arch Intern Med. 1978 Aug;138(8):1224–1227. [PubMed] [Google Scholar]
  13. Naraqi S., Jackson G. G., Jonasson O., Yamashiroya H. M. Prospective study of prevalence, incidence, and source of herpesvirus infections in patients with renal allografts. J Infect Dis. 1977 Oct;136(4):531–540. doi: 10.1093/infdis/136.4.531. [DOI] [PubMed] [Google Scholar]
  14. Oill P. A., Fiala M., Schofferman J., Byfield P. E., Guze L. B. Cytomegalovirus mononucleosis in a healthy adult: association with hepatitis, secondary Epstein-Barr Virus antibody response and immunosuppression. Am J Med. 1977 Mar;62(3):413–417. doi: 10.1016/0002-9343(77)90840-3. [DOI] [PubMed] [Google Scholar]
  15. Onorato I. M., Morens D. M., Martone W. J., Stansfield S. K. Epidemiology of cytomegaloviral infections: recommendations for prevention and control. Rev Infect Dis. 1985 Jul-Aug;7(4):479–497. doi: 10.1093/clinids/7.4.479. [DOI] [PubMed] [Google Scholar]
  16. Osborn J. E., Blazkovec A. A., Walker D. L. Immunosuppression during acute murine cytomegalovirus infection. J Immunol. 1968 Apr;100(4):835–844. [PubMed] [Google Scholar]
  17. Rand K. H., Pollard R. B., Merigan T. C. Increased pulmonary superinfections in cardiac-transplant patients undergoing primary cytomegalovirus infection. N Engl J Med. 1978 Apr 27;298(17):951–953. doi: 10.1056/NEJM197804272981705. [DOI] [PubMed] [Google Scholar]
  18. Rubin R. H., Cosimi A. B., Tolkoff-Rubin N. E., Russell P. S., Hirsch M. S. Infectious disease syndromes attributable to cytomegalovirus and their significance among renal transplant recipients. Transplantation. 1977 Dec;24(6):458–464. doi: 10.1097/00007890-197712000-00010. [DOI] [PubMed] [Google Scholar]
  19. Sakuma S., Furukawa T., Plotkin S. A. The characterization of IgG receptor induced by human cytomegalovirus. Proc Soc Exp Biol Med. 1977 Jun;155(2):168–172. doi: 10.3181/00379727-155-39767. [DOI] [PubMed] [Google Scholar]
  20. Sanders E. Bacterial interference. I. Its occurrence among the respiratory tract flora and characterization of inhibition of group A streptococci by viridans streptococci. J Infect Dis. 1969 Dec;120(6):698–707. doi: 10.1093/infdis/120.6.698. [DOI] [PubMed] [Google Scholar]
  21. Sprunt K., Redman W. Evidence suggesting importance of role of interbacterial inhibition in maintaining balance of normal flora. Ann Intern Med. 1968 Mar;68(3):579–590. doi: 10.7326/0003-4819-68-3-579. [DOI] [PubMed] [Google Scholar]
  22. Walker D. P., Longson M., Mallick N. P., Johnson R. W. A prospective study of cytomegalovirus and herpes simplex virus disease in renal transplant recipients. J Clin Pathol. 1982 Nov;35(11):1190–1193. doi: 10.1136/jcp.35.11.1190. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Westmoreland D., Watkins J. F. The IgG receptor induced by herpes simplex virus: studies using radioiodinated IgG. J Gen Virol. 1974 Jul;24(1):167–178. doi: 10.1099/0022-1317-24-1-167. [DOI] [PubMed] [Google Scholar]
  24. Woods D. E., Straus D. C., Johanson W. G., Jr, Bass J. A. Role of fibronectin in the prevention of adherence of Pseudomonas aeruginosa to buccal cells. J Infect Dis. 1981 Jun;143(6):784–790. doi: 10.1093/infdis/143.6.784. [DOI] [PubMed] [Google Scholar]
  25. Woods D. E., Straus D. C., Johanson W. G., Jr, Bass J. A. Role of salivary protease activity in adherence of gram-negative bacilli to mammalian buccal epithelial cells in vivo. J Clin Invest. 1981 Dec;68(6):1435–1440. doi: 10.1172/JCI110395. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Epidemiology and Infection are provided here courtesy of Cambridge University Press

RESOURCES