Introduction: An association with Ureplasma urealyticum, Ureaplasma parvum and Mycoplasma hominis infections has been proposed to play a causative role in hyperammonemia syndrome (HS), a rare but often fatal condition observed in LTRs.

Methods: We describe four cases of HS among LTRs at our center between November 2012 and October 2016. We also report the results of a screening program implemented in June 2017 in which the first post-transplant bronchoscopy specimen is tested by PCR to detect the 16S rRNA gene of the Mycoplasmataceae family, followed by sequencing for speciation.

Results: The four cases from our center are summarized below.

BAL – Bronchoalveolar lavage. LOC – Level of consciousness. IPF – Idiopathic Pulmonary Fibrosis

Since initiation of our protocol we have tested 18 of 37 sequential LTRs. Seven patients had positive results: three M. salivarium, two M. pneumoniae, one U. parvum and one M. hominis and M. anseris co-infection. There have been no cases of HS during the surveillance period and one case of M. hominis infection with pleural space and wound infection.

Conclusion: Our HS cases suggest an association with Mycoplasma/Ureaplasma infection. Surveillance of donors and recipients early post-transplant may provide insight into the incidence and source of these infections and permit pre-emptive treatment that might prevent not only HS but also surgical site infections, pleuritis and mediastinitis that have been associated with M. hominis infection.

CITATION INFORMATION: Somerville L., Sligl W., Zelyas N., Lien D., Preiksaitis J. Surveillance for Mycoplasma/Ureaplasma Infection in Lung Transplant Recipients (LTRs) Am J Transplant. 2017;17 (suppl 3).

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