Mycoplasma hominis and Ureaplasma species are urogenital mollicutes that can cause serious donor-derived infections in lung transplant recipients. Best practices for mollicute screening remain unknown. We conducted a single-center prospective study analyzing lung transplants performed from October 5, 2020, to September 25, 2021, whereby donor and recipient bronchoalveolar lavage (BAL) samples obtained at time of transplant underwent mollicute screening via culture and polymerase chain reaction (PCR). Of 115 total lung transplants performed, 99 (86%) donors underwent combined mollicute BAL culture and PCR testing. The study cohort included these 99 donors and their matched recipients. In total, 18 (18%) of 99 donors screened positive via culture or PCR. Among recipients, 92 (93%) of 99 had perioperative BAL screening performed, and only 3 (3%) had positive results. After transplant, 9 (9%) recipients developed mollicute infection. Sensitivity of donor screening in predicting recipient mollicute infection was 67% (6/9) via culture and 56% (5/9) via PCR. Positive predictive value for donor culture was 75% (6/8), compared with 33% (5/15) for PCR. Donor screening via culture predicted all serious recipient mollicute infections and had better positive predictive value than PCR; however, neither screening test predicted all mollicute infections. Independent of screening results, clinicians should remain suspicious for posttransplant mollicute infection.

中文翻译：

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肺移植受者供体来源的支原体和解脲支原体感染：供体和受者呼吸道筛查和受者结局的前瞻性研究


人支原体和解脲支原体是泌尿生殖系统软胆菌门，可导致肺移植受者发生严重的供体来源感染。mollicut 筛查的最佳实践仍然未知。我们进行了一项单中心前瞻性研究，分析了 2020 年 10 月 5 日至 2021 年 9 月 25 日进行的肺移植，其中移植时获得的供体和受体支气管肺泡灌洗液 （BAL） 样本通过培养和聚合酶链反应 （PCR） 进行了软体细胞筛选。在总共进行的 115 例肺移植中，99 例 （86%） 供体接受了联合软体动物 BAL 培养和 PCR 检测。研究队列包括这 99 名捐献者及其匹配的接受者。总共 18 名供体中有 18 名 （99%） 通过培养或 PCR 筛查呈阳性。在受者中，99 例中有 92 例 （93%） 进行了围手术期 BAL 筛查，只有 3 例 （3%） 结果呈阳性。移植后，9 例 （9%） 受者发生软体动物感染。供体筛查预测受体软体动物感染的敏感性为67% （6/9），PCR 56% （5/9）。供体培养的阳性预测值为 75% （6/8），而 PCR 为 33% （5/15）。通过培养进行供体筛查可预测所有严重的受者软体动物感染，并且比 PCR 具有更好的阳性预测值;然而，两种筛查测试均未预测所有 mollicute 感染。无论筛查结果如何，临床医生都应保持对移植后软体动物感染的怀疑。