Diagnostic bronchoscopy in solid-organ and hematopoietic stem cell transplantation

Annals of the American Thoracic Society

Volumn 10, Issue 1, 2013, Pages 39-49

  Harris, Bianca ^a   Lowy, Franklin David ^a   Stover, Diane Elizabeth ^b   Arcasoy, Selim Mehmet ^a,c  

^a Columbia University ^*  (United States)

^b MEMORIAL SLOAN KETTERING CANCER CENTER   (United States)

^c NewYork Presbyterian Hospital   (United States)

Author keywords

Bronchoscopy; Hematopoietic stem cell transplant; Opportunistic infection; Pulmonary complications; Solid organ transplant

Indexed keywords

ACUTE GRAFT REJECTION; ANTIBIOTIC RESISTANCE; ANTIMICROBIAL THERAPY; BLEEDING; BRONCHIOLITIS OBLITERANS; BRONCHIOLITIS OBLITERANS ORGANIZING PNEUMONIA; BRONCHITIS; BRONCHOSPASM; FIBEROPTIC BRONCHOSCOPY; GRAFT RECIPIENT; GRAFT REJECTION; HEMATOPOIETIC STEM CELL TRANSPLANTATION; HOST SUSCEPTIBILITY; HUMAN; HYPOXEMIA; IDIOPATHIC PNEUMONIA SYNDROME; LUNG ALVEOLUS PROTEINOSIS; LUNG BIOPSY; LUNG HEMORRHAGE; LUNG INFECTION; LUNG TRANSPLANTATION; ORGAN TRANSPLANTATION; ORGANIZING PNEUMONIA; OUTCOME ASSESSMENT; PNEUMONIA; PNEUMOTHORAX; PRIMARY GRAFT DYSFUNCTION; REVIEW; RISK ASSESSMENT;

BRONCHOSCOPY; EARLY DIAGNOSIS; HEMATOPOIETIC STEM CELL TRANSPLANTATION; HUMANS; IMMUNOCOMPROMISED HOST; LUNG DISEASES; OPPORTUNISTIC INFECTIONS; ORGAN TRANSPLANTATION; OUTCOME AND PROCESS ASSESSMENT (HEALTH CARE); PATIENT ACUITY; PATIENT SELECTION; POSTOPERATIVE COMPLICATIONS; RISK ASSESSMENT; TIME-TO-TREATMENT;

EID: 84878057914     PISSN: 23256621     EISSN: None     Source Type: Journal    
DOI: 10.1513/AnnalsATS.201212-114FR     Document Type: Review

References (104)

1. Kotloff RM, Ahya VN, Crawford SW. Pulmonary complications of solid organ and hematopoietic stem cell transplantation. Am J Respir Crit Care Med 2004;170:22-48.
2. Wahidi MM, Rocha AT, Hollingsworth JW, Govert JA, Feller-Kopman D, Ernst A. Contraindications and safety of transbronchial lung biopsy via flexible bronchoscopy: a survey of pulmonologists and review of the literature. Respiration 2005;72:285-295.
3. Duncan MD, Wilkes DS. Transplant-related immunosuppression. Proc Am Thorac Soc 2005;2:449-455.
4. Fishman JA. Infection in solid-organ transplant recipients. N Engl J Med 2007;357:2601-2614.
5. Speich R, van der Bij W. Epidemiology and management of infections after lung transplantation. Clin Infect Dis 2001;33:S58-S65.
6. Shah RM, Miller W Jr. Pulmonary complications of transplantation: radiographic considerations. Clin Chest Med 2005;26:545-560.
7. Shorr A, Susla GM, O'Grady NP. Pulmonary infiltrates in the non- HIV-infected immunocompromised patient. Chest 2004;125: 260-271.
8. Gasink LB, Blumberg EA. Bacterial and mycobacterial pneumonia in transplant recipients. Clin Chest Med 2005;26:647-659. (vii.).
9. Morris MR, Daly JS, Blumberg E, Kumar D, Sester M, Schluger N, Kim SH, Schwartz BS, Ison MG, Humar A, et al. Diagnosis and management of tuberculosis in transplant donors: a donor-derived infections consensus conference report. Am J Transplant 2012;12: 2288-2300.
10. Ruiz I, Gavalda J, Monforte V, Len O, Roman A, Bravo C, Ferrer A, Tenorio L, Roman F, Maestre J, et al. Donor-to-host transmission of bacterial and fungal infections in lung transplantation. Am J Transplant 2006;6:178-182.
11. Park BJ, Pappas PG, Wannemuehler KA, Alexander BD, Anaissie EJ, Andes DR, Baddley JW, Brown JM, Brumble LM, Freifeld AG, et al. Invasive non-Aspergillus mold infections in transplant recipients, United States, 2001-2006. Emerg Infect Dis 2011;17:1855-1864.
12. Kumar D, Erdman D, Keshavjee S, Peret T, Tellier R, Hadjiliadis D, Johnson G, Ayers M, Siegal D, Humar A. Clinical impact of community-acquired respiratory viruses on bronchiolitis obliterans after lung transplant. Am J Transplant 2005;15:2031-2036.
13. Christie JD, Edwards LB, Kucheryavaya AY, Benden C, Dipchand AI, Dobbels F, Kirk R, Rahmel AO, Stehlik J, Hertz MI, for the International Society of Heart and Lung Transplantation. The registry of the International Society for Heart and Lung Transplantation: 29th adult lung and heart-lung transplant report- 2012. J Heart Lung Transplant 2012;31:1073-1086.
14. Wahidi MM, Ernst A. The role of bronchoscopy in the management of lung transplant recipients. Respir Care Clin N Am 2004;10:549-562.
15. Sandrini A, Glanville AR. The controversial role of surveillance bronchoscopy after lung transplantation. Curr Opin Organ Transplant 2009;14:494-498.
16. Estenne M, Maurer JR, Boehlelr A, Egan JJ, Frost A, Hertz M, Mallory GB, Snell GI, Yousem S. Bronchiolitis obliterans syndome 2001: an update of the diagnostic criteria. J Heart Lung Transplant 2002;21: 297-310.
17. Santacruz JF, Mehta AC. Airway complications and management after lung transplantation. Proc Am Thorac Soc 2009;6:79-93.
18. Atasaver A, Bacakoglu F, Uysal FE, Nalbantgli S, Karyagdi T, Guzelant A, Sayiner A. Pulmonary complications in heart transplant recipients. Transplant Proc 2006;38:1530-1534.
19. Lenner R, Padilla ML, Teirstein AS, Gass A, Schilero GJ. Pulmonary complications in cardiac transplantation. Chest 2001;120:508-513.
20. Hong SK, Hwang S, Lee SG, Lee LS, Ahn CS, Kim KH, Moon DB, Ha TY. Pulmonary complications following adult liver transplantation. Transplant Proc 2006;38:2979-2981.
21. Singh N, Gayowski T, Wagener M, Marino IR. Pulmonary infiltrates in liver transplant recipients in the intensive care unit. Transplantation 1999;67:1138-1144.
22. Canet E, Osman D, Lambert J, Guitton C, Heng AE, Argaud L, Mourad G, Legendre C, Timsit JF, Rondeau E, et al. Acute respiratory failure in kidney transplant recipients: a multicenter study. Crit Care 2001; 15:R91.
23. Peters SG, Afessa B. Acute lung injury after hematopoietic stem cell transplantation. Clin Chest Med 2005;26:561-569. (vi.).
24. Afessa B, Abdulai RM, Kremers WK, Hogan WJ, Litzow MR, Peters SG. Risk factors and outcome of pulmonary complications after autologous hematopoietic stem cell transplant. Chest 2012;141:442-450.
25. Narreddy S, Mellon-Reppen S, Abidi MH, Klein JL, Peres E, Heilbrun LK, Smith D, Alangaden G, Chandrasekar PH. Non-bacterial infections in allogeneic non-myeloablative stem cell transplant recipients. Transpl Infect Dis 2007;1007:3-10.
26. Barton TD, Blumberg EA. Viral pneumonias other than cytomegalovirus in transplant recipients. Clin Chest Med 2005;26:707-720. (xi.).
27. Afessa B, Peters SG. Chronic lung disease after hematopoietic stem cell transplantation. Clin Chest Med 2005;26:571-586. (vi.).
28. British Thoracic Society Bronchoscopy Guidelines Committee. A Subcommittee of the Standards of Care Committee of the British Thoracic Society. Thorax 2001;56:i1-i21.
29. Hohenadel IA, Kiworr M, Genitsariotis R, Zeidler D, Lorenz J. Role of bronchoalveolar lavage in immunocompromised patients with pneumonia treated with a broad spectrum antibiotic and antifungal regimen. Thorax 2001;56:115-120.
30. Carr IM, Koefelenberg CF, von Groote-Bidlingmaier F, Mowlana A, Thijs Haverman KS, Diacon AH, Bollinger CT. Blood loss during flexible bronchoscopy: a prospective observational study. Respiration 2012;84:312-318.
31. Mehta A, Prakash UBS, Garland R, Haponik E, Moses L, Schaffner W, Silvestri G. American College of Chest Physicians and American Association for Bronchology consensus statement. Chest 2005; 128:1743-1755.
32. Starobin D, Fink G, Shitrit D, Izbicki G, Bendayan D, Bakal I, Kramer MR. The role of fiberoptic bronchoscopy evaluating transplant recipients with suspected pulmonary infections: analysis of 168 cases in a multi-organ transplantation center. Transplant Proc 2003; 35:659-660.
33. Lehto JT, Koskinene PK, Anttila VJ, Lautenschlager I, Lemstrom K, Sipponen J, Tukiainen P, Halme M. Bronchoscopy in the diagnosis and surveillance of respiratory infections in lung and heart-lung transplant recipients. Transpl Int 2005;18:562-571.
34. Shannon VR, Andersson BS, Lei X, Champlin RE, Kontoyianni DP. Utility of early versus late fiberoptic bronchoscopy in the evaluation of new pulmonary infiltrates following hematopoietic stem cell transplantation. Bone Marrow Transplant 2010;45:647-665.
35. Patel NR, Lee PS, Kim JH, Weinhouse GL, Koziel H. Comparing adult autologous and allogenic bone marrow transplant patients. Chest 2005;127:1388-1396.
36. Dunegan DP, Baker AM, Hurd DD, Haponik EF. Bronchoscopic evaluation of pulmonary infiltrates following bone marrow transplantation. Chest 1997;111:135-141.
37. Jain P, Sandur S, Meli Y, Arroliga AC, Stoller JK, Mehta AC. Role of flexible bronchoscopy in immunocompromised patients with lung infiltrates. Chest 2004;125:712-722.
38. Cazzadori A, DiPerri G, Todeschini G, Luzzati R, Boschiero L, Perona G, Concia E. Transbronchial biopsy in the diagnosis of pulmonary infiltrates in immunosuppressed patients. Chest 1995;197:101-106.
39. Yanik GA, Ho VT, Levine JE, White ES, Braun T, Antin JH, Whitfield J, Custer J, Jones D, Ferrara JLM, et al. The impact of soluble tumor necrosis factor receptor etanercept on the treatment of idiopathic pneumonia syndrome after allogenic hematopoietic stem cell transplantation. Blood 2008;112:3073-3081.
40. Smith L, Singer JP, Hayes M, Golden JA, Leard LE. An analysis of potential risk factors for early complications from fiberoptic bronchoscopy in lung transplant recipients. Transpl Int 2012;25: 172-178.
41. Feinstein M, Mokhtari M, Ferreiro R, Stover DE, Jakubowski A. Fiberoptic bronchoscopy in allogeneic bone marrow transplantation. Chest 2004;120:1094-1100.
42. Hofmeister CC, Czerlanis C, Forsythe S, Stuff PJ. Retrospective utility of bronchoscopy after hematopoietic stem cell transplant. Bone Marrow Transplant 2006;38:693-698.
43. McWilliams TJ, Williams TJ, Whitfor HM, Snell GI. Surveillance bronchoscopy in lung transplant recipients: risk versus benefit. J Heart Lung Transplant 2008;27:1203-1209.
44. Weiss SM, Gert RC, Gianola FJ, Clark JG, Crawford SW. Complications of fiberoptic bronchoscopy in thrombocytopenic patients. Chest 1993;104:1025-1028.
45. Chhajed PN, Aboyoun C, Malouf MA, Hopkins PM, Plit ML, Glanville AR. Risk factors and management of bleeding associated with transbronchial lung biopsy in lung transplant recipients. J Heart Lung Transplant 2003;22:195-197.
46. Chhajed PN, Aboyoun C, Malouf MA, Hopkins PM, Plit ML, Gruenstein RR, Glanville AR. Management of acute hypoxemia during flexible bronchoscopy with insertion of a nasopharyngeal tube in lung transplant recipients. Chest 2002;121:1350-1354.
47. Azoulay E, Mokart D, Rabbat A, Pene FP, Kouatchet A, Bruneel F, Vincent F, Hamidfar R, Moreaur D, Mohammedi I, et al. Diagnostic bronchoscopy in hematology and oncology patients with acute respiratory failure: prospective multi-center data. Crit Care Med 2008;1:100-107.
48. Kuehnhardt D, Hannemann M, Schmidt B, Heider U, Possinger K, Eucker J. Therapeutic implication of BAL in patients with neutropenia. Ann Hematol 2009;88:1249-1256.
49. Pereira Gomes JC, Pedreira WL Jr., Araujo EM, Soriano FG, Negri EM, Antonangelo L, Tadeu Velasco I. Impact of BAL in the management of pneumonia with treatment failure: positivity of BAL culture under antibiotic therapy. Chest 2000;118:1739-1746.
50. Da Silva RM, Teixeira PJZ, Moreira JDS. The clinical utility of induced sputum for the diagnosis of bacterial community acquired pneumonia in HIV-infected patients: a prospective cross-sectional study. Braz J Infect Dis 2006;10:89-93.
51. Baughman RP, Lower EE. Diagnosis of pneumonia in immunocompromised patient. In: Agusti C, Torres A, editors. Pulmonary infection in the immunocompromised patient: strategies for management. Chichester, United Kingdom: Wiley-Blackwell; 2009. pp. 53-93.
52. Bartlett JG. Diagnostic tests for agents of community-acquired pneumonia. Clin Infect Dis 2011;52:S296-S304.
53. Reinwald M, Hummel M, Kovalevskaya E, Spiess B, Heinz WJ, Vehreschild J, Schultheis B, Krause SW, Claus B, Suedhoff T, et al. Therapy with antifungals decreases the diagnostic performance of PCR for diagnosing invasive aspergillosis in bronchoalveolar lavage samples of patients with haematological malignancies. J Antimicrob Chemother 2012;67:2260-2267.
54. Chan CC, Abi-Saleh WJ, Arroliga AC, Stillwell PC, Kirby TJ, Gordon SM, Petras RE, Mehta AC. Diagnostic yield and therapeutic impact of flexible bronchoscopy in lung transplant recipients. J Heart Lung Transplant 1996;15:196-205.
55. Kupeli E, Akcay S, Ulubay G, Ozyurek BA, Ozdemirel TS, Haberal M. Diagnostic utility of flexible bronchoscopy in recipients of solid organ transplants. Transplant Proc 2011;43:543-546.
56. Chang GC, Wu CL, Pan SH, Yang TY, Chin CS, Yang YC, Chiang CD. The diagnosis of pneumonia in renal transplant recipients using invasive and noninvasive procedures. Chest 2004;125:541-547.
57. Torres A, Ewig S, Insausti J, Guergue JM, Xaubet A, Mas A, Salmeron JM. Etiology and microbial patterns of pulmonary infiltrates in patients with orthotopic liver transplantation. Chest 2000;117: 494-502.
58. Lehto JT, Veli-Jukka A, Lommi J, Nieminen MS, Harjula A, Taskinen E, Tukiainen P, Halme M. Clinical usefulness of bronchoalveolar lavage in heart transplant recipients with suspected lower respiratory tract infection. J Heart Lung Transplant 2004;23: 570-576.
59. Hoyo I, Linares L, Cervera C, Almela M, Marcos MA, Sanclemente G, Cofam F, Ricart MJ, Moreno A. Epidemiology of pneumonia in kidney transplantation. Transplant Proc 2010;42:2938-2940.
60. Gruson D, Hilbert G, Valentino R, Vargas F, Chene G, Bebear C, Allery A, Pigneux A, Gbikpi-Benissan G. Utility of fiberoptic bronchoscopy in neutropenic patients admitted to the intensive care unit with pulmonary infiltrates. Crit Care Med 2000;28:2224-2230.
61. Rano A, Agusti C, Jiminez P, Angrill J, Benito N, Danes C, Gonzalez J, Rovira M, Pumarola T, Moreno A, et al. Pulmonary infiltrates in non- HIV immunocompromised patients: a diagnostic approach using non-invasive and bronchoscopic procedures. Thorax 2001;56: 379-387.
62. Meduri GU, Stover DE, Greeno RA, Nash T, Zaman MB. Bilateral bronchoalveolar lavage in the diagnosis of opportunistic pulmonary infections. Chest 1991;100:1272-1276.
63. Kasow KA, King E, Rochester R, Tong X, Srivastava DK, Horwaitz EM, Leung W, Woodard P, Handgretinger R, Hale GA. Diagnostic yield of bronchoalveolar lavage is low in allogeneic hematopoietic stem cell recipients receiving immunosuppressive therapy or with acute-graft-versus-host disease: the St. Jude experience. Biol Blood Marrow Transplant 2007;13:831-837.
64. Aboyoun CL, Tamm M, Chhajed PN, Hopkins P, Malouf MA, Rainer S, Glanville AR. Diagnostic value of follow-up transbronchial lung biopsy after lung rejection. Am J Respir Crit Care Med 2001;164: 460-463.
65. Burger CD. Utility of positive bronchoalveolar lavage in predicting respiratory failure after hematopoietic stem cell transplantation: a retrospective analysis. Transplant Proc 2007;39:1623-1625.
66. Sternberg RI, Baughman RP, DohnMN, FirstMR. Utility of bronchoalveolar lavage in assessing pneumonia in immunosuppressed liver transplant recipients. Am J Med 1993;95:358-364.
67. Slatter MA, Rogerson EJ, Taylor CE, Galloway A, Clark JE, Flood TJ, Abinun M, Cant AJ, Gennery AR. Value of bronchoalveolar lavage before hematopoietic stem cell transplantation for primary immunodeficiency or autoimmune diseases. Bone Marrow Transplant 2007;40:529-533.
68. Winters HA, Parbhoo RK, Schafer JJ, Goff DA. Extended-spectrum beta-lactamase-producing bacterial infections in adult solid organ transplant recipients. Ann Pharmacother 2001;45: 309-316.
69. Hamandi B, Holbrook AM, Humar A, Brunton J, Papadimitropoulos EA, Wong GG, Thabane L. Delay of adequate empiric antibiotic therapy is associated with increased mortality among solid-organ transplant patients. Am J Transplant 2009;9:1657-1665.
70. White P, Bonacum JT, Miller CB. Utility of fiberoptic bronchoscopy in bone marrow transplant patients. Bone Marrow Transplant 1997;20: 681-687.
71. Neuberger S, Maschmeyer G. Update on management of infections in cancer and stem cell transplant patients. Ann Hematol 2006;85: 346-356.
72. Magi B, Bargagli E, Bini L, Pottoli P. Proteome analysis of bronchoalveolar lavage in lung diseases. Proteomics 2006;6:6345-6369.
73. Boersma WG, Erjavec Z, ven der Werf TS, de Vries-Hosper HG, Gouw ASH, Manson WL. Bronchoscopic diagnosis of pulmonary infiltrates in granulocytopenic patients with hematologic malignancies: BAL versus PSB and PBAL. Respir Med 2001;101: 317-325.
74. Hsu JL, Kuschner WG, Paik J, Bower N, Vazquez Guillamet MC, Kothary N. The diagnostic yield of CT-guided percutaneous lung biopsy in solid organ transplant recipients. Clin Transplant 2012;26: 615-621.
75. Burdett CL, Critchley RJ, Black F, Barnard S, Clark SC, Corris PA, Gould KF, Butt T, Dark JH. Invasive biopsy is effective and useful after lung transplant. J Heart Lung Transplant 2010;29:759-763.
76. Endimiani A, Hujer KM, Hujer AM, Kurz S, Jacobs MR, Perlin DS, Bonomo RA. Are we ready for novel detection methods to treat respiratory pathogens in hospital-acquired pneumonia? Clin Infect Dis 2011;52:S373-S383.
77. Loens K, Beck T, Ursi D, Overdijk M, Sillekens P, Goossens H, Ieven M. Development of real-time multiplex nucleic acid sequencebased amplification for detection of Mycoplasma pneumonia, Chlamydophila pneumonia and Legionella spp in respiratory specimens. J Clin Microbiol 2008;46:185-191.
78. Wanner TJ, Gerhardt SG, Diette GB, Rosenthal DL, Orens JB. The utility of cytopathology testing in lung transplant recipients. J Heart Lung Transplant 2005;24:870-874.
79. Knox KS, Meinke L. Role of bronchoalveolar lavage diagnostics in fungal infection. Clin Chest Med 2009;30:355-365.
80. Stolz D, Stulz A, Muller B, Gratwohl A, Tamm M. BAL neutrophils, serum procalcitonin and C reactive protein to predict bacterial infection in the immunocompromised host. Chest 2007;132: 504-514.
81. Ieven M. Microbiologic diagnosis of respiratory infections in the immunocompromised. In: Agusti C, Torres A, editors. Pulmonary infection in the immunocompromised patient: strategies for management. Chichester, United Kingdom: Wiley-Blackwell; 2009. pp. 29-45.
82. D'Haese J, Theunissen K, Vereulen E, Schoemans H, De Vlieger GD, Lammertijn L, Meersseman P, Meersseman W, Lagrou K, Maertens J. Detection of galactomannan in bronchoalveolar lavage fluid samples of patients at risk for invasive pulmonary aspergillosis: analytical and clinical validity. J Clin Microbiol 2012;50:1258-1263.
83. Pasqualotto AC, Xavier MO, Sanchez LB, de Oliveira Costa CDA, Schio AM, Camargo SM, Camargo JJ, Sukiennik TCT, Severo LC. Diagnosis of invasive aspergillosis in lung transplant recipients by detection of galactomannan in the bronchoalveolar lavage fluid. Transplantation 2010;90:306-311.
84. Theel ES, Jespersen DJ, Iqbal S, Bestrom JE, Rollins LO, Misner LJ, Markley BJ, Mandrekar J, Baddour LM, Limper AH, et al. Detection of (1,3) b-D glucan in bronchoalveolar lavage and serum samples collected from immunocompromised hosts. Mycopathologia 2012; 50:1258-1263.
85. Schlischewsky E, Fuehner T, Warnecke G, Welte T, Haverich A, Ganzenmueller T, Heim A, Gottleib J. Clinical significance of quantitative cytomegalovirus detection in bronchoalveolar lavage fluid in lung transplant recipients. Transpl Infect Dis 2012;1:1-10.
86. Campos S, Caramori M, Teixeira R, Afonso J Jr, Carraro R, Strabelli T, Samana M, Pego-Fernandes P, Jatene F. Bacterial and fungal pneumonias after lung transplantation. Transplant Proc 2008;40: 822-824.
87. Rasmussen TR, Korsgarrd J, Moller JK, Sommer T, Kilian M. Quantitative culture of bronchoalveolar fluid in community acquired lower respiratory tract infections. Respir Med 2001;95:885-890.
88. Sethi S, Maloney J, Grove L, Wrona C, Berenson CS. Airway inflammation and bronchial bacterial colonization in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2006; 173:991-998.
89. Meyer KC, Raghu G, Baughman RP, Brown KK, Costabel U, du Bois RM, Drent M, Haslam PL, Kim DS, Nagai S, et al; American Thoracic Society Committee on BAL in Interstitial Lung Disease. An official American Thoracic Society Clinical Practice Guideline: The clinical utility of bronchoalveolar lavage cellular analysis in interstitial lung disease. Am J Respir Crit Care Med 2012;185:1004-1014.
90. Kiley JP. Advances in respiratory research. Chest 2011;140:497-501.
91. Lee JC, Christie JD. Primary graft dysfunction. Clin Chest Med 2001; 32:279-293.
92. Nelsestuen GL, Martinez MB, Hertz M, Savik K, Wendt CH. Proteomic identification of human neutrophil alpha-defensins in chronic lung allograft rejection. Proteomics 2005;5:1705-1713.
93. Fontana JM, Alexander E, Salvatore M. Translational research in infectious disease: current paradigms and challenges ahead. Transl Res 2012;159:430-453.
94. Minero MV, Marin M, Cercenado E, Rabadan PM, Bouza E, Munoz P. Nocardiosis at the turn of the century. Medicine 2009;88:250-261.
95. Nichols WG, Prentice J, Houze Y, Carlson L, Cookson BT. Fatal pulmonary infection associated with a novel organism, "Parastreptomyces abscessus." J Clin Microbiol 2005;43: 5376-5379.
96. Relman DA. Microbial genomics and infectious diseases. N Engl J Med 2011;365:347-355.
97. Beck JM, Young VB, Huffnagle GB. The microbiome of the lung. Transl Res 2012;160:258-266.
98. Charlson ES, Diamond JM, Bittinger K, Fitzgerald AS, Yadav A, Haas AR, Bushman FD, Collman RG. Lung-enriched organisms and aberrant bacterial and fungal respiratory microbiota following lung transplant. Am J Respir Crit Care Med 2012;186:536-545.
99. Borewicz K, Pragman AA, Kim HB, Hertz M, Wendt C, Isaacson RE. Longitudinal analysis of the lung microbiome in lung transplantation. FEMS Microbiol Lett 2013;339:57-65.
100. Soubani AO. Respiratory infections following hematopoietic stem cell transplantation. In: Agusti C, Torres A, editors. Pulmonary infection in the immunocompromised patient: strategies for management. West Sussex, UK: Wiley-Blackwell; 2009. pp. 213-256.
101. Afessa B, Peters SG. Chronic non-infectious pulmonary complications in hematopoietic stem cell transplantation. In: Agusti C, Torres A, editors. Pulmonary infection in the immunocompromised patient: strategies for management. West Sussex, UK: Wiley-Blackwell; 2009. xcdsfxcvzpp. 257-284.
102. Loens K, Van Heirstraeten L, Malhotra-Kumar S, Goossens H, Ieven M. Optimal sampling sites and methods for detection of pathogens possibly causing community-acquired lower respiratory tract infections. J Clin Microbiol 2009;47:21-31.
103. Carroll KC. Laboratory diagnosis of lower respiratory tract infections: controversy and conundrums. J Clin Microbiol 2002;40:3115-3120.
104. Baselski V, Wunderink RG. Bronchoscopic diagnosis of pneumonia. Clin Microbiol Rev 1994;7:533-558.