<i>Mycobacterium abscessus</i> Complex Infections Among Lung Transplant Recipients: A Multicenter Retrospective Cohort Study in Canada
Bibliographic record
Abstract
BACKGROUND: Mycobacterium abscessus complex is known to cause life-threatening disease in lung transplantation (LT) recipients (LTRs). Therefore, many centers consider the presence of M. abscessus as a relative contraindication to LT. METHODS: We conducted a multicenter retrospective cohort study including all 4 LT centers in Canada. All LTRs transplanted in 2006-2016 with at least one respiratory sample positive for M. abscessus prior or posttransplantation were included. Pulmonary disease was defined using the American Thoracic Society criteria. Minimal follow-up duration was 5 years after transplantation. RESULTS: Among 2181 LTRs across Canada, 14 had M. abscessus disease after LT (incidence rate 1.1/1000 transplant-years) and 6 had pulmonary colonization (incidence rate 0.5/1000 transplant-years). Fifteen patients had M. abscessus cultured before LT. Among those with pretransplant M. abscessus, 53% (8/15) developed M. abscessus infection posttransplant (6 disease, 2 colonization). Posttransplant disease was less frequent among those with microbiologic eradication before transplant (0% vs. 85.7%, p = 0.001). LTRs with pretransplant M. abscessus had comparable survival to those without M. abscessus (log rank p = 0.37). Among patients with pretransplant infection, mortality was higher in those who did not achieve microbiological eradication before transplantation (57.1% vs. 0%, p = 0.03) and those who developed disease after transplantation (66.7% vs. 0%, p = 0.01). CONCLUSIONS: M. abscessus is an uncommon cause of infection among LTRs. Survival among those with pretransplant M. abscessus infection was similar to that observed in noninfected LTRs. However, lack of eradication before transplantation was associated with higher posttransplant disease and mortality.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.003 | 0.001 |
| Scholarly communication | 0.002 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".