Gram-negative bacterial colonizations before bilateral lung transplant. The impact of 'targeted' versus 'standard' surgical prophylaxis

被引:1
作者
Congedi, Sabrina [1 ]
Peralta, Arianna [2 ]
Muraro, Luisa [2 ]
Biscaro, Martina [1 ]
Pettenuzzo, Tommaso [2 ]
Sella, Nicolo [2 ]
Crociani, Silvia [1 ]
Tagne, Armela Anne-Sabine [1 ]
Caregnato, Ida [1 ]
Monteleone, Francesco [1 ]
Rossi, Elisa [2 ]
Roca, Gabriella [2 ]
Manfrin, Silvia [1 ]
Marinello, Serena [2 ]
Mazzitelli, Maria [2 ]
Dell'Amore, Andrea [2 ]
Cattelan, Annamaria [2 ]
Rea, Federico [2 ]
Navalesi, Paolo [1 ,2 ]
Boscolo, Annalisa [1 ,2 ]
机构
[1] Univ Padua, Dept Med DIMED, Padua, Italy
[2] Azienda Osped Univ Padova, Padua, Italy
关键词
Surgical prophylaxis; Prophylaxis; Antimicrobial stewardship; Lung transplant; Bilateral lung transplant; Antibiotics; MULTIDRUG-RESISTANT BACTERIA; SOLID-ORGAN TRANSPLANTATION; RISK-FACTORS; INFECTIONS; MANAGEMENT; RECIPIENTS;
D O I
10.1186/s12879-024-09199-y
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
BackgroundInfections are one of the most common causes of death after lung transplant (LT). However, the benefit of 'targeted' prophylaxis in LT recipients pre-colonized by Gram-negative (GN) bacteria is still unclear.MethodsAll consecutive bilateral LT recipients admitted to the Intensive Care Unit of the University Hospital of Padua (February 2016-2023) were retrospectively screened. Only patients with pre-existing GN bacterial isolations were enrolled and analyzed according to the antimicrobial surgical prophylaxis ('standard' vs. 'targeted' on the preoperative bacterial isolation).ResultsOne hundred eighty-one LT recipients were screened, 46 enrolled. Twenty-two (48%) recipients were exposed to 'targeted' prophylaxis, while 24 (52%) to 'standard' prophylaxis. Overall prevalence of postoperative multi-drug resistant (MDR) GN bacteria isolation was 65%, with no differences between the two surgical prophylaxis (p = 0.364). Eleven (79%) patients treated with 'standard' prophylaxis and twelve (75%) with 'targeted' therapy reconfirmed the preoperative GN pathogen (p = 0.999). The prevalence of postoperative infections due to MDR GN bacteria was 50%. Of these recipients, 4 belonged to the 'standard' and 11 to the 'targeted' prophylaxis (p = 0.027).ConclusionsThe administration of a 'targeted' prophylaxis in LT pre-colonized recipients seemed not to prevent the occurrence of postoperative MDR GN infections.
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