Donor-derived bacterial infections in lung transplant recipients in the era of multidrug resistance.

Autor: Bunsow E; Vall d'Hebron Institut of Research (VHIR), Barcelona, Spain., Los-Arcos I; Infectious Diseases Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Departament of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Spanish Network for Research in Infectious Diseases (REIPI), Instituto de Salud Carlos III, Madrid, Spain. Electronic address: ilosarco@vhebron.net., Martin-Gómez MT; Microbiology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain., Bello I; Thoracic Surgery Deparment, Hospital Universitari Vall d'Hebron, Barcelona, Spain., Pont T; Transplant Coordination Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain., Berastegui C; Lung Transplant Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain., Ferrer R; Critical Care Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain., Nuvials X; Critical Care Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain., Deu M; Thoracic Surgery Deparment, Hospital Universitari Vall d'Hebron, Barcelona, Spain., Peghin M; Infectious Diseases Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Spanish Network for Research in Infectious Diseases (REIPI), Instituto de Salud Carlos III, Madrid, Spain., González-López JJ; Spanish Network for Research in Infectious Diseases (REIPI), Instituto de Salud Carlos III, Madrid, Spain; Microbiology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain., Lung M; Spanish Network for Research in Infectious Diseases (REIPI), Instituto de Salud Carlos III, Madrid, Spain; Microbiology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain., Román A; Lung Transplant Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain., Gavaldà J; Infectious Diseases Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Departament of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Spanish Network for Research in Infectious Diseases (REIPI), Instituto de Salud Carlos III, Madrid, Spain., Len O; Infectious Diseases Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Departament of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Spanish Network for Research in Infectious Diseases (REIPI), Instituto de Salud Carlos III, Madrid, Spain.
Jazyk: angličtina
Zdroj: The Journal of infection [J Infect] 2020 Feb; Vol. 80 (2), pp. 190-196. Date of Electronic Publication: 2019 Dec 13.
DOI: 10.1016/j.jinf.2019.12.006
Abstrakt: Objectives: Our aim was to analyze the prevalence of multidrug-resistant bacterial infections in lung transplant donors and to evaluate its influence on donor-derived bacterial infections.
Methods: We conducted a retrospective study of adult patients who underwent lung transplantation (2013-2016) at our hospital. Donor-derived bacterial infection was defined as the isolation of the same bacteria with identical antibiotic susceptibility patterns in the recipient and the perioperative cultures from the donor during the first month posttransplantation. We utilized a preventive antibiotic strategy adapted to the bacteria identified in donor cultures using systemic and nebulized antibiotics.
Results: 252 lung transplant recipients and 243 donors were included. In 138/243 (56.8%) donors, one bacterial species was isolated from at least one sample; graft colonization (118/243; 48.6%), blood cultures (5/243; 2.1%) and the contamination of preservation fluids (56/243; 23%). Multidrug-resistant bacteria were isolated from 12/243 (4.9%) donors; four Enterobacterales, four Stenotrophomonas maltophilia, three Pseudomonas aeruginosa and one methicillin-resistant Staphylococcus aureus. There was no transmission of these multidrug-resistant bacteria. Donor-derived infections, primarily tracheobronchitis due to non-MDR bacteria, were diagnosed in 7/253 (2.9%) recipients, with good clinical outcomes.
Conclusions: The lungs of donors colonized with multidrug-resistant bacteria may be safely used when recipients receive prompt tailored antibiotic treatment.
Competing Interests: Declaration of Competing Interest The authors declare no conflict of interest.
(Copyright © 2019. Published by Elsevier Ltd.)
Databáze: MEDLINE
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