Incidence, risk factors and clinical outcome of multidrug-resistant organisms after heart transplantation.

Autor:	Hatzianastasiou S; Microbiology Department and Infection Control Office, Onassis Cardiac Surgery Center, Athens 17674, Greece., Vlachos P; Heart Transplantation Unit, Onassis Cardiac Surgery Center, Athens 17674, Greece., Stravopodis G; Microbiology Department and Infection Control Office, Onassis Cardiac Surgery Center, Athens 17674, Greece., Elaiopoulos D; Cardiac Surgery Intensive Care Unit, Onassis Cardiac Surgery Center, Athens 17674, Greece., Koukousli A; Microbiology Department and Infection Control Office, Onassis Cardiac Surgery Center, Athens 17674, Greece., Papaparaskevas J; Microbiology Department and Infection Control Office, Onassis Cardiac Surgery Center, Athens 17674, Greece., Chamogeorgakis T; Heart Transplantation Unit, Onassis Cardiac Surgery Center, Athens 17674, Greece., Papadopoulos K; Cardiac Surgery Intensive Care Unit, Onassis Cardiac Surgery Center, Athens 17674, Greece., Soulele T; Cardiac Surgery Intensive Care Unit, Onassis Cardiac Surgery Center, Athens 17674, Greece., Chilidou D; Heart Transplantation Unit, Onassis Cardiac Surgery Center, Athens 17674, Greece., Kolovou K; Cardiac Surgery Intensive Care Unit, Onassis Cardiac Surgery Center, Athens 17674, Greece., Gkouziouta A; Heart Transplantation Unit, Onassis Cardiac Surgery Center, Athens 17674, Greece., Bonios M; Heart Transplantation Unit, Onassis Cardiac Surgery Center, Athens 17674, Greece., Adamopoulos S; Heart Transplantation Unit, Onassis Cardiac Surgery Center, Athens 17674, Greece., Dimopoulos S; Cardiac Surgery Intensive Care Unit, Onassis Cardiac Surgery Center, Athens 17674, Greece. stdimop@gmail.com.
Jazyk:	angličtina
Zdroj:	World journal of transplantation [World J Transplant] 2024 Jun 18; Vol. 14 (2), pp. 93567.
DOI:	10.5500/wjt.v14.i2.93567
Abstrakt:	Background: Transplant recipients commonly harbor multidrug-resistant organisms (MDROs), as a result of frequent hospital admissions and increased exposure to antimicrobials and invasive procedures. Aim: To investigate the impact of patient demographic and clinical characteristics on MDRO acquisition, as well as the impact of MDRO acquisition on intensive care unit (ICU) and hospital length of stay, and on ICU mortality and 1-year mortality post heart transplantation. Methods: This retrospective cohort study analyzed 98 consecutive heart transplant patients over a ten-year period (2013-2022) in a single transplantation center. Data was collected regarding MDROs commonly encountered in critical care. Results: Among the 98 transplanted patients (70% male), about a third (32%) acquired or already harbored MDROs upon transplantation (MDRO group), while two thirds did not (MDRO-free group). The prevalent MDROs were Acinetobacter baumannii (14%), Pseudomonas aeruginosa (12%) and Klebsiella pneumoniae (11%). Compared to MDRO-free patients, the MDRO group was characterized by higher body mass index ( P = 0.002), higher rates of renal failure ( P = 0.017), primary graft dysfunction (10% vs 4.5%, P = 0.001), surgical re-exploration (34% vs 14%, P = 0.017), mechanical circulatory support (47% vs 26% P = 0.037) and renal replacement therapy (28% vs 9%, P = 0.014), as well as longer extracorporeal circulation time (median 210 vs 161 min, P = 0.003). The median length of stay was longer in the MDRO group, namely ICU stay was 16 vs 9 d in the MDRO-free group ( P = 0.001), and hospital stay was 38 vs 28 d ( P = 0.006), while 1-year mortality was higher (28% vs 7.6%, log-rank- χ 2 : 7.34). Conclusion: Following heart transplantation, a predominance of Gram-negative MDROs was noted. MDRO acquisition was associated with higher complication rates, prolonged ICU and total hospital stay, and higher post-transplantation mortality. Competing Interests: Conflict-of-interest statement: The authors have no financial relationships or other conflict of interest to disclose with regard to this study. (©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.)
Databáze:	MEDLINE
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