Epidemiology and Outcomes of Deep Surgical Site Infections Following Lung Transplantation
| Autor: | Jay K. Bhama, Joseph M. Pilewski, Norihisa Shigemura, Rima Abdel-Massih, Cornelius J. Clancy, Lucio R. Minces, Maria Crespo, Ryan K. Shields, Eun J. Kwak, Fernanda P. Silveira, Y. Toyoda, Minh Hong Nguyen, Christian Bermudez |
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| Rok vydání: | 2013 |
| Předmět: |
Adult
Graft Rejection Lung Diseases Male medicine.medical_specialty Adolescent medicine.medical_treatment Mycobacterium abscessus Gram-Positive Bacteria Young Adult Pericarditis Postoperative Complications Risk Factors Gram-Negative Bacteria medicine Humans Surgical Wound Infection Immunology and Allergy Lung transplantation Pharmacology (medical) Gram-Positive Bacterial Infections Aged Retrospective Studies Aged 80 and over Transplantation biology business.industry Retrospective cohort study Perioperative Middle Aged Prognosis medicine.disease biology.organism_classification Mediastinitis United States Empyema Surgery Survival Rate Cardiothoracic surgery Female Gram-Negative Bacterial Infections business Follow-Up Studies Lung Transplantation |
| Zdroj: | American Journal of Transplantation. 13:2137-2145 |
| ISSN: | 1600-6135 |
| DOI: | 10.1111/ajt.12292 |
| Popis: | We conducted a retrospective study of deep surgical site infections (SSIs) among consecutive patients who underwent lung transplantation (LTx) at a single center from 2006 through 2010. Thirty-one patients (5%) developed SSIs at median 25 days after LTx. Empyema was most common (42%), followed by surgical wound infections (29%), mediastinitis (16%), sternal osteomyelitis (6%), and pericarditis (6%). Pathogens included Gram-positive bacteria (41%), Gram-negative bacteria (41%), fungi (10%) and Mycobacterium abscessus, Mycoplasma hominis and Lactobacillus sp. (one each). Twenty-three percent of SSIs were due to pathogens colonizing recipients' native lungs at time of LTx, suggesting surgical seeding as a source. Patient-related independent risk factors for SSIs were diabetes and prior cardiothoracic surgery; procedure-related independent risk factors were LTx from a female donor, prolonged ischemic time and number of perioperative red blood cell transfusions. Mediastinitis and sternal infections were not observed among patients undergoing minimally invasive LTx. SSIs were associated with 35% mortality at 1 year post-LTx. Lengths of stay and mortality in-hospital and at 6 months and 1 year were significantly greater for patients with SSIs other than empyema. In conclusion, deep SSIs were uncommon, but important complications in LTx recipients because of their diverse microbiology and association with increased mortality. |
| Databáze: | OpenAIRE |
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