학술논문
Gram-negative bacterial colonizations before bilateral lung transplant. The impact of 'targeted' versus 'standard' surgical prophylaxis.
Document Type
Article
Author
Congedi, Sabrina; Peralta, Arianna; Muraro, Luisa; Biscaro, Martina; Pettenuzzo, Tommaso; Sella, Nicolò; Crociani, Silvia; Tagne, Arméla Anne-Sabine; Caregnato, Ida; Monteleone, Francesco; Rossi, Elisa; Roca, Gabriella; Manfrin, Silvia; Marinello, Serena; Mazzitelli, Maria; Dell'Amore, Andrea; Cattelan, Annamaria; Rea, Federico; Navalesi, Paolo; Boscolo, Annalisa
Source
Subject
*LUNG transplantation
*BACTERIAL colonies
*GRAM-negative bacteria
*PREVENTIVE medicine
*INTENSIVE care units
*
*
*
*
Language
ISSN
1471-2334
Abstract
Background: Infections 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. Methods: All 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). Results: One 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). Conclusions: The administration of a 'targeted' prophylaxis in LT pre-colonized recipients seemed not to prevent the occurrence of postoperative MDR GN infections. [ABSTRACT FROM AUTHOR]