Published in:
Open Access
01-12-2024 | Antibiotic | Research
Gram-negative bacterial colonizations before bilateral lung transplant. The impact of ‘targeted’ versus ‘standard’ surgical prophylaxis
Authors:
Sabrina Congedi, Arianna Peralta, Luisa Muraro, Martina Biscaro, Tommaso Pettenuzzo, Nicolò Sella, Silvia Crociani, Arméla Anne-Sabine Tagne, Ida Caregnato, Francesco Monteleone, Elisa Rossi, Gabriella Roca, Silvia Manfrin, Serena Marinello, Maria Mazzitelli, Andrea Dell’Amore, Annamaria Cattelan, Federico Rea, Paolo Navalesi, Annalisa Boscolo
Published in:
BMC Infectious Diseases
|
Issue 1/2024
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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.