Gram-negative bacterial colonizations before bilateral lung transplant. The impact of ‘targeted’ versus ‘standard’ surgical prophylaxis
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 Intensi...
| Main Authors: | , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2024-03-01
|
| Series: | BMC Infectious Diseases |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12879-024-09199-y |
| _version_ | 1827316194620735488 |
|---|---|
| author | 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 |
| author_facet | 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 |
| author_sort | Sabrina Congedi |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-04-24T23:10:39Z |
| format | Article |
| id | doaj.art-9acc84be5d9d44d7bebdd06385cd7d14 |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-04-24T23:10:39Z |
| publishDate | 2024-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-9acc84be5d9d44d7bebdd06385cd7d142024-03-17T12:16:48ZengBMCBMC Infectious Diseases1471-23342024-03-012411810.1186/s12879-024-09199-yGram-negative bacterial colonizations before bilateral lung transplant. The impact of ‘targeted’ versus ‘standard’ surgical prophylaxisSabrina Congedi0Arianna Peralta1Luisa Muraro2Martina Biscaro3Tommaso Pettenuzzo4Nicolò Sella5Silvia Crociani6Arméla Anne-Sabine Tagne7Ida Caregnato8Francesco Monteleone9Elisa Rossi10Gabriella Roca11Silvia Manfrin12Serena Marinello13Maria Mazzitelli14Andrea Dell’Amore15Annamaria Cattelan16Federico Rea17Paolo Navalesi18Annalisa Boscolo19Department of Medicine (DIMED), University of PaduaAzienda Ospedale - Univerisità PadovaAzienda Ospedale - Univerisità PadovaDepartment of Medicine (DIMED), University of PaduaAzienda Ospedale - Univerisità PadovaAzienda Ospedale - Univerisità PadovaDepartment of Medicine (DIMED), University of PaduaDepartment of Medicine (DIMED), University of PaduaDepartment of Medicine (DIMED), University of PaduaDepartment of Medicine (DIMED), University of PaduaAzienda Ospedale - Univerisità PadovaAzienda Ospedale - Univerisità PadovaDepartment of Medicine (DIMED), University of PaduaAzienda Ospedale - Univerisità PadovaAzienda Ospedale - Univerisità PadovaAzienda Ospedale - Univerisità PadovaAzienda Ospedale - Univerisità PadovaAzienda Ospedale - Univerisità PadovaDepartment of Medicine (DIMED), University of PaduaDepartment of Medicine (DIMED), University of PaduaAbstract 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.https://doi.org/10.1186/s12879-024-09199-ySurgical prophylaxisProphylaxisAntimicrobial stewardshipLung transplantBilateral lung transplantAntibiotics |
| spellingShingle | 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 Gram-negative bacterial colonizations before bilateral lung transplant. The impact of ‘targeted’ versus ‘standard’ surgical prophylaxis BMC Infectious Diseases Surgical prophylaxis Prophylaxis Antimicrobial stewardship Lung transplant Bilateral lung transplant Antibiotics |
| title | Gram-negative bacterial colonizations before bilateral lung transplant. The impact of ‘targeted’ versus ‘standard’ surgical prophylaxis |
| title_full | Gram-negative bacterial colonizations before bilateral lung transplant. The impact of ‘targeted’ versus ‘standard’ surgical prophylaxis |
| title_fullStr | Gram-negative bacterial colonizations before bilateral lung transplant. The impact of ‘targeted’ versus ‘standard’ surgical prophylaxis |
| title_full_unstemmed | Gram-negative bacterial colonizations before bilateral lung transplant. The impact of ‘targeted’ versus ‘standard’ surgical prophylaxis |
| title_short | Gram-negative bacterial colonizations before bilateral lung transplant. The impact of ‘targeted’ versus ‘standard’ surgical prophylaxis |
| title_sort | gram negative bacterial colonizations before bilateral lung transplant the impact of targeted versus standard surgical prophylaxis |
| topic | Surgical prophylaxis Prophylaxis Antimicrobial stewardship Lung transplant Bilateral lung transplant Antibiotics |
| url | https://doi.org/10.1186/s12879-024-09199-y |
| work_keys_str_mv | AT sabrinacongedi gramnegativebacterialcolonizationsbeforebilaterallungtransplanttheimpactoftargetedversusstandardsurgicalprophylaxis AT ariannaperalta gramnegativebacterialcolonizationsbeforebilaterallungtransplanttheimpactoftargetedversusstandardsurgicalprophylaxis AT luisamuraro gramnegativebacterialcolonizationsbeforebilaterallungtransplanttheimpactoftargetedversusstandardsurgicalprophylaxis AT martinabiscaro gramnegativebacterialcolonizationsbeforebilaterallungtransplanttheimpactoftargetedversusstandardsurgicalprophylaxis AT tommasopettenuzzo gramnegativebacterialcolonizationsbeforebilaterallungtransplanttheimpactoftargetedversusstandardsurgicalprophylaxis AT nicolosella gramnegativebacterialcolonizationsbeforebilaterallungtransplanttheimpactoftargetedversusstandardsurgicalprophylaxis AT silviacrociani gramnegativebacterialcolonizationsbeforebilaterallungtransplanttheimpactoftargetedversusstandardsurgicalprophylaxis AT armelaannesabinetagne gramnegativebacterialcolonizationsbeforebilaterallungtransplanttheimpactoftargetedversusstandardsurgicalprophylaxis AT idacaregnato gramnegativebacterialcolonizationsbeforebilaterallungtransplanttheimpactoftargetedversusstandardsurgicalprophylaxis AT francescomonteleone gramnegativebacterialcolonizationsbeforebilaterallungtransplanttheimpactoftargetedversusstandardsurgicalprophylaxis AT elisarossi gramnegativebacterialcolonizationsbeforebilaterallungtransplanttheimpactoftargetedversusstandardsurgicalprophylaxis AT gabriellaroca gramnegativebacterialcolonizationsbeforebilaterallungtransplanttheimpactoftargetedversusstandardsurgicalprophylaxis AT silviamanfrin gramnegativebacterialcolonizationsbeforebilaterallungtransplanttheimpactoftargetedversusstandardsurgicalprophylaxis AT serenamarinello gramnegativebacterialcolonizationsbeforebilaterallungtransplanttheimpactoftargetedversusstandardsurgicalprophylaxis AT mariamazzitelli gramnegativebacterialcolonizationsbeforebilaterallungtransplanttheimpactoftargetedversusstandardsurgicalprophylaxis AT andreadellamore gramnegativebacterialcolonizationsbeforebilaterallungtransplanttheimpactoftargetedversusstandardsurgicalprophylaxis AT annamariacattelan gramnegativebacterialcolonizationsbeforebilaterallungtransplanttheimpactoftargetedversusstandardsurgicalprophylaxis AT federicorea gramnegativebacterialcolonizationsbeforebilaterallungtransplanttheimpactoftargetedversusstandardsurgicalprophylaxis AT paolonavalesi gramnegativebacterialcolonizationsbeforebilaterallungtransplanttheimpactoftargetedversusstandardsurgicalprophylaxis AT annalisaboscolo gramnegativebacterialcolonizationsbeforebilaterallungtransplanttheimpactoftargetedversusstandardsurgicalprophylaxis |