Risk Factors and Outcome of Multidrug-Resistant Infections after Heart Transplant: A Contemporary Single Center Experience
(1) Background: The aim of this study was to assess risk factors for multidrug-resistant/extensively drug-resistant (MDR/XDR) bacterial infections in heart transplant (HT) patients within three months after surgery and its impact on patient outcome. (2) Methods: Retrospective analysis of clinical, h...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-06-01
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| Series: | Microorganisms |
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| Online Access: | https://www.mdpi.com/2076-2607/9/6/1210 |
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| author | Arta Karruli Jacopo de Cristofaro Roberto Andini Domenico Iossa Mariano Bernardo Cristiano Amarelli Irene Mattucci Rosa Zampino Raffaele Zarrilli Emanuele Durante-Mangoni |
| author_facet | Arta Karruli Jacopo de Cristofaro Roberto Andini Domenico Iossa Mariano Bernardo Cristiano Amarelli Irene Mattucci Rosa Zampino Raffaele Zarrilli Emanuele Durante-Mangoni |
| author_sort | Arta Karruli |
| collection | DOAJ |
| description | (1) Background: The aim of this study was to assess risk factors for multidrug-resistant/extensively drug-resistant (MDR/XDR) bacterial infections in heart transplant (HT) patients within three months after surgery and its impact on patient outcome. (2) Methods: Retrospective analysis of clinical, hemato-chemical, imaging, treatment and outcome data from 47 heart transplant recipients from January 2016 to December 2018. MDR/XDR infections were compared to non-MDR/XDR and noninfected patients. (3) Results: Most participants were males, median age 51 years: 35 (74.5%) developed an infection after HT; 14 (29.8%) were MDR/XDR infections. Prolonged hospital stay before HT correlated to MDR/XDR infection (<i>p</i> < 0.001). Sequential organ failure assessment (SOFA) score at sampling day was higher in MDR/XDR (<i>p</i> = 0.027). MDR/XDR were mostly blood-stream (BSI) (<i>p</i> = 0.043) and skin-soft tissue (SSTI) (<i>p</i> = 0.047) infections. Gram-negative infections were the most frequent, specifically carbapenem-resistant <i>Klebsiella pneumoniae</i>. Antibiotic therapy duration for MDR/XDR infections was longer (<i>p</i> = 0.057), eradication rate lower (<i>p</i> = 0.083) and hospital stay longer (<i>p</i> = 0.005) but not associated with a worse outcome. (4) Conclusions: MDR/XDR infections affect compromised HT recipients with a history of prolonged hospitalization, causing a lower rate of eradication and increased hospital stay. These frequently present as BSI and SSTI. We emphasize the need to prevent contamination of central venous catheters and the surgical site. |
| first_indexed | 2024-03-10T10:45:08Z |
| format | Article |
| id | doaj.art-a78c6a7884f343f48e1618d6058d699d |
| institution | Directory Open Access Journal |
| issn | 2076-2607 |
| language | English |
| last_indexed | 2024-03-10T10:45:08Z |
| publishDate | 2021-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Microorganisms |
| spelling | doaj.art-a78c6a7884f343f48e1618d6058d699d2023-11-21T22:41:28ZengMDPI AGMicroorganisms2076-26072021-06-0196121010.3390/microorganisms9061210Risk Factors and Outcome of Multidrug-Resistant Infections after Heart Transplant: A Contemporary Single Center ExperienceArta Karruli0Jacopo de Cristofaro1Roberto Andini2Domenico Iossa3Mariano Bernardo4Cristiano Amarelli5Irene Mattucci6Rosa Zampino7Raffaele Zarrilli8Emanuele Durante-Mangoni9Department of Precision Medicine, University of Campania ‘L. Vanvitelli’, 80138 Naples, ItalyDepartment of Precision Medicine, University of Campania ‘L. Vanvitelli’, 80138 Naples, ItalyUnit of Infectious and Transplant Medicine, AORN Ospedali dei Colli-Monaldi Hospital, 80131 Naples, ItalyDepartment of Precision Medicine, University of Campania ‘L. Vanvitelli’, 80138 Naples, ItalyUnit of Microbiology & Virology, AORN Ospedali dei Colli, 80131 Naples, ItalyUnit of Cardiac Transplant, AORN Ospedali dei Colli-Monaldi Hospital, 80131 Naples, ItalyUnit of Cardiac Transplant, AORN Ospedali dei Colli-Monaldi Hospital, 80131 Naples, ItalyUnit of Infectious and Transplant Medicine, AORN Ospedali dei Colli-Monaldi Hospital, 80131 Naples, ItalyDepartment of Public Health, University of Naples Federico II, 80138 Naples, ItalyDepartment of Precision Medicine, University of Campania ‘L. Vanvitelli’, 80138 Naples, Italy(1) Background: The aim of this study was to assess risk factors for multidrug-resistant/extensively drug-resistant (MDR/XDR) bacterial infections in heart transplant (HT) patients within three months after surgery and its impact on patient outcome. (2) Methods: Retrospective analysis of clinical, hemato-chemical, imaging, treatment and outcome data from 47 heart transplant recipients from January 2016 to December 2018. MDR/XDR infections were compared to non-MDR/XDR and noninfected patients. (3) Results: Most participants were males, median age 51 years: 35 (74.5%) developed an infection after HT; 14 (29.8%) were MDR/XDR infections. Prolonged hospital stay before HT correlated to MDR/XDR infection (<i>p</i> < 0.001). Sequential organ failure assessment (SOFA) score at sampling day was higher in MDR/XDR (<i>p</i> = 0.027). MDR/XDR were mostly blood-stream (BSI) (<i>p</i> = 0.043) and skin-soft tissue (SSTI) (<i>p</i> = 0.047) infections. Gram-negative infections were the most frequent, specifically carbapenem-resistant <i>Klebsiella pneumoniae</i>. Antibiotic therapy duration for MDR/XDR infections was longer (<i>p</i> = 0.057), eradication rate lower (<i>p</i> = 0.083) and hospital stay longer (<i>p</i> = 0.005) but not associated with a worse outcome. (4) Conclusions: MDR/XDR infections affect compromised HT recipients with a history of prolonged hospitalization, causing a lower rate of eradication and increased hospital stay. These frequently present as BSI and SSTI. We emphasize the need to prevent contamination of central venous catheters and the surgical site.https://www.mdpi.com/2076-2607/9/6/1210MDRXDRinfectionheart transplantrisk factorshospitalization |
| spellingShingle | Arta Karruli Jacopo de Cristofaro Roberto Andini Domenico Iossa Mariano Bernardo Cristiano Amarelli Irene Mattucci Rosa Zampino Raffaele Zarrilli Emanuele Durante-Mangoni Risk Factors and Outcome of Multidrug-Resistant Infections after Heart Transplant: A Contemporary Single Center Experience Microorganisms MDR XDR infection heart transplant risk factors hospitalization |
| title | Risk Factors and Outcome of Multidrug-Resistant Infections after Heart Transplant: A Contemporary Single Center Experience |
| title_full | Risk Factors and Outcome of Multidrug-Resistant Infections after Heart Transplant: A Contemporary Single Center Experience |
| title_fullStr | Risk Factors and Outcome of Multidrug-Resistant Infections after Heart Transplant: A Contemporary Single Center Experience |
| title_full_unstemmed | Risk Factors and Outcome of Multidrug-Resistant Infections after Heart Transplant: A Contemporary Single Center Experience |
| title_short | Risk Factors and Outcome of Multidrug-Resistant Infections after Heart Transplant: A Contemporary Single Center Experience |
| title_sort | risk factors and outcome of multidrug resistant infections after heart transplant a contemporary single center experience |
| topic | MDR XDR infection heart transplant risk factors hospitalization |
| url | https://www.mdpi.com/2076-2607/9/6/1210 |
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