TORNA ALL’ELENCO

Infections in liver and lung transplant recipients: A national prospective cohort in European Journal of Clinical Microbiology and Infectious Diseases

2018
AOU Città della Salute di Torino

Tipo pubblicazione

Article

Autori/Collaboratori (87)Vedi tutti...

Gagliotti C
Azienda Ospedaliera Universitaria Policlinico Vittorio Emanuele Ferrarotto, Santa Marta, S. Bambino, Catania, Italy
Morsillo F
Azienda Ospedaliera Universitaria Policlinico Vittorio Emanuele Ferrarotto, Santa Marta, S. Bambino, Catania, Italy
Moro ML
Azienda Ospedaliera Universitaria Policlinico Vittorio Emanuele Ferrarotto, Santa Marta, S. Bambino, Catania, Italy

et alii...

Abstract

Infections are a major complication of solid organ transplants (SOTs). This study aimed to describe recipients’ characteristics, and the frequency and etiology of infections and transplant outcome in liver and lung SOTs, and to investigate exposures associated to infection and death in liver transplant recipients. The study population included recipients of SOTs performed in Italy during a 1-year period in ten Italian lung transplant units and eight liver transplant units. Data on comorbidities, infections, retransplantation, and death were prospectively collected using a web-based system, with a 6-month follow-up. The cumulative incidence of infection was 31.7% and 47.8% in liver and lung transplants, respectively, with most infections occurring within the first month after transplantation. Gram-negatives, which were primarily multidrug-resistant, were the most frequent cause of infection. Death rates were 0.42 per 1000 recipient-days in liver transplants and 1.41 per 1000 recipient-days in lung transplants. Infection after SOT in adult liver recipients is associated to an increased risk of death (OR = 13.25; p-value < 0.001). Given the frequency of infection caused by multidrug-resistant microorganisms in SOT recipients in Italy and the heavy impact of infections on the transplant outcome, the reinforcement of surveillance and control activities to prevent the transmission of multidrug-resistant microorganisms in SOT recipients represents a priority. The implementation of the study protocol in liver and lung transplant units and the sharing of results have increased the awareness about the threat due to antimicrobial resistance in the country.

PMID : 29380226

DOI : 10.1007/s10096-018-3183-0

Keywords

central venous catheter; intravascular catheter; Acinetobacter baumannii; Acinetobacter infection; adult; article; bacteremia; biliary tract infection; Candida; candidiasis; catheter infection; clinical outcome; Clostridium difficile infection; coagulase negative Staphylococcus; cohort analysis; comorbidity; Cytomegalovirus; cytomegalovirus infection; death; descriptive research; disease association; Enterobacteriaceae; Enterobacteriaceae infection; enterococcal infection; Enterococcus; Enterococcus faecium; Escherichia coli; Escherichia coli infection; exposure; female; follow up; gender; graft infection; graft recipient; Gram negative infection; human; incidence; Klebsiella pneumoniae; Klebsiella pneumoniae infection; length of stay; liver transplantation; lung transplantation; major clinical study; male; methicillin resistant Staphylococcus aureus; methicillin resistant Staphylococcus aureus infection; middle aged; Model For End Stage Liver Disease Score; morbidity; mortality rate; mortality risk; Clostridioides difficile; peritonitis; pneumococcal infection; pneumonia; priority journal; prospective study; Pseudomonas aeruginosa; Pseudomonas infection; retransplantation; sepsis; Staphylococcus aureus; Staphylococcus infection; Stenotrophomonas maltophilia; Streptococcus pneumoniae; surgical infection; urinary tract infection;