Acinetobacter baumannii infection in solid organ transplant recipients. (30th January 2015)

• Record Type: Journal Article
• Authors: Kitazono, Hidetaka; Rog, Dominik; Grim, Shellee A.; Clark, Nina M.; Reid, Gail E.
• Is Part Of: Clinical transplantation. Volume 29:Number 3(2015)
• Page Start: 227
• Page End: 232
• Publication Date: 2015-01-30
• Subjects: Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ctr.12508
• Languages: English
• ISSNs: 0902-0063

Abstract

<abstract abstract-type="main" id="ctr12508-abs-0001"> <title>Abstract</title> <sec id="ctr12508-sec-0001" sec-type="section"> <title>Introduction</title> <p> <italic>Acinetobacter baumannii</italic> can cause serious infection in susceptible patients, but little has been published regarding risk factors for infection and outcomes in solid organ transplant (SOT) recipients.</p> </sec> <sec id="ctr12508-sec-0002" sec-type="section"> <title>Methods</title> <p>We identified <italic>A. baumannii</italic> infection among adult SOT recipients that occurred between January 2001 and March 31, 2008 at a Chicago transplant center and evaluated characteristics of these infections and outcomes.</p> </sec> <sec id="ctr12508-sec-0003" sec-type="section"> <title>Results</title> <p>Thirty‐three individuals developed <italic>A. baumannii</italic> infection during the study period. Seventy‐nine percent had healthcare‐associated infection with respiratory tract as the most common site of infection (64%). Eighty‐two percent of patients had received antibiotics within two wk prior to <italic>A. baumannii</italic> infection and multidrug resistance (MDR) or extensive resistance (XDR) occurred in 85%. The median time to onset of infection was five months after transplant. The 30‐d mortality was 24% and was associated with XDR. Administration of an appropriate antibiotic within three d was associated with lower 30‐d mortality (OR 0.16, p = 0.047). All isolates tested against colistin were susceptible.</p> </sec> <sec id="ctr12508-sec-0004" sec-type="section"> <title>Conclusion</title> <p>SOT recipients with <italic>A. baumannii</italic> infection had high mortality associated with delay in appropriate antibiotic therapy and XDR organisms. The use of colistin‐containing treatment regimens should be considered in these patients when <italic>A. baumannii</italic> infection is suspected or identified in patients who have received prior antibiotics.</p> </sec> </abstract>