Isolation of antibiotic‐resistant gram‐negative organisms from donor respiratory culture does not impact non‐lung solid organ recipient management. Issue 8 (28th July 2019)

• Record Type: Journal Article
• Authors: Benamu, Esther; Pereira, Marcus R.; Taimur, Sarah; Jacobs, Samantha E.; Friedman, Amy L.; Jenkins, Stephen G.; Herold, Betsy C.; Pellett Madan, Rebecca
• Is Part Of: Clinical transplantation. Volume 33:Issue 8(2019)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2019-07-28
• Subjects: antibiotic prophylaxis -- antimicrobial resistance -- donor-derived infections; Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ctr.13646
• Languages: English
• ISSNs: 0902-0063

Abstract

Abstract: Background: Multidrug‐resistant (MDR) and extensively drug‐resistant (XDR) gram‐negative bacteria may be transmitted from organ donors to solid organ transplant recipients and are associated with poor outcomes post‐transplant. Methods: We reported the prevalence of MDR/XDR gram‐negative respiratory colonization among 702 deceased organ donors in the New York City area from 2011 to 2014 and performed chart reviews for a subset of recipients to determine whether donor respiratory culture results were predictive of subsequent recipient infection or used to guide post‐transplant antimicrobial therapy. Results: Fifty donors (7% of the cohort) had MDR or XDR gram‐negative bacteria isolated from endotracheal aspirate or bronchoalveolar lavage culture. Organs from these 50 donors were transplanted into 120 recipients; chart review was performed for 89 of these recipients (38 kidney, 32 liver, 11 heart, 6 kidney/pancreas, 1 liver/kidney, 1 lung). None of the 89 recipients of organs from donors with MDR/XDR gram‐negative respiratory colonization were reported to have a donor‐derived infection post‐transplant, and chart review for the 88 non‐lung recipients indicated that peri‐transplant antibiotics were not adjusted specifically for donor respiratory culture results. Conclusion: These results suggest that donor respiratory culture results are not predictive of post‐transplant infection in non‐lung recipients and are unlikely to impact post‐transplant management.