Donor-derived carbapenem-resistant gram-negative bacterial infections in solid organ transplant recipients: Active surveillance enhances recipient safety
Resource type
Journal Article
Authors/contributors
- Mularoni, Alessandra (Author)
- Cona, Andrea (Author)
- Campanella, Maria (Author)
- Barbera, Floriana (Author)
- Medaglia, Alice Annalisa (Author)
- Cervo, Adriana (Author)
- Cuscino, Nicola (Author)
- Di Mento, Giuseppina (Author)
- Graziano, Elena (Author)
- El Jalbout, Jana Dib (Author)
- Alduino, Rossella (Author)
- Tuzzolino, Fabio (Author)
- Monaco, Francesco (Author)
- Cascio, Antonio (Author)
- Peghin, Maddalena (Author)
- Gruttadauria, Salvatore (Author)
- Bertani, Alessandro (Author)
- Conaldi, Pier Giulio (Author)
- Mikulska, Malgorzata (Author)
- Grossi, Paolo Antonio (Author)
Title
Donor-derived carbapenem-resistant gram-negative bacterial infections in solid organ transplant recipients: Active surveillance enhances recipient safety
Abstract
Donor-derived infections (DDIs) caused by carbapenem-resistant gram-negative bacteria (CR-GNB) in solid organ transplant recipients are potentially life-threatening. In this prospective study, we evaluated the incidence, factors associated with transmission, and the outcome of recipients with unexpected CR-GNB DDIs after the implementation of our local active surveillance system (LASS). LASS provides for early detection of unexpected donor CR-GNB infections, prophylaxis of recipients at high risk, and early diagnosis and treatment of DDIs. Whole genome sequencing confirmed DDI. Among 791 recipients, 38 (4.8%) were at high risk of unexpected CR-GNB DDI: 25 for carbapenem-resistant Enterobacterales (CRE) and 13 for carbapenem-resistant Acinetobacter baumannii (CRAB). Transmission did not occur in 27 (71%) cases, whereas DDIs occurred in 9 of 25 of CRE and 2 of 13 of CRAB cases. Incidence of CR-GNB DDI was 1.4%. Recipients of organs with CR-GNB-positive preservation fluid and liver recipients from a donor with CRE infection were at the highest risk of DDI. There was no difference in length of hospital stay or survival in patients with and without CR-GNB DDI. Our LASS contains transmission and mitigates the negative impacts of CR-GNB DDI. Under well-defined conditions, organs from donors with CR-GNB may be considered after a thorough evaluation of the risk/benefit profile.
Publication
American Journal of Transplantation: Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons
Volume
24
Issue
6
Pages
1046-1056
Date
2024-06
Journal Abbr
Am J Transplant
Language
eng
ISSN
1600-6143
Short Title
Donor-derived carbapenem-resistant gram-negative bacterial infections in solid organ transplant recipients
Library Catalog
PubMed
Extra
PMID: 38342183
Citation
Mularoni, A., Cona, A., Campanella, M., Barbera, F., Medaglia, A. A., Cervo, A., Cuscino, N., Di Mento, G., Graziano, E., El Jalbout, J. D., Alduino, R., Tuzzolino, F., Monaco, F., Cascio, A., Peghin, M., Gruttadauria, S., Bertani, A., Conaldi, P. G., Mikulska, M., & Grossi, P. A. (2024). Donor-derived carbapenem-resistant gram-negative bacterial infections in solid organ transplant recipients: Active surveillance enhances recipient safety. American Journal of Transplantation: Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 24(6), 1046–1056. https://doi.org/10.1016/j.ajt.2024.02.005
SOLID ORGANS AND MCSS
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