1. Impact of Perioperative Prophylaxis With Enterococcus Activity on Risk of Surgical-Site Infection After Pancreas Transplantation
- Author
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Zachary A. Yetmar, MD, Molly McCord, PharmD, Brian D. Lahr, MS, Yogish C. Kudva, MD, Maria Teresa Seville, MD, Wendelyn Bosch, MD, Adley Lemke, PharmD, Nitin N. Katariya, MD, Kunam S. Reddy, MBBS, Dana K. Perry, MD, Janna L. Huskey, MD, Tambi Jarmi, MD, Aleksandra Kukla, MD, Patrick G. Dean, MD, Stacy A. Bernard, PharmD, and Elena Beam, MD
- Subjects
Surgery ,RD1-811 - Abstract
Background. Surgical-site infection (SSI) is the most common early infectious complication after pancreas transplantation (PT). Although SSI has been shown to worsen outcomes, little data exist to guide optimal choices in perioperative prophylaxis. Methods. We performed a retrospective cohort study of PT recipients from 2010–2020 to examine the effect of perioperative antibiotic prophylaxis with Enterococcus coverage. Enterococcus coverage included antibiotics that would be active for penicillin-susceptible Enterococcus isolates. The primary outcome was SSI within 30 d of transplantation, and secondary outcomes were Clostridioides difficile infection (CDI) and a composite of pancreas allograft failure or death. Outcomes were analyzed by multivariable Cox regression. Results. Of 477 PT recipients, 217 (45.5%) received perioperative prophylaxis with Enterococcus coverage. Eighty-seven recipients (18.2%) developed an SSI after a median of 15 d from transplantation. In multivariable Cox regression analysis, perioperative Enterococcus prophylaxis was associated with reduced risk of SSI (hazard ratio [HR] 0.58; 95% confidence interval [CI], 0.35-0.96; P = 0.034). Anastomotic leak was also significantly associated with elevated risk of SSI (HR 13.95; 95% CI, 8.72-22.32; P
- Published
- 2023
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