1. Gram-negative bacterial colonizations before bilateral lung transplant. The impact of 'targeted' versus 'standard' surgical prophylaxis.
- Author
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Congedi, Sabrina, Peralta, Arianna, Muraro, Luisa, Biscaro, Martina, Pettenuzzo, Tommaso, Sella, Nicolò, Crociani, Silvia, Tagne, Arméla Anne-Sabine, Caregnato, Ida, Monteleone, Francesco, Rossi, Elisa, Roca, Gabriella, Manfrin, Silvia, Marinello, Serena, Mazzitelli, Maria, Dell'Amore, Andrea, Cattelan, Annamaria, Rea, Federico, Navalesi, Paolo, and Boscolo, Annalisa
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LUNG transplantation , *BACTERIAL colonies , *GRAM-negative bacteria , *PREVENTIVE medicine , *INTENSIVE care units - Abstract
Background: Infections are one of the most common causes of death after lung transplant (LT). However, the benefit of 'targeted' prophylaxis in LT recipients pre-colonized by Gram-negative (GN) bacteria is still unclear. Methods: All consecutive bilateral LT recipients admitted to the Intensive Care Unit of the University Hospital of Padua (February 2016–2023) were retrospectively screened. Only patients with pre-existing GN bacterial isolations were enrolled and analyzed according to the antimicrobial surgical prophylaxis ('standard' vs. 'targeted' on the preoperative bacterial isolation). Results: One hundred eighty-one LT recipients were screened, 46 enrolled. Twenty-two (48%) recipients were exposed to 'targeted' prophylaxis, while 24 (52%) to 'standard' prophylaxis. Overall prevalence of postoperative multi-drug resistant (MDR) GN bacteria isolation was 65%, with no differences between the two surgical prophylaxis (p = 0.364). Eleven (79%) patients treated with 'standard' prophylaxis and twelve (75%) with 'targeted' therapy reconfirmed the preoperative GN pathogen (p = 0.999). The prevalence of postoperative infections due to MDR GN bacteria was 50%. Of these recipients, 4 belonged to the 'standard' and 11 to the 'targeted' prophylaxis (p = 0.027). Conclusions: The administration of a 'targeted' prophylaxis in LT pre-colonized recipients seemed not to prevent the occurrence of postoperative MDR GN infections. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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