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Isolation of antibiotic‐resistant gram‐negative organisms from donor respiratory culture does not impact non‐lung solid organ recipient management
Author(s) -
Benamu Esther,
Pereira Marcus R.,
Taimur Sarah,
Jacobs Samantha E.,
Friedman Amy L.,
Jenkins Stephen G.,
Herold Betsy C.,
Pellett Madan Rebecca
Publication year - 2019
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.13646
Subject(s) - medicine , bronchoalveolar lavage , lung , respiratory system , antibiotics , lung transplantation , microbiological culture , transplantation , kidney transplantation , microbiology and biotechnology , bacteria , biology , genetics
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.