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Multidrug-resistant Acinetobacter baumannii infections in lung transplant patients in the cardiothoracic intensive
P Biderman1, Y Bugaevsky2, H Ben-Zvi3,4
1Cardio-Thoracic Intensive Care Unit, Rabin Medical Center, Petach-Tikva, Israel.
Background:
Multidrug-resistant (MDR) gram-negative bacteria are a growing threat to solid organ transplantation (SOT) patients in the intensive care unit (ICU). We aimed to examine the mortality rates of gram-negative MDR bacterial infection in SOT patients compared with patient population undergoing other cardiothoracic surgeries and hospitalized under similar ICU conditions.
Methods:
A retrospective study from a single medical center, including patients with MDR Acinetobacter baumannii and carbapenem-resistant Klebsiella pneumoniae infection, hospitalized in the cardiothoracic ICU. Data were collected from computerized databases, and data were verified using the hospitalization files. Microbiological data were provided by the microbiology laboratory.
Results:
During the study period, 205 SOT patients and 5031 other patients were hospitalized in the cardiothoracic ICU. Active infection with gram-negative MDR bacteria was identified in 147 patients, of which 37 underwent SOT (18% of total transplant recipients) and 110 underwent another cardiothoracic surgery (2% of total patients who are not transplant recipients). Mortality rates were high among both groups of patients, with no significant difference between them.
Conclusions:
Infection with resistant bacteria is more prevalent among patients following SOT compared with patients following other cardiothoracic surgeries. Mortality is high in all patients regardless of the immunocompromised condition.
Insights
Multidrug-resistant gram-negative bacterial infections pose a significant risk to solid organ transplantation (SOT) patients. Mortality rates were high in both SOT and other cardiothoracic surgery patients, indicating a critical need for effective infection control strategies.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Transplantation Surgery
Background:
- Multidrug-resistant (MDR) gram-negative bacteria present a substantial and increasing threat to patients undergoing solid organ transplantation (SOT), particularly those in intensive care units (ICUs).
- Understanding the comparative mortality associated with MDR gram-negative bacterial infections in SOT recipients versus other cardiothoracic surgery patients under similar ICU conditions is crucial for risk stratification and management.
Purpose of the Study:
- To investigate and compare the mortality rates of gram-negative MDR bacterial infections in SOT patients against a cohort of patients undergoing other cardiothoracic surgeries within the same ICU environment.
- To assess the prevalence and outcomes of MDR gram-negative bacterial infections in a vulnerable SOT patient population.
Main Methods:
- A retrospective study was conducted at a single medical center, focusing on patients diagnosed with MDR Acinetobacter baumannii and carbapenem-resistant Klebsiella pneumoniae infections.
- Data were meticulously collected from computerized databases and validated through hospitalization files, with microbiological data sourced from the central microbiology laboratory.
Main Results:
- The study included 205 SOT patients and 5031 other patients in the cardiothoracic ICU. Active MDR gram-negative bacterial infections were identified in 147 patients (37 SOT recipients and 110 non-SOT cardiothoracic surgery patients).
- While infections were more prevalent in SOT recipients (18% of transplant recipients vs. 2% of non-transplant recipients), mortality rates were comparably high across both groups, showing no statistically significant difference.
Conclusions:
- Infections caused by resistant bacteria are demonstrably more common in patients following SOT compared to those who have undergone other cardiothoracic surgeries.
- High mortality rates were observed in all infected patients, irrespective of their immunocompromised status, underscoring the severity of these infections in critically ill patients.
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