Gram-negative bacterial colonizations before bilateral lung transplant. The impact of 'targeted' versus 'standard' surgical prophylaxis
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View abstract on PubMed
Summary
This summary is machine-generated.Targeted prophylaxis did not prevent Gram-negative infections after lung transplant (LT) in patients already colonized by these bacteria. This study suggests standard prophylaxis may be as effective in reducing postoperative multi-drug resistant infections.
Area Of Science
- Infectious Diseases
- Transplant Surgery
- Antimicrobial Stewardship
Background
- Infections are a leading cause of mortality post-lung transplant (LT).
- The efficacy of targeted antimicrobial prophylaxis for Gram-negative (GN) bacterial colonization in LT recipients remains uncertain.
Purpose Of The Study
- To evaluate the effectiveness of targeted antimicrobial prophylaxis compared to standard prophylaxis in preventing postoperative Gram-negative bacterial infections in lung transplant recipients with pre-existing GN colonization.
Main Methods
- Retrospective analysis of bilateral LT recipients at the University Hospital of Padua (2016-2023).
- Patients with pre-existing GN bacterial isolations were divided into 'standard' and 'targeted' antimicrobial prophylaxis groups.
- Outcomes assessed included postoperative multi-drug resistant (MDR) GN bacteria isolation and infection rates.
Main Results
- Among 46 enrolled LT recipients, 22 received targeted and 24 received standard prophylaxis.
- Postoperative isolation of MDR GN bacteria occurred in 65% of patients, with no significant difference between prophylaxis groups (p=0.364).
- The prevalence of postoperative infections due to MDR GN bacteria was 50%, with a significantly higher rate in the targeted prophylaxis group (11 vs. 4 patients, p=0.027).
Conclusions
- Targeted prophylaxis in LT recipients with pre-existing GN colonization did not appear to prevent postoperative MDR GN infections.
- The findings suggest that standard prophylaxis may be equally or more effective than targeted prophylaxis in this patient population.
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