Impact of surveillance stool culture guided selection of antibiotics in the management of pediatric small bowel transplant recipients

Minnie John, Gabriel Gondolesi, Betsy Herold, Stuart Kaufman, Thomas Fishbein, Roberto Posada

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Surveillance stool cultures (SSC) have been used in immunocompromised populations to predict the organisms associated with invasive infections and aid in the selection of empiric antibiotic regimens. To evaluate the utility of this approach in pediatric small bowel transplant (SBT) recipients, we conducted a retrospective review of 33 patients who underwent SBT, 16 of whom had SSC done. In no case was the same organism isolated from SSC and subsequent blood, peritoneal fluid or wound cultures. In the first month post-transplantation, blood cultures were positive in 44% and 35% of patients that had and did not have SSC done, respectively (p = 0.73); peritoneal fluid cultures in 44% and 65% (p = 0.30); and wound cultures in 44% and 24% (p = 0.28). There were no significant differences among both groups in time to first infection, duration of ICU stay following SBT, graft survival or long-term patient survival. We conclude that SSC-guided antibiotic selection does not have a significant impact on the incidence of invasive infections in the first month following SBT or on specific indicators of patient outcome. This suggests that empiric antibiotic regimens should be selected based on clinical presentation and hospital flora and susceptibility patterns.

Original languageEnglish (US)
Pages (from-to)198-204
Number of pages7
JournalPediatric Transplantation
Volume10
Issue number2
DOIs
StatePublished - Mar 2006
Externally publishedYes

Fingerprint

Pediatrics
Anti-Bacterial Agents
Ascitic Fluid
Transplants
Infection
Wounds and Injuries
Graft Survival
Transplantation
Survival
Transplant Recipients
Incidence
Population
Blood Culture

Keywords

  • Infection
  • Pediatrics
  • Small intestine
  • Transplant

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Transplantation

Cite this

Impact of surveillance stool culture guided selection of antibiotics in the management of pediatric small bowel transplant recipients. / John, Minnie; Gondolesi, Gabriel; Herold, Betsy; Kaufman, Stuart; Fishbein, Thomas; Posada, Roberto.

In: Pediatric Transplantation, Vol. 10, No. 2, 03.2006, p. 198-204.

Research output: Contribution to journalArticle

John, Minnie ; Gondolesi, Gabriel ; Herold, Betsy ; Kaufman, Stuart ; Fishbein, Thomas ; Posada, Roberto. / Impact of surveillance stool culture guided selection of antibiotics in the management of pediatric small bowel transplant recipients. In: Pediatric Transplantation. 2006 ; Vol. 10, No. 2. pp. 198-204.
@article{ad33adf48993441d89cd111de4d66791,
title = "Impact of surveillance stool culture guided selection of antibiotics in the management of pediatric small bowel transplant recipients",
abstract = "Surveillance stool cultures (SSC) have been used in immunocompromised populations to predict the organisms associated with invasive infections and aid in the selection of empiric antibiotic regimens. To evaluate the utility of this approach in pediatric small bowel transplant (SBT) recipients, we conducted a retrospective review of 33 patients who underwent SBT, 16 of whom had SSC done. In no case was the same organism isolated from SSC and subsequent blood, peritoneal fluid or wound cultures. In the first month post-transplantation, blood cultures were positive in 44{\%} and 35{\%} of patients that had and did not have SSC done, respectively (p = 0.73); peritoneal fluid cultures in 44{\%} and 65{\%} (p = 0.30); and wound cultures in 44{\%} and 24{\%} (p = 0.28). There were no significant differences among both groups in time to first infection, duration of ICU stay following SBT, graft survival or long-term patient survival. We conclude that SSC-guided antibiotic selection does not have a significant impact on the incidence of invasive infections in the first month following SBT or on specific indicators of patient outcome. This suggests that empiric antibiotic regimens should be selected based on clinical presentation and hospital flora and susceptibility patterns.",
keywords = "Infection, Pediatrics, Small intestine, Transplant",
author = "Minnie John and Gabriel Gondolesi and Betsy Herold and Stuart Kaufman and Thomas Fishbein and Roberto Posada",
year = "2006",
month = "3",
doi = "10.1111/j.1399-3046.2005.00424.x",
language = "English (US)",
volume = "10",
pages = "198--204",
journal = "Pediatric Transplantation",
issn = "1397-3142",
publisher = "Wiley-Blackwell",
number = "2",

}

TY - JOUR

T1 - Impact of surveillance stool culture guided selection of antibiotics in the management of pediatric small bowel transplant recipients

AU - John, Minnie

AU - Gondolesi, Gabriel

AU - Herold, Betsy

AU - Kaufman, Stuart

AU - Fishbein, Thomas

AU - Posada, Roberto

PY - 2006/3

Y1 - 2006/3

N2 - Surveillance stool cultures (SSC) have been used in immunocompromised populations to predict the organisms associated with invasive infections and aid in the selection of empiric antibiotic regimens. To evaluate the utility of this approach in pediatric small bowel transplant (SBT) recipients, we conducted a retrospective review of 33 patients who underwent SBT, 16 of whom had SSC done. In no case was the same organism isolated from SSC and subsequent blood, peritoneal fluid or wound cultures. In the first month post-transplantation, blood cultures were positive in 44% and 35% of patients that had and did not have SSC done, respectively (p = 0.73); peritoneal fluid cultures in 44% and 65% (p = 0.30); and wound cultures in 44% and 24% (p = 0.28). There were no significant differences among both groups in time to first infection, duration of ICU stay following SBT, graft survival or long-term patient survival. We conclude that SSC-guided antibiotic selection does not have a significant impact on the incidence of invasive infections in the first month following SBT or on specific indicators of patient outcome. This suggests that empiric antibiotic regimens should be selected based on clinical presentation and hospital flora and susceptibility patterns.

AB - Surveillance stool cultures (SSC) have been used in immunocompromised populations to predict the organisms associated with invasive infections and aid in the selection of empiric antibiotic regimens. To evaluate the utility of this approach in pediatric small bowel transplant (SBT) recipients, we conducted a retrospective review of 33 patients who underwent SBT, 16 of whom had SSC done. In no case was the same organism isolated from SSC and subsequent blood, peritoneal fluid or wound cultures. In the first month post-transplantation, blood cultures were positive in 44% and 35% of patients that had and did not have SSC done, respectively (p = 0.73); peritoneal fluid cultures in 44% and 65% (p = 0.30); and wound cultures in 44% and 24% (p = 0.28). There were no significant differences among both groups in time to first infection, duration of ICU stay following SBT, graft survival or long-term patient survival. We conclude that SSC-guided antibiotic selection does not have a significant impact on the incidence of invasive infections in the first month following SBT or on specific indicators of patient outcome. This suggests that empiric antibiotic regimens should be selected based on clinical presentation and hospital flora and susceptibility patterns.

KW - Infection

KW - Pediatrics

KW - Small intestine

KW - Transplant

UR - http://www.scopus.com/inward/record.url?scp=33645096600&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33645096600&partnerID=8YFLogxK

U2 - 10.1111/j.1399-3046.2005.00424.x

DO - 10.1111/j.1399-3046.2005.00424.x

M3 - Article

C2 - 16573607

AN - SCOPUS:33645096600

VL - 10

SP - 198

EP - 204

JO - Pediatric Transplantation

JF - Pediatric Transplantation

SN - 1397-3142

IS - 2

ER -