Isolation of antibiotic-resistant gram-negative organisms from donor respiratory culture does not impact non-lung solid organ recipient management

Esther Benamu, Marcus R. Pereira, Sarah Taimur, Samantha E. Jacobs, Amy L. Friedman, Stephen G. Jenkins, Betsy C. Herold, Rebecca Pellett Madan

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Article numbere13646
JournalClinical Transplantation
Volume33
Issue number8
DOIs
StatePublished - Jan 1 2019

Keywords

  • antibiotic prophylaxis
  • antimicrobial resistance
  • donor-derived infections

ASJC Scopus subject areas

  • Transplantation

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