Incidence and risk factors for surgical site infection after simultaneous pancreas–kidney transplantation

Perdiz, Luciana Baria; Furtado, Guilherme Henrique Campos; Linhares, Marcelo Moura; Gonzalez, A.M.; Pestana, José Osmar Medina; Medeiros, Eduardo Alexandrino

doi:10.1016/j.jhin.2009.04.016

Cited by 28 publications

(24 citation statements)

References 20 publications

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“…Pancreas transplantation is a widely accepted treatment option to improve long-term survival for type I diabetic patients. 1 The success of pancreas transplantation has improved over time through advances in surgical technique, improved antirejection medications, better organ preservation, and the effective use of antibiotics to prevent and treat infectious complications. 2 Despite reductions of complications in these patients, surgical site infection (SSI) remains a significant cause of morbidity and mortality.…”

Section: Discussionmentioning

confidence: 99%

Correlation of intraoperative donor duodenal-segment swab cultures with the subsequent occurrence of surgical site infections in kidney and pancreas transplant recipients

Alabdulla

Alrehily

Natori

et al. 2020

Infect. Control Hosp. Epidemiol.

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Background: Pancreas transplantation is employed for the treatment of type I diabetes mellitus. It is postulated that surgical site infection (SSI), particularly organ-space infections, after pancreas transplantation may arise from microbial contamination arising from the donor duodenal segment. Therefore, some centers have adopted the practice of culturing the donor duodenal segment and subsequently administering antimicrobial therapy to the recipient directed at the microorganisms isolated to prevent SSI. Methods: In this retrospective cohort study, we evaluated the correlation between positive donor duodenal-segment cultures and SSIs in the recipients. Data were recorded and analyzed to assess the correlation of the organisms isolated in the donor duodenal cultures with those producing SSI in the recipients. Results: We evaluated 379 consecutive pancreas transplant recipients from January 2000 to December 2015. Donor duodenal swab cultures were performed at the time of pancreas transplantation, and 206 (54.3%) were positive. SSIs occurred in 51 of the 206 recipients (24.8%) with positive duodenal-segment cultures and in 41 of 173 individuals (23.7%) with negative cultures (P = .81; r = 0.00). Notably, deep and organ-space SSIs were observed in 27 of 206 of the positive duodenal culture groups (13.1%) versus 29 of 173 of the negative duodenal culture groups (16.8%; P = 0.31; r = −0.059). No differences were detected in the pathogens producing SSIs between the group with a positive duodenal swab versus the group with a negative swab. Microorganisms producing SSIs matched those found in the positive donor duodenal cultures in only 15 patients (7.8%). Conclusion: Although positive cultures from the donor duodenal segment prompted the administration of antimicrobial therapy in the recipient directed against the pathogen isolated, this practice did not reduce SSIs compared with those transplant recipients with culture-negative duodenal swabs. In addition, the organisms isolated from the donor duodenal segment were not predictive of subsequent SSI.

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Section: Discussionmentioning

confidence: 99%

Correlation of intraoperative donor duodenal-segment swab cultures with the subsequent occurrence of surgical site infections in kidney and pancreas transplant recipients

Alabdulla

Alrehily

Natori

et al. 2020

Infect. Control Hosp. Epidemiol.

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“…The author does not provide data on the isolated bacterial strains or their susceptibility [11]. Results from the transplantation center in San Paulo (SPK 119) indicate that the most common Gram-negative bacteria in SSI's K. pneumoniae (28%), P. aeruginosa (22%) and A. baumannii (11%).…”

Section: Discussionmentioning

confidence: 99%

“…Among the Gram-positive were S. aureus (22%), and Enterococcus spp (5.5%). Among the strains of K. pneumoniae ESBL was 42% (þ) [11]. Data from Denmark (66 SPKs) and Italy (54 SPKs) showed the predominance of Gram-positive bacteria isolated from surgical sites, particularly of enterococci (47%) [12,13].…”

Section: Discussionmentioning

confidence: 99%

Bacterial and Fungal Infections in the Early Post-transplantation Period After Simultaneous Pancreas-kidney Transplantation: Etiological Agents and Their Susceptibility

Kawecki

Kwiatkowski

Sawicka-Grzelak

et al. 2014

Transplantation Proceedings

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“…En los pacientes sometidos a trasplante doble de riñón y páncreas la incidencia de infección quirúrgica es muy elevada, y los principales patógenos responsables son bacilos gramnegativos. Los factores de riesgo para infección de la herida quirúrgica incluyen necrosis tubular aguda, el desarrollo de fístulas y el rechazo del injerto 15 . En los receptores de trasplante de corazón la incidencia de infección quirúrgica ocurre en el 5% de los pacientes, predominantemente cocos grampositivos, aunque en algunos casos se aíslan bacilos gramnegativos y Candida spp.…”

Section: Infecciones Nosocomiales Según Focounclassified

Infección nosocomial en el paciente receptor de un trasplante de órgano sólido o de precursores hematopoyéticos

Camacho

Ruiz‐Camps

2014

Enfermedades Infecciosas y Microbiología Clínica

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Bacterial infections are the most common infections in solid organ transplant recipients. These infections occur mainly in the first month after transplantation and are hospital-acquired. Nosocomial infections cause significant morbidity and are the most common cause of mortality in this early period of transplantation. These infections are caused by multi-drug resistant (MDR) microorganisms, mainly Gram-negative enterobacteria, non-fermentative Gram-negative bacilli, enterococci, and staphylococci. The patients at risk of developing nosocomial bacterial infections are those previously colonized with MDR bacteria while on the transplant waiting list. Intravascular catheters, the urinary tract, the lungs, and surgical wounds are the most frequent sources of infection. Preventive measures are the same as those applied in non-immunocompromised, hospitalized patients except in patients at high risk for developing fungal infection. These patients need antifungal therapy during their hospitalization, and for preventing some bacterial infections in the early transplant period, patients need vaccinations on the waiting list according to the current recommendations. Although morbidity and mortality related to infectious diseases have decreased during the last few years in haematopoietic stem cell transplant recipients, they are still one of the most important complications in this population. Furthermore, as occurs in the general population, the incidence of nosocomial infections has increased during the different phases of transplantation. It is difficult to establish general preventive measures in these patients, as there are many risk factors conditioning these infections. Firstly, they undergo multiple antibiotic treatments and interventions; secondly, there is a wide variability in the degree of neutropenia and immunosuppression among patients, and finally they combine hospital and home stay during the transplant process. However, some simple measures could be implemented to improve the current situation.

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Incidence and risk factors for surgical site infection after simultaneous pancreas–kidney transplantation

Cited by 28 publications

References 20 publications

Correlation of intraoperative donor duodenal-segment swab cultures with the subsequent occurrence of surgical site infections in kidney and pancreas transplant recipients

Correlation of intraoperative donor duodenal-segment swab cultures with the subsequent occurrence of surgical site infections in kidney and pancreas transplant recipients

Bacterial and Fungal Infections in the Early Post-transplantation Period After Simultaneous Pancreas-kidney Transplantation: Etiological Agents and Their Susceptibility

Infección nosocomial en el paciente receptor de un trasplante de órgano sólido o de precursores hematopoyéticos

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