Colonization and Risk of Bacteremia by Multi-Drug Resistant Organisms in Intestinal Transplant Recipients.

J. Simkins,¹ J. Camargo,¹ M. Morris,¹ R. Vianna,² T. Beduschi,² L. Abbo.¹

¹Medicine/Infectious Diseases, University of Miami Miller School of Medicine, Miami, FL
²Surgery, Miami Transplant Institute/University of Miami, Miami, FL.

Meeting: 2016 American Transplant Congress

Abstract number: 163

Keywords: Bacterial infection, Infection, Intestinal transplantation, Survival

Session Information

Session Name: Concurrent Session: Organ Transplantation in the Era of Highly Resistant Pathogens

Session Type: Concurrent Session

Date: Sunday, June 12, 2016

Session Time: 4:30pm-6:00pm

Presentation Time: 5:06pm-5:18pm

Location: Room 311

Background: This study is the first to evaluate colonization rates and subsequent bacteremia with multi-drug resistant organisms (MDRO) in intestinal transplant (ITx) recipients.

Methods: Retrospective study of adult patients who underwent ITx (isolated or multi-visceral) from 2009 to 2014 at Jackson Memorial Hospital (Miami, FL). Data on demographics, MDRO colonization and 1-year clinical outcomes (bacteremia due to the same MDRO they were colonized with, and patient survival) were obtained. Colonization was defined as a positive surveillance culture (SC; perirectal, nasal or respiratory) with a MDRO within 3 months prior and 6 months after ITx without evidence of infection. SC were typically obtained on a weekly basis in the ICU. MDRO included: vancomycin-resistant Enterococcus (VRE), carbapenem-resistant gram negative bacteria (CR-GNB) and methicillin-resistant S. aureus (MRSA).

Results: 35 ITx patients were evaluated (female: 60%, mean age: 44.6±11.6 years). 16(46%) ITx were multivisceral, 13(37%) isolated and 6(17%) modified multivisceral. 26(74%) patients were colonized with MDRO (VRE in 20[57%], MRSA in 8[23%] and CR-GNB in 6[17%] patients). The colonizers CR-GNB were, P. aeruginosa (3 patients), K. pneumoniae (2) and A. baumannii (1). MDRO colonization occurred prior to ITx in 11 patients (7 with VRE, 3 with MRSA and 1 with VRE and MRSA). VRE and CR-GNB-colonized patients were more likely to develop bacteremia than non-colonized patients, 6/20(30%) vs. 1/15(7%), P=0.2 and 2/6(22%) vs. 2/29(7%), P=0.13, respectively. The median time from positive SC to MDRO bacteremia was 64 days (IQR=29-92). 21(60%) patients were alive at 1-year post-ITx. There was no difference in survival between patients colonized with MDRO vs. those not colonized, 15(58%) vs. 6(67%), P=0.71. However, survival was significantly lower among MDRO-colonized patients who developed bacteremia compared to colonized patients who did not, 1/8(13%) vs. 14/18(82%), P=0.003.

Conclusions: Most of our patients were colonized with MDRO. VRE and CR-GNB bacteremia were more common among colonized patients. Although, not statistically significant due to small sample. 1-year survival was lower among MDRO-colonized patients who developed bacteremia.

CITATION INFORMATION: Simkins J, Camargo J, Morris M, Vianna R, Beduschi T, Abbo L. Colonization and Risk of Bacteremia by Multi-Drug Resistant Organisms in Intestinal Transplant Recipients. Am J Transplant. 2016;16 (suppl 3).

To cite this abstract in AMA style:

Simkins J, Camargo J, Morris M, Vianna R, Beduschi T, Abbo L. Colonization and Risk of Bacteremia by Multi-Drug Resistant Organisms in Intestinal Transplant Recipients. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/colonization-and-risk-of-bacteremia-by-multi-drug-resistant-organisms-in-intestinal-transplant-recipients/. Accessed November 22, 2024.

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