Comparison of Perioperative Antibiotic Prophylaxis Regimens on Surgical Site Infections in Pancreas Transplant Recipients
1Division of Infectious Diseases, Mayo Clinic, Rochester, MN, 2Department of Pharmacy, Mayo Clinic, Rochester, MN, 3Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, 4Division of Transplantation Surgery, Mayo Clinic, Rochester, MN, 5Division of Endocrinology, Diabetes, Metabolism & Nutrition, Mayo Clinic, Rochester, MN, 6Division of Infectious Diseases, Mayo Clinic, Scottsdale, AZ, 7Division of Infectious Diseases, Mayo Clinic, Jacksonville, FL
Meeting: 2022 American Transplant Congress
Abstract number: 1344
Keywords: Infection, Pancreas transplantation, Prophylaxis, Surgical complications
Topic: Clinical Science » Infection Disease » 24 - All Infections (Excluding Kidney & Viral Hepatitis)
Session Information
Session Name: All Infections (Excluding Kidney & Viral Hepatitis) III
Session Type: Poster Abstract
Date: Monday, June 6, 2022
Session Time: 7:00pm-8:00pm
Presentation Time: 7:00pm-8:00pm
Location: Hynes Halls C & D
*Purpose: Pancreas transplant recipients are at high risk of surgical site infection (SSI), with rates ranging from 9-45%. Several risk factors for SSI have been identified, though perioperative prophylaxis has not been significantly evaluated. We sought to evaluate the impact of perioperative prophylaxis regimens on rate of SSI following pancreas transplantation.
*Methods: We performed a retrospective cohort study including adult patients who underwent pancreas-after-kidney (PAK) or pancreas transplant alone (PTA) from 2010-2020. Perioperative prophylaxis regimens were analyzed in groups including 3rd generation cephalosporins (3GC), broad spectrum antibiotics (defined as use of piperacillin-tazobactam or vancomycin with aztreonam) and other. Outcomes included 30-day SSI, allograft loss and mortality. Associations were evaluated by univariable analysis via Pearson χ2 test or Cox proportional hazard regression.
*Results: 128 patients met inclusion criteria during the study period. This included 79 PTA and 49 PAK. Common perioperative prophylaxis regimens were piperacillin-tazobactam (51; 39.8%), ceftriaxone (28; 21.9%), cefotaxime (27; 21.1%) and vancomycin with aztreonam (6; 4.7%). Baseline demographics and outcomes are detailed in Table 1. 27 SSIs, mostly organ/space infection (21; 77.8%), were found with the most common organisms being coagulase-negative Staphylococcus spp. (11), Enterococcus spp. (7) and Candida albicans (5). 24 (18.8%) patients had graft thrombosis, with 6 (25.0%) developing SSI. 30-day SSI rate was significantly different by perioperative prophylaxis grouping (3GC 36.4%, broad spectrum antibiotics 12.3%, other 0%; p < .001). 30-day SSI was not significantly associated with subsequent mortality (HR 2.61, p = .114) or allograft loss (HR 1.31, p = .631).
| Age at transplant (years) | 44.7 (35.5-53.6) |
| Sex (female) | 72 (56.2%) |
| 3rd generation cephalosporins | 55 (43.0%) |
| Broad spectrum antibiotics | 57 (44.5%) |
| Other | 16 (12.5%) |
| 30-day SSI | 27 (21.1%) |
| 12-Month Mortality | 3 (2.4%) |
| 12-Month Allograft loss | 10 (7.9%) |
*Conclusions: Perioperative prophylaxis with broad spectrum agents may reduce rates of 30-day SSI following pancreas transplantation as compared to 3GC. Larger studies are required to confirm this association and investigate the impact of pathogen-targeted prophylactic regimens.
To cite this abstract in AMA style:
Yetmar ZA, McCord M, Lahr B, Lemke A, Dean PG, Kudva YC, Seville MT, Bosch W, Bernard SA, Beam E. Comparison of Perioperative Antibiotic Prophylaxis Regimens on Surgical Site Infections in Pancreas Transplant Recipients [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/comparison-of-perioperative-antibiotic-prophylaxis-regimens-on-surgical-site-infections-in-pancreas-transplant-recipients/. Accessed December 3, 2024.« Back to 2022 American Transplant Congress