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Correlation of Intraoperative Donor Duodenal Segment Swab Cultures with the Subsequent Occurrence of Surgical Site Infections in Kidney-Pancreas Transplant Recipients

C. M. Rotstein1, M. Alabdulla1, S. Al Rehily1, Y. Natori2, K. Van1, M. Cattral1, T. Reichman1

1University Health Network, Toronto, ON, Canada, 2Division of ID, University of Miami, Miami, FL

Meeting: 2020 American Transplant Congress

Abstract number: D-155

Keywords: Infection, Pancreas transplantation, Surgical complications

Session Information

Session Name: Poster Session D: All Infections (Excluding Kidney & Viral Hepatitis)

Session Type: Poster Session

Date: Saturday, May 30, 2020

Session Time: 3:15pm-4:00pm

 Presentation Time: 3:30pm-4:00pm

Location: Virtual

*Purpose:

Pancreas transplantation (PT) is commonly employed for the treatment of type I diabetes mellitus. It has been postulated that surgical site infections (SSIs), particularly organ/space infections, noted after PT may arise from microbial contamination, arising from the donor duodenal stump. Therefore, some centers have adopted the practice of culturing the donor duodenal stump and subsequently administering antimicrobial therapy to the recipient directed at the microorganisms isolated in an attempt to prevent SSIs.

*Methods: We conducted a retrospective cohort study of PT from 2000 to 2015 to evaluate the correlation between positive donor duodenal stump cultures and the development of SSIs in PT recipients to assess if the duodenal cultures were predictive of SSIs caused by the same organisms.

*Results: A total of 379 PT recipients had duodenal swabs cultures performed and 206 (54.3%) were positive. SSIs occurred in 51/206 (24.8%) of the recipients with positive duodenal segment cultures and 41/173 (23.7%) of those individuals with negative cultures (p=0.81), with organ/space infections predominating in both groups. Of note, deep and organ/space SSIs were observed in 27/206 (13.1%) versus 29/173 (16.8%) (p=0.31) of the positive compared to the negative duodenal culture groups. Microorganisms isolated from the duodenal cultures did not correlate with those producing infection and there were no appreciable differences in the pathogens producing SSIs between the positive duodenal culture group versus the negative culture one.

*Conclusions: Culturing the duodenal stump was of no clinical utility in predicting the development of SSIs in PT recipients and is an unnecessary practice that should be abandoned.

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To cite this abstract in AMA style:

Rotstein CM, Alabdulla M, Rehily SAl, Natori Y, Van K, Cattral M, Reichman T. Correlation of Intraoperative Donor Duodenal Segment Swab Cultures with the Subsequent Occurrence of Surgical Site Infections in Kidney-Pancreas Transplant Recipients [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/correlation-of-intraoperative-donor-duodenal-segment-swab-cultures-with-the-subsequent-occurrence-of-surgical-site-infections-in-kidney-pancreas-transplant-recipients/. Accessed May 11, 2025.

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