Objectives: Rapidly increased multiple drug resistant (MDR) gram negative bacilli like Acinetobacter baumannii (AB) become the main pathogen in ICU nowdays. Our study is intended to assess the effect of multidrug-resistant Acinetobacter baumannii (MRAB) contamination of preservation solution on transplant outcomes and to discuss about optimal prophylactic therapy. Methods: Renal transplant cases at our center between October 27, 2011 and October 22, 2015 were retrospectively reviewed. Outcomes including delayed graft function (DGF), acute rejection (AR), graft function, patient and graft survival were compared and risk factors were reanalyzed by binary logistic regression. Results: Totally 487 cases were included and 36 MRAB positive in preservation solution culture. In MRAB+ patients, 6 were treated with Stage 1 therapy (before August 2013, treatment same as routine), 16 were Stage 2 (between, 7-10 days prophylaxis with tigecycline) and 14 were Stage 3 (after September 2014, 14 prophylaxis with tigecycline combined with sulbactam regimen). Totally 6 recipients with MRAB+ preservation solution and 1 recipient with MRAB- preservation solution was confirmed infected. The latter was proved to be contaminated from an infected wardmate. With our efficient treatment, infection caused no difference in DGF, AR, both patient and graft survival, and graft function (P > 0.05). By logistic regression analysis, ICU stay duration, therapy strategies and induction was main risk factors related to MRAB infection. Conclusions: MRAB contamination of preservation solution is closely relevant to infection post-operation. With efficient therapy, the infection won't lead to poor prognosis. Forteen days prophylaxis with tigecycline combined with sulbactam regimen is recomended.

CITATION INFORMATION: Wang R, Zhou J, Wu J. Prophylactic Therapy Against Multidrug-Resistant Acinetobacter baumannii Contamination of Preservation Solution in Renal Transplantation: A Single Center Experience. Am J Transplant. 2017;17 (suppl 3).

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