Risk Factors for Acquisition of Carbapenem-Resistant Gram-Negative Bacteria among Adult Patients of Respiratory Tract within 90 Days after Lung Transplantation
China-Japan Friendship Hospital, Beijing, China
Meeting: 2020 American Transplant Congress
Abstract number: D-162
Keywords: Infection, Risk factors
Session Information
Date: Saturday, May 30, 2020
Session Name: Poster Session D: All Infections (Excluding Kidney & Viral Hepatitis)
Session Time: 3:15pm-4:00pm
Presentation Time: 3:30pm-4:00pm
Location: Virtual
*Purpose: Carbapenem-resistant Gram-negative bacteria (CR-GNB) such as Klebsiella pneumoniae, Acinetobacter baumannii and Pseudomonas aeruginosa are challenges in the management of lung transplantation patients. We conducted the study to investigate the risk factors for acquisition of CR-GNB within the first 90 days after lung transplantation.
*Methods: All patients who underwent lung transplantation between March 2017 and July 2018 at China-Japan Friendship Hospital were retrospectively reviewed. Patients who died within the first 7 days were excluded. CR-GNB acquisition was defined as (i). a negative screening pre-operation with a positive one during the 90 days post-operation or (ii). a positive screening pre-operation and a positive one with different CR-GNB isolates during the 90 days post-operation. Incidence and risk factors of this were identified.
*Results: A total of 97 patients were included in the study. 322 strains of bacteria were isolatesd from the patients’ respiratory tract. CR-GNB accounted for 23.9% (77/322) including 18.2% (18/77) Klebsiella pneumoniae, 15.6% (24/77) Pseudomonas aeruginosa and 7.8% (6/77) Acinetobacter baumannii. Overall, carriage rates of CR-GNB were 10.3%(10/97) and 52.6%(51/97) pre-operation and post-operation respectively. 86.7% (13/15) CR Klebsiella pneumoniae,100%(20/20) CR Acinetobacter baumannii and 86.7% (13/15) CR Pseudomonas aeruginosa occurred within the first 30 days after the surgey. However, acquisition rate of CR-GNB were up to 48.5%(47/97). Among the factors such as age, gender, pretransplant diabetes, admission to ICU before transplant, operation methods(single lung transplantation/bilateral lung transplantation), cold ischemic time(CIT), postoperative length of ICU stay , the use of glucocorticoid within 14 days pretransplant, the use of carbapenem within 90 days before CR-GNB culture positive, multivariate analysis revealed that the use of glucocorticoid and carbapenem were the independent risk factors for acquisition of CR-GNB within 90 days after lung transplantation.
*Conclusions: The acquisition rate of CR-GNB was high within 90days after transplantation which would be a big potential threat to the patients. More strict prevention and control measures such us avoiding prophylactic carbapenem need to be performed.
To cite this abstract in AMA style:
Chen W, Zhao L, Guo L, Du S, Liang C, Li M, Cao B, Lu B, Chen J, Wang C. Risk Factors for Acquisition of Carbapenem-Resistant Gram-Negative Bacteria among Adult Patients of Respiratory Tract within 90 Days after Lung Transplantation [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/risk-factors-for-acquisition-of-carbapenem-resistant-gram-negative-bacteria-among-adult-patients-of-respiratory-tract-within-90-days-after-lung-transplantation/. Accessed September 25, 2020.« Back to 2020 American Transplant Congress