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Transport Medium Fluid Cultures in Paediatric Renal Transplantation: Are We Ready to Make a Consensus on Prophylaxis?

D. Furnell1, S. Boyle1, N. Kessaris2, S. D. Marks1, J. Stojanovic1

1Nephrology, Great Ormond Street Hospital, London, United Kingdom, 2Transplantation, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom

Meeting: 2019 American Transplant Congress

Abstract number: C224

Keywords: Bacterial infection, Kidney transplantation, Pediatric, Urinalysis

Session Information

Session Name: Poster Session C: Kidney: Pediatrics

Session Type: Poster Session

Date: Monday, June 3, 2019

Session Time: 6:00pm-7:00pm

 Presentation Time: 6:00pm-7:00pm

Location: Hall C & D

*Purpose: To establish the rate of positive transport medium fluid cultures and sensitivity to antibiotics in paediatric renal transplant recipients.

*Methods: We analysed the electronic records of 125 renal transplant recipients transplanted at a large paediatric renal transplant centre from January 2012 to December 2017. 36 had deceased donor kidney transplants (DDTx) and 89 has living donor transplants (LDTx). 50 patients were excluded as no culture was sent, leaving 27 DDTx and 48 LDTx patients. We looked into TMF growth and sensitivity to the prophylactic antibiotics used.

*Results: 30% of the DDTx recipients had a positive TMF culture.75% grew a single bacteria and 25% grew multiple organisms (Table 1). Coliforms were the most common bacteria grown(30%). Only 50% of the bacteria were sensitive to the prophylactic antibiotics used at the time (protocol revised from ciprofloxacin to co-amoxiclav in 2017). 60% of growths were sensitive to amikacin, whereas only 30% were sensitive to co-amoxiclav and 27% to ciprofloxacin.

19% of LDTx recipients had a positive TMF culture. 78% grew a single organism and 22% had multiple growth. (Table 2) Coagulase negative staphylococcus was most commonly grown(55%). 36% of the bacteria were sensitive to the prophylactic antibiotics. 64% of cultures were sensitive to amikacin. Only 9% were sensitive to co-amoxiclav and 27% to ciprofloxacin.

*Conclusions: Bacterial growth of TMF cultures differs between DDTx and LDTx. Only 30% of bacteria were sensitive to the prophylactic antibiotics. Amikacin was the antibiotic that most organisms were sensitive to in both groups although there are concerns using aminoglycosides in this patient cohort.

TMF Cultures and Sensitivities to Prophylactic Antibiotics in Deceased Donor Transplant Recipients
Bacterial Growth No. of positive TMF cultures Sensitive to Prophylactic Antibiotics Used
Klebsiella oxytoca 1 Yes
Staphylococcus epidermidis 1 No
Staphylococcus warneri 2 No, unknown
Staphylococcus hominis 1 Yes
Staphylococcus aureus 1 Yes
Enterococcus 1 No
Coliforms 3 Yes,Yes, No

TMF Cultures and Sensitivities to Prophylactic Antibiotics in Living Donor Transplant Recipients
Bacterial Growth No. of positive TMF Cultures Sensitive to ProphylacticAntibiotics used
Coagulase negative staphylococcus 6 No,no,no,yes, yes, unknown
Staphylococcus wareni 1 No
Staphylococcus epidermidis 1 No
Staphylococcus Sp. 1 No
Staphylococcus haemoliticus 1 Yes
Bacillus species 1 No

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To cite this abstract in AMA style:

Furnell D, Boyle S, Kessaris N, Marks SD, Stojanovic J. Transport Medium Fluid Cultures in Paediatric Renal Transplantation: Are We Ready to Make a Consensus on Prophylaxis? [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/transport-medium-fluid-cultures-in-paediatric-renal-transplantation-are-we-ready-to-make-a-consensus-on-prophylaxis/. Accessed May 16, 2025.

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