Infections in liver and lung transplant recipients

a national prospective cohort

SInT Collaborative Study Group

Research output: Contribution to journalArticle

Abstract

Infections are a major complication of solid organ transplants (SOTs). This study aimed to describe recipients' characteristics, and the frequency and etiology of infections and transplant outcome in liver and lung SOTs, and to investigate exposures associated to infection and death in liver transplant recipients. The study population included recipients of SOTs performed in Italy during a 1-year period in ten Italian lung transplant units and eight liver transplant units. Data on comorbidities, infections, retransplantation, and death were prospectively collected using a web-based system, with a 6-month follow-up. The cumulative incidence of infection was 31.7% and 47.8% in liver and lung transplants, respectively, with most infections occurring within the first month after transplantation. Gram-negatives, which were primarily multidrug-resistant, were the most frequent cause of infection. Death rates were 0.42 per 1000 recipient-days in liver transplants and 1.41 per 1000 recipient-days in lung transplants. Infection after SOT in adult liver recipients is associated to an increased risk of death (OR = 13.25; p-value < 0.001). Given the frequency of infection caused by multidrug-resistant microorganisms in SOT recipients in Italy and the heavy impact of infections on the transplant outcome, the reinforcement of surveillance and control activities to prevent the transmission of multidrug-resistant microorganisms in SOT recipients represents a priority. The implementation of the study protocol in liver and lung transplant units and the sharing of results have increased the awareness about the threat due to antimicrobial resistance in the country.

Original languageEnglish
Pages (from-to)399-407
Number of pages9
JournalEuropean Journal of Clinical Microbiology and Infectious Diseases
Volume37
Issue number3
DOIs
Publication statusPublished - Mar 2018

Fingerprint

Transplants
Lung
Liver
Infection
Transplant Recipients
Italy
Comorbidity
Transplantation
Mortality
Incidence

Keywords

  • Adult
  • Anti-Bacterial Agents/pharmacology
  • Bacteria/drug effects
  • Bacterial Infections/epidemiology
  • Drug Resistance, Multiple, Bacterial
  • Female
  • Humans
  • Incidence
  • Italy/epidemiology
  • Liver Transplantation/adverse effects
  • Lung Transplantation/adverse effects
  • Male
  • Middle Aged
  • Postoperative Complications/epidemiology
  • Prospective Studies
  • Transplant Recipients/statistics & numerical data

Cite this

Infections in liver and lung transplant recipients : a national prospective cohort. / SInT Collaborative Study Group.

In: European Journal of Clinical Microbiology and Infectious Diseases, Vol. 37, No. 3, 03.2018, p. 399-407.

Research output: Contribution to journalArticle

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title = "Infections in liver and lung transplant recipients: a national prospective cohort",
abstract = "Infections are a major complication of solid organ transplants (SOTs). This study aimed to describe recipients' characteristics, and the frequency and etiology of infections and transplant outcome in liver and lung SOTs, and to investigate exposures associated to infection and death in liver transplant recipients. The study population included recipients of SOTs performed in Italy during a 1-year period in ten Italian lung transplant units and eight liver transplant units. Data on comorbidities, infections, retransplantation, and death were prospectively collected using a web-based system, with a 6-month follow-up. The cumulative incidence of infection was 31.7{\%} and 47.8{\%} in liver and lung transplants, respectively, with most infections occurring within the first month after transplantation. Gram-negatives, which were primarily multidrug-resistant, were the most frequent cause of infection. Death rates were 0.42 per 1000 recipient-days in liver transplants and 1.41 per 1000 recipient-days in lung transplants. Infection after SOT in adult liver recipients is associated to an increased risk of death (OR = 13.25; p-value < 0.001). Given the frequency of infection caused by multidrug-resistant microorganisms in SOT recipients in Italy and the heavy impact of infections on the transplant outcome, the reinforcement of surveillance and control activities to prevent the transmission of multidrug-resistant microorganisms in SOT recipients represents a priority. The implementation of the study protocol in liver and lung transplant units and the sharing of results have increased the awareness about the threat due to antimicrobial resistance in the country.",
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author = "{SInT Collaborative Study Group} and Carlo Gagliotti and Filomena Morsillo and Moro, {Maria Luisa} and Lucia Masiero and Francesco Procaccio and Francesca Vespasiano and Annalisa Pantosti and Monica Monaco and Giulia Errico and Andrea Ricci and Paolo Grossi and {Nanni Costa}, Alessandro",
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T1 - Infections in liver and lung transplant recipients

T2 - a national prospective cohort

AU - SInT Collaborative Study Group

AU - Gagliotti, Carlo

AU - Morsillo, Filomena

AU - Moro, Maria Luisa

AU - Masiero, Lucia

AU - Procaccio, Francesco

AU - Vespasiano, Francesca

AU - Pantosti, Annalisa

AU - Monaco, Monica

AU - Errico, Giulia

AU - Ricci, Andrea

AU - Grossi, Paolo

AU - Nanni Costa, Alessandro

PY - 2018/3

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N2 - Infections are a major complication of solid organ transplants (SOTs). This study aimed to describe recipients' characteristics, and the frequency and etiology of infections and transplant outcome in liver and lung SOTs, and to investigate exposures associated to infection and death in liver transplant recipients. The study population included recipients of SOTs performed in Italy during a 1-year period in ten Italian lung transplant units and eight liver transplant units. Data on comorbidities, infections, retransplantation, and death were prospectively collected using a web-based system, with a 6-month follow-up. The cumulative incidence of infection was 31.7% and 47.8% in liver and lung transplants, respectively, with most infections occurring within the first month after transplantation. Gram-negatives, which were primarily multidrug-resistant, were the most frequent cause of infection. Death rates were 0.42 per 1000 recipient-days in liver transplants and 1.41 per 1000 recipient-days in lung transplants. Infection after SOT in adult liver recipients is associated to an increased risk of death (OR = 13.25; p-value < 0.001). Given the frequency of infection caused by multidrug-resistant microorganisms in SOT recipients in Italy and the heavy impact of infections on the transplant outcome, the reinforcement of surveillance and control activities to prevent the transmission of multidrug-resistant microorganisms in SOT recipients represents a priority. The implementation of the study protocol in liver and lung transplant units and the sharing of results have increased the awareness about the threat due to antimicrobial resistance in the country.

AB - Infections are a major complication of solid organ transplants (SOTs). This study aimed to describe recipients' characteristics, and the frequency and etiology of infections and transplant outcome in liver and lung SOTs, and to investigate exposures associated to infection and death in liver transplant recipients. The study population included recipients of SOTs performed in Italy during a 1-year period in ten Italian lung transplant units and eight liver transplant units. Data on comorbidities, infections, retransplantation, and death were prospectively collected using a web-based system, with a 6-month follow-up. The cumulative incidence of infection was 31.7% and 47.8% in liver and lung transplants, respectively, with most infections occurring within the first month after transplantation. Gram-negatives, which were primarily multidrug-resistant, were the most frequent cause of infection. Death rates were 0.42 per 1000 recipient-days in liver transplants and 1.41 per 1000 recipient-days in lung transplants. Infection after SOT in adult liver recipients is associated to an increased risk of death (OR = 13.25; p-value < 0.001). Given the frequency of infection caused by multidrug-resistant microorganisms in SOT recipients in Italy and the heavy impact of infections on the transplant outcome, the reinforcement of surveillance and control activities to prevent the transmission of multidrug-resistant microorganisms in SOT recipients represents a priority. The implementation of the study protocol in liver and lung transplant units and the sharing of results have increased the awareness about the threat due to antimicrobial resistance in the country.

KW - Adult

KW - Anti-Bacterial Agents/pharmacology

KW - Bacteria/drug effects

KW - Bacterial Infections/epidemiology

KW - Drug Resistance, Multiple, Bacterial

KW - Female

KW - Humans

KW - Incidence

KW - Italy/epidemiology

KW - Liver Transplantation/adverse effects

KW - Lung Transplantation/adverse effects

KW - Male

KW - Middle Aged

KW - Postoperative Complications/epidemiology

KW - Prospective Studies

KW - Transplant Recipients/statistics & numerical data

U2 - 10.1007/s10096-018-3183-0

DO - 10.1007/s10096-018-3183-0

M3 - Article

VL - 37

SP - 399

EP - 407

JO - European Journal of Clinical Microbiology and Infectious Diseases

JF - European Journal of Clinical Microbiology and Infectious Diseases

SN - 0934-9723

IS - 3

ER -