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Impact of donor multidrug-resistant organisms on solid organ transplant recipient outcomes
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2 2022
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Source: Transpl Infect Dis. 24(1):e13783
[PDF-499.89 KB]
Details:
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Alternative Title:Transpl Infect Dis
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Personal Author:
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Description:Background:
The impact of donor colonization or infection with multidrug-resistant organisms (MDROs) on solid organ transplant (SOT) recipient outcomes remains uncertain. We thus evaluated the association between donor MDROs and risk of posttransplant infection, graft failure, and mortality.
Methods:
A multicenter retrospective cohort study was performed. All SOT recipients with a local deceased donor were included. The cohort was divided into three exposure groups: recipients whose donors had (1) an MDRO, (2) a non-MDRO bacterial or candidal organism, or (3) no growth on cultures. The primary outcomes were (1) bacterial or invasive candidal infection within 3 months and (2) graft failure or death within 12 months posttransplant. Mixed effect multivariable frailty models were developed to evaluate each association.
Results:
Of 658 total SOT recipients, 93 (14%) had a donor with an MDRO, 477 (73%) had a donor with a non-MDRO organism, and 88 (13%) had a donor with no organisms on culture. On multivariable analyses, donor MDROs were associated with a significantly increased hazard of infection compared to those with negative donor cultures (adjust hazard ratio [aHR] 1.63, 95% CI 1.01–2.62, p = .04) but were not associated with graft failure or death (aHR 0.45, 95% CI 0.15–1.36, p = .16).
Conclusions:
MDROs on donor culture increase the risk of early posttransplant infection but do not appear to affect long-term graft or recipient survival, suggesting organ donors with MDROs on culture maybe safely utilized. Future studies aimed at reducing early posttransplant infections associated with donor MDROs are needed.
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Pubmed ID:34968006
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Pubmed Central ID:PMC9495582
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Document Type:
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Funding:K01-AI137317/NH/NIH HHSUnited States/ ; K24 AI080942/AI/NIAID NIH HHSUnited States/ ; L30 AI133754/AI/NIAID NIH HHSUnited States/ ; K24-AI080942/NH/NIH HHSUnited States/ ; FOA#CK16-004/Centers for Disease Control and Prevention: Epicenters for the Prevention of Healthcare Associated Infections/ ; ... More +
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