Risk factors for multidrug-resistant organisms among deceased organ donors

Details

• Alternative Title:
  Am J Transplant
• Personal Author:
  Anesi, Judith A. ; Blumberg, Emily A. ; Han, Jennifer H. ; Lee, Dong Heun ; Clauss, Heather ; Climaco, Antonette ; Hasz, Richard ; Molnar, Esther ; Alimenti, Darcy ; West, Sharon ; Bilker, Warren B. ; Tolomeo, Pam ; Lautenbach, Ebbing
• Corporate Authors:
  CDC Prevention Epicenters Program
• Description:
  Donor infection or colonization with a multidrug-resistant organism (MDRO) affects organ utilization and recipient antibiotic management. Approaches to identifying donors at risk of carrying MDROs are unknown. We sought to determine the risk factors for MDROs among transplant donors. A multicenter retrospective cohort study was conducted at four transplant centers between 2015 and 2016. All deceased donors who donated at least one organ were included. Cultures obtained during the donor's terminal hospitalization and organ procurement were evaluated. The primary outcome was isolation of an MDRO on culture. Multivariable Cox regression was used to determine risk factors associated with time to donor MDRO. Of 440 total donors, 64 (15%) donors grew an MDRO on culture. Predictors of an MDRO on donor culture included hepatitis C viremia (hazard ratio [HR] 4.09, 95% confidence interval [CI] 1.71-9.78, P = .002), need for dialysis (HR 4.59, 95% CI 1.09-19.21, P = .037), prior hematopoietic cell transplant (HR 7.57, 95% CI 1.03-55.75, P = .047), and exposure to antibiotics with a narrow gram-negative spectrum (HR 1.13, 95% CI 1.00-1.27, P = .045). This is the first study to determine risk factors for MDROs among deceased donors and will be important for risk stratifying potential donors and informing transplant recipient prophylaxis.
• Keywords:
  Adult Anti-Bacterial Agents Cross Infection Drug Resistance, Multiple, Bacterial Female Hematopoietic Stem Cell Transplantation Hepatitis C Hospitalization Humans Kaplan-Meier Estimate Male Middle Aged Multivariate Analysis Proportional Hazards Models Renal Dialysis Retrospective Studies Risk Factors Tissue And Organ Procurement Tissue Donors Transplant Recipients Treatment Outcome

  More +
• Source:
  Am J Transplant. 19(9):2468-2478
• Pubmed ID:
  31162785
• Pubmed Central ID:
  PMC6711782
• Document Type:
  Journal Article
• Funding:
  K24 AI080942/AI/NIAID NIH HHSUnited States/ ; L30 AI133754/AI/NIAID NIH HHSUnited States/ ; Transplant Foundation's Innovative Research Grant ProgramInternational/ ; UM1 AI104681/AI/NIAID NIH HHSUnited States/ ; FOA#CK16-004/Centers for Disease Control and Prevention (CDC), Epicenters for the Prevention of Healthcare Associated InfectionsInternational/ ; U54CK000485/ACL/ACL HHSUnited States/ ; U54CK000163/ACL/ACL HHSUnited States/ ; K01 AI137317/AI/NIAID NIH HHSUnited States/
• Volume:
  19
• Issue:
  9
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:bc693c2ac2407e95718be296869c173ba3505ab62edc24a8bf9ad37aa5d27efa
• Download URL:
  https://stacks.cdc.gov/view/cdc/81058/cdc_81058_DS1.pdf
• File Type:
  [PDF - 510.60 KB ]