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Positive Cultures of Organ Preservation Fluid Predict Postoperative Infections in Solid Organ Transplantation Recipients

Published online by Cambridge University Press:  02 January 2015

Cedric P. Yansouni ,
Nandini Dendukuri ,
Guoyuan Liu ,
Myriam Fernandez ,
Charles Frenette ,
Steven Paraskevas  and
Donald C. Sheppard
Cedric P. Yansouni*
Affiliation:
Division of Infectious Diseases and Department of Medical Microbiology, McGill University Health Centre, Montreal, Quebec, Canada
Nandini Dendukuri
Affiliation:
Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
Guoyuan Liu
Affiliation:
Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
Myriam Fernandez
Affiliation:
Department of Surgery, McGill University Health Centre, Montreal, Quebec, Canada
Charles Frenette
Affiliation:
Division of Infectious Diseases and Department of Medical Microbiology, McGill University Health Centre, Montreal, Quebec, Canada Department of Infection Prevention and Control, McGill University Health Centre, Montreal, Quebec, Canada
Steven Paraskevas
Affiliation:
Department of Surgery, McGill University Health Centre, Montreal, Quebec, Canada
Donald C. Sheppard
Affiliation:
Division of Infectious Diseases and Department of Medical Microbiology, McGill University Health Centre, Montreal, Quebec, Canada
*
Department of Clinical Sciences, Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerp, Belgium (cedric.yansouni@mail.mcgill.ca)
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Abstract

Objective.

The significance of positive cultures of organ preservation fluid (OPF) in solid organ transplantation is not known. We sought to describe the microbiology and define the clinical impact of positive OPF cultures.

Design.

Retrospective cohort study.

Setting.

Tertiary care hospital.

Patients.

A consecutive sample of all solid organ transplantations at our center between July 2006 and January 2009 was reviewed. A total of 331 allografts (185 kidneys, 104 livers, 31 pancreases, and 11 hearts) met the inclusion criterion of having OPF cultures taken from the transplanted allograft.

Methods.

Organisms recovered from OPF were classified as high or low risk according to their virulence. Clinical outcomes were compared between recipients of organs with positive OPF cultures and recipients of organs with negative OPF cultures.

Results.

OPF cultures were positive in 62.2% of allografts and yielded high-risk organisms in 17.8%. Normal skin flora constituted the majority of positive OPF cultures, while Enterobacteriaceae spp. and Staphylococcus aureus made up the majority of high-risk organisms. Recipients of allografts with positive OPF cultures developed more frequent bacterial infections, regardless of allograft type (relative risk, 2.39; 95% confidence interval [CI], 1.61–3.54). Moreover, isolation of a given organism in OPF samples was associated with the development of a clinical infection with the same organism, regardless of allograft type.

Conclusions.

Positive cultures of OPF are common events in solid organ transplantation, frequently involve high-risk organisms, and are associated with the development of postoperative clinical bacterial infections. Further study is required to determine the optimal strategies for their prevention and management.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 33 , Issue 7 , July 2012 , pp. 672 - 680
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2012

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References

1. Fischer, SA, Avery, RK. Screening of donor and recipient prior to solid organ transplantation. Am J Transplant 2009;9(suppl 4): S7–S18.CrossRefGoogle ScholarPubMed
2. Gottesdiener, KM. Transplanted infections: donor-to-host transmission with the allograft. Ann Intern Med 1989;110(12): 1001–1016.Google Scholar
3. Cerutti, E, Stratta, C, Romagnoli, R, et al. Bacterial- and fungal-positive cultures in organ donors: clinical impact in liver transplantation. Liver Transplant 2006;12(8):1253–1259.Google Scholar
4. Calvino, J, Romero, R, Pintos, E, et al. Renal artery rupture secondary to pretransplantation Candida contamination of the graft in two different recipients. Am J Kidney Dis 1999;33(1): E3.Google Scholar
5. Horan, TC, Andrus, M, Dudeck, MA. CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control 2008;36(5):309–332.Google Scholar
6. Albano, L, Bretagne, S, Mamzer-Bruneel, MF, et al. Evidence that graft-site candidiasis after kidney transplantation is acquired during organ recovery: a multicenter study in France. Clin Infect Dis 2009;48(2):194–202.Google Scholar
7. Sharma, AK, Smith, G, Smith, D, et al. Clinical outcome of cadaveric renal allografts contaminated before transplantation. Transplant Int 2005;18(7):824–827.Google Scholar
8. Matignon, M, Botterel, F, Audard, V, et al. Outcome of renal transplantation in eight patients with Candida sp. contamination of preservation fluid. Am J Transplant 2008;8(3):697–700.Google Scholar
9. Canaud, G, Timsit, MO, Zuber, J, et al. Early conservative intervention for Candida contamination of preservative fluid without allograft nephrectomy. Nephrol Dial Transplant 2009;24(4): 1325–1327.Google Scholar
10. Linares, L, Cofan, F, Cervera, C, et al. Infection-related mortality in a large cohort of renal transplant recipients. Transplant Proc 2007;39(7):2225–2227.Google Scholar
11. Bert, F, Larroque, B, Paugam-Burtz, C, et al. Microbial epidemiology and outcome of bloodstream infections in liver transplant recipients: an analysis of 259 episodes. Liver Transplant 2010;16(3):393–401.Google Scholar
12. Polk, RE, Fox, C, Mahoney, A, Letcavage, J, MacDougall, C. Measurement of adult antibacterial drug use in 130 US hospitals: comparison of defined daily dose and days of therapy. Clin Infect Dis 2007;44(5):664–670.Google Scholar
13. Fridkin, SK, Edwards, JR, Courval, JM, et al. The effect of vancomycin and third-generation cephalosporins on prevalence of vancomycin-resistant enterococci in 126 U.S. adult intensive care units. Ann Intern Med 2001;135(3):175–183.Google Scholar
14. Freeman, RB, Giatras, I, Falagas, ME, et al. Outcome of transplantation of organs procured from bacteremic donors. Transplantation 1999;68(8):1107–1111.CrossRefGoogle ScholarPubMed