{Reference Type}: Journal Article
{Title}: Gram-negative bacterial colonizations before bilateral lung transplant. The impact of 'targeted' versus 'standard' surgical prophylaxis.
{Author}: Congedi S;Peralta A;Muraro L;Biscaro M;Pettenuzzo T;Sella N;Crociani S;Tagne AA;Caregnato I;Monteleone F;Rossi E;Roca G;Manfrin S;Marinello S;Mazzitelli M;Dell'Amore A;Cattelan A;Rea F;Navalesi P;Boscolo A;
{Journal}: BMC Infect Dis
{Volume}: 24
{Issue}: 1
{Year}: 2024 Mar 13
{Factor}: 3.667
{DOI}: 10.1186/s12879-024-09199-y
{Abstract}: <B>BACKGROUND: </B>Infections are one of the most common causes of death after lung transplant (LT). However, the benefit of 'targeted' prophylaxis in LT recipients pre-colonized by Gram-negative (GN) bacteria is still unclear.<BR><B>METHODS: </B>All consecutive bilateral LT recipients admitted to the Intensive Care Unit of the University Hospital of Padua (February 2016-2023) were retrospectively screened. Only patients with pre-existing GN bacterial isolations were enrolled and analyzed according to the antimicrobial surgical prophylaxis ('standard' vs. 'targeted' on the preoperative bacterial isolation).<BR><B>RESULTS: </B>One hundred eighty-one LT recipients were screened, 46 enrolled. Twenty-two (48%) recipients were exposed to 'targeted' prophylaxis, while 24 (52%) to 'standard' prophylaxis. Overall prevalence of postoperative multi-drug resistant (MDR) GN bacteria isolation was 65%, with no differences between the two surgical prophylaxis (p = 0.364). Eleven (79%) patients treated with 'standard' prophylaxis and twelve (75%) with 'targeted' therapy reconfirmed the preoperative GN pathogen (p = 0.999). The prevalence of postoperative infections due to MDR GN bacteria was 50%. Of these recipients, 4 belonged to the 'standard' and 11 to the 'targeted' prophylaxis (p = 0.027).<BR><B>CONCLUSIONS: </B>The administration of a 'targeted' prophylaxis in LT pre-colonized recipients seemed not to prevent the occurrence of postoperative MDR GN infections.