Surgical site infections in the early posttransplant period after simultaneous pancreas-kidney transplantation

Transplant Proc. 2009 Oct;41(8):3143-7. doi: 10.1016/j.transproceed.2009.07.066.

Abstract

Objective: This study evaluated the frequency of microbial isolates and their susceptibility profiles among cultures from the "surgical site" of 26 simultaneous pancreas-kidney (SPKT) recipients in the early posttransplant period.

Patients and methods: Data on microbiologic cultures of 26 adult patients undergoing SPKT were collected prospectively from 2001 to the end of 2006. The isolation and identification of cultured micro-organisms was performed according to standard microbiological procedures and commercially available tests. Susceptibility of the strains to antibacterial agents was made by the Clinical and Laboratory Standards Institute (CLSI) guidelines.

Results: All patients were followed prospectively for the first 4 weeks after surgery yielding 168 microbial isolates from the surgical site. The most commonly isolated organisms were Gram-positive bacteria (65.5%) with domination of staphylococci (52.7%) as methicillin-resistant S aureus and methicillin-resistant coagulase-negative staphylococci. The second most common were enterococci (33.6%) with the presence of an high level aminoglycoside-resistant strains (64.9%) and vancomycin-resistant strains (2.7%). Gram-negative bacteria comprised 19% of positive cultures; among them were isolated extended spectrum beta-lactamase producers and carbapenem-resistant strains. Yeast-like fungi comprised 15.5% of positive cultures. In conclusion, we observed predominantly Gram-positive bacteria, comprising 65.5% of isolates. The increased proportion of multi-drug-resistant bacterial isolates may be due to the frequent prophylaxis of bacterial infections in patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / therapeutic use
  • Cadaver
  • Drug Resistance, Multiple
  • Female
  • Gram-Positive Bacterial Infections / drug therapy
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Infusions, Intravenous
  • Kidney Transplantation / adverse effects*
  • Kidney Transplantation / immunology
  • Male
  • Methicillin-Resistant Staphylococcus aureus
  • Middle Aged
  • Pancreas Transplantation / adverse effects*
  • Pancreas Transplantation / immunology
  • Postoperative Complications / drug therapy
  • Postoperative Complications / epidemiology
  • Postoperative Complications / microbiology*
  • Staphylococcal Infections / drug therapy
  • Surgical Wound Infection / drug therapy*
  • Surgical Wound Infection / epidemiology
  • Tissue Donors

Substances

  • Anti-Bacterial Agents
  • Immunosuppressive Agents