Infection and Drug Resistance (Jan 2022)
Prevention and Treatment of Carbapenem-Resistant Organism Bacilli from Liver Transplantation Donors – Single Center Experience
Abstract
Li He,1,* Zhi Fu,2,* Menglong Wang,2 Xin Wang,1 Lu Wang,1 Guangming Li,2 Dongdong Lin2 1Department of Intensive Care Unit, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, People’s Republic of China; 2Department of General Surgery Center, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, People’s Republic of China*These authors contributed equally to this workCorrespondence: Guangming Li; Dongdong LinDepartment of General Surgery Center, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, People’s Republic of ChinaTel +86 10 83997733; Tel/Fax +86 10 83997733Email [email protected]; [email protected]: To evaluate and explore the effectiveness of the new prevention and control measures for the donor-derived infection (DDI) associated with CRO after liver transplantation.Methods: The data of 120 organ donors and recipients from January 2018 to May 2020 were retrospectively analyzed at The Liver Transplantation Center of Beijing Youan Hospital, Capital Medical University, to investigate the epidemiological status of CRO in donors. The cases were divided into two groups. The implemented group was treated according to the execution of a clustered CRO prevention and control measure based on active screening combined with early initiation of prophylactic/therapeutic administration of antibiotics. The effectiveness of the prevention and control measures was evaluated by comparing the length of postoperative ICU stay, total postoperative length of hospital stay, duration of ventilator use, duration of restricted antibiotics use, the incidence of DDI, incidence and composition distribution of DDI-related CRO, and incidence of severe DDI-relevant adverse events between the two groups.Results: There was a high detection rate of 39.32% (105 strains) of drug-resistant bacteria in the donors. Fifty-six strains of CRO were detected. Participants in group B, which implemented the new prevention and control measures, were transferred out of the ICU sooner (P = 0.023), used fewer restrictive antibiotics (P = 0.003), and were discharged more quickly (P = 0.013) than those in group A. Postoperative DDI incidences (P = 0.113) and severe DDI-related adverse events were not statistically different between the two groups (P = 0.062). CR-Kp-related DDI was less common in group B (P = 0.021).Conclusion: The situation of donor-derived drug-resistant bacterial infections remains critical. The clustered prevention and control measures for CRO based on active screening combined with early initiation of prophylactic/therapeutic application of antibiotics would be beneficial.Keywords: organ donation, liver transplantation, drug-resistant bacteria, epidemiology, carbapenem-resistant Enterobacteriaceae, active screening, novel β-lactamase inhibitors
