Infections are a major complication of solid organ transplants (SOTs). This study aimed to describe recipients' characteristics, and the frequency and etiology of infections and transplant outcome in liver and lung SOTs, and to investigate exposures associated to infection and death in liver transplant recipients. The study population included recipients of SOTs performed in Italy during a 1-year period in ten Italian lung transplant units and eight liver transplant units. Data on comorbidities, infections, retransplantation, and death were prospectively collected using a web-based system, with a 6-month follow-up. The cumulative incidence of infection was 31.7% and 47.8% in liver and lung transplants, respectively, with most infections occurring within the first month after transplantation. Gram-negatives, which were primarily multidrug-resistant, were the most frequent cause of infection. Death rates were 0.42 per 1000 recipient-days in liver transplants and 1.41 per 1000 recipient-days in lung transplants. Infection after SOT in adult liver recipients is associated to an increased risk of death (OR = 13.25; p-value < 0.001). Given the frequency of infection caused by multidrug-resistant microorganisms in SOT recipients in Italy and the heavy impact of infections on the transplant outcome, the reinforcement of surveillance and control activities to prevent the transmission of multidrug-resistant microorganisms in SOT recipients represents a priority. The implementation of the study protocol in liver and lung transplant units and the sharing of results have increased the awareness about the threat due to antimicrobial resistance in the country.

Infections in liver and lung transplant recipients. A national prospective cohort / Gagliotti, Carlo; Morsillo, Filomena; Luisa Moro, Maria; Masiero, Lucia; Procaccio, Francesco; Vespasiano, Francesca; Pantosti, Annalisa; Monaco, Monica; Errico, Giulia; Ricci, Andrea; Grossi, Paolo; Nanni Costa, Alessandro; Adorno, Domenico; Ambretti, Simone; Amoroso, Antonio; Arghittu, Milena; Berloco, Pasquale Bartolomeo; Bertani Manuela Bonizzoli, Alessandro; Cambieri, Patrizia; Canzonieri, Marco; Caprio, Mario; Carrara, Elena; Carrinola, Rosaria; Cibelli, Eva; Cillo, Umberto; Colledan, Michele; Colombo, MARIA ROSARIA; Coluccio, Elena; Giulio Conaldi, Pier; Cusi, Mariagrazia; Maria D’Armini, Andrea; Da Riva, Adelaide; D'Auria, Bianca; De Carlis, Luciano; De Cillia, Carlo; De Gasperi, Andrea; Di Caro, Antonino; Di Ciaccio, Paola; Dondossola, Daniele; Farina, Claudio; Feltrin, Giuseppe; Carola Finarelli, Alba; Fossati, Lucina; Gaibani, Paolo; Garcia Fernandez, Aurora; Gesu, Giovanni; Giacometti, Raffaella; Gona, Floriana; Gridelli, Bruno; Henrici De Angelis, Lucia; Paola Landini, Maria; Maldarelli, Federica; Mancini, Carlo; Marone, Piero; Mularoni, Alessandra; Paglialunga, Giulia; Paladini, Piero; Palù, Giorgio; Parisi, Saverio; Peris, Adriano; Daniele Pinna, Antonio; Platto, Marco; Pugliese, Francesco; Puoti, Francesca; Rago, Claudio; Ravini, Mario; Rea, Federico; Rinaldi, Mauro; Rossi, Giorgio; Rossi, Lucia; Rossi, Massimo; Salizzoni, Mauro; Sangiorgi, Gabriela; Santambrogio, Luigi; Spada, Marco; Sparacino, Vito; Stella, Franco; Torelli, Rosanna; Torresani, Erminio; Tosi, Davide; Vailati, Francesca; Valeri, Maurizio; Venuta, Federico; Vesconi, Sergio; Viale, Pierluigi; Vismara., Chiara. - In: EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES. - ISSN 0934-9723. - STAMPA. - 37:3(2018), pp. 399-407. [10.1007/s10096-018-3183-0]

Infections in liver and lung transplant recipients. A national prospective cohort

Monica Monaco;Giulia Errico;Andrea Ricci;Paolo Grossi;Antonio Amoroso;Pasquale Berloco;Rosaria Colombo;Bianca D'Auria;Federica Maldarelli;Carlo Mancini;Giulia Paglialunga;Francesco Pugliese;Federico Rea;Giorgio Rossi;Lucia Rossi;Massimo Rossi;Marco Spada;Federico Venuta;
2018

Abstract

Infections are a major complication of solid organ transplants (SOTs). This study aimed to describe recipients' characteristics, and the frequency and etiology of infections and transplant outcome in liver and lung SOTs, and to investigate exposures associated to infection and death in liver transplant recipients. The study population included recipients of SOTs performed in Italy during a 1-year period in ten Italian lung transplant units and eight liver transplant units. Data on comorbidities, infections, retransplantation, and death were prospectively collected using a web-based system, with a 6-month follow-up. The cumulative incidence of infection was 31.7% and 47.8% in liver and lung transplants, respectively, with most infections occurring within the first month after transplantation. Gram-negatives, which were primarily multidrug-resistant, were the most frequent cause of infection. Death rates were 0.42 per 1000 recipient-days in liver transplants and 1.41 per 1000 recipient-days in lung transplants. Infection after SOT in adult liver recipients is associated to an increased risk of death (OR = 13.25; p-value < 0.001). Given the frequency of infection caused by multidrug-resistant microorganisms in SOT recipients in Italy and the heavy impact of infections on the transplant outcome, the reinforcement of surveillance and control activities to prevent the transmission of multidrug-resistant microorganisms in SOT recipients represents a priority. The implementation of the study protocol in liver and lung transplant units and the sharing of results have increased the awareness about the threat due to antimicrobial resistance in the country.
2018
lung transplant, liver transplant, infectious
01 Pubblicazione su rivista::01a Articolo in rivista
Infections in liver and lung transplant recipients. A national prospective cohort / Gagliotti, Carlo; Morsillo, Filomena; Luisa Moro, Maria; Masiero, Lucia; Procaccio, Francesco; Vespasiano, Francesca; Pantosti, Annalisa; Monaco, Monica; Errico, Giulia; Ricci, Andrea; Grossi, Paolo; Nanni Costa, Alessandro; Adorno, Domenico; Ambretti, Simone; Amoroso, Antonio; Arghittu, Milena; Berloco, Pasquale Bartolomeo; Bertani Manuela Bonizzoli, Alessandro; Cambieri, Patrizia; Canzonieri, Marco; Caprio, Mario; Carrara, Elena; Carrinola, Rosaria; Cibelli, Eva; Cillo, Umberto; Colledan, Michele; Colombo, MARIA ROSARIA; Coluccio, Elena; Giulio Conaldi, Pier; Cusi, Mariagrazia; Maria D’Armini, Andrea; Da Riva, Adelaide; D'Auria, Bianca; De Carlis, Luciano; De Cillia, Carlo; De Gasperi, Andrea; Di Caro, Antonino; Di Ciaccio, Paola; Dondossola, Daniele; Farina, Claudio; Feltrin, Giuseppe; Carola Finarelli, Alba; Fossati, Lucina; Gaibani, Paolo; Garcia Fernandez, Aurora; Gesu, Giovanni; Giacometti, Raffaella; Gona, Floriana; Gridelli, Bruno; Henrici De Angelis, Lucia; Paola Landini, Maria; Maldarelli, Federica; Mancini, Carlo; Marone, Piero; Mularoni, Alessandra; Paglialunga, Giulia; Paladini, Piero; Palù, Giorgio; Parisi, Saverio; Peris, Adriano; Daniele Pinna, Antonio; Platto, Marco; Pugliese, Francesco; Puoti, Francesca; Rago, Claudio; Ravini, Mario; Rea, Federico; Rinaldi, Mauro; Rossi, Giorgio; Rossi, Lucia; Rossi, Massimo; Salizzoni, Mauro; Sangiorgi, Gabriela; Santambrogio, Luigi; Spada, Marco; Sparacino, Vito; Stella, Franco; Torelli, Rosanna; Torresani, Erminio; Tosi, Davide; Vailati, Francesca; Valeri, Maurizio; Venuta, Federico; Vesconi, Sergio; Viale, Pierluigi; Vismara., Chiara. - In: EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES. - ISSN 0934-9723. - STAMPA. - 37:3(2018), pp. 399-407. [10.1007/s10096-018-3183-0]
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