Surgical site infections (SSI’s) in the early post-transplant period after simultaneous pancreas-kidney transplantation
D Kawecki, A Kwiatkowski, G Michalak, A Sawicka-Grzelak, A Mlynarczyk, B Sokol-Leszczynska, B Lazinska, J Czerwinski, W Lisik, M Bieniasz, M Wszola, P Domagala, W Rowinski, M Durlik, M Luczak, A Chmura, G Mlynarczyk
Ann Transplant 2009; 14(1): 70-70
Background: This study aims at evaluation of the frequency of microbial isolates and their susceptibility profiles; cultured from clinical samples obtained from "surgical site" of 26 simultaneous pancreas-kidney (SPKTX) recipients suspected of surgical site infections (SSIs) in the early post-transplant period.
Material/Methods: Data on microbiologic culture of 26 adult patients under-going SPKTX was collected prospectively from 2001 to the end of 2006. The isolation and identification of the cultured microorganisms 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 the patients were followed prospectively for the first four weeks after surgery. In total 168 microbial isolates from clinical samples from "surgical site" taken from 26 recipients were cultured. The most commonly isolated were: Gram-positive bacteria (65.5%) with domination of staphylococci (52.7%): presence of MRSA, MRCNS and enterococci (33.6%) with presence of high level aminoglycoside resistant strains - HLAR (64.9%) and vancomycin resistant strains - VRE (2.7%). Gram-negative bacteria comprised 19% of positive cultures: among them were isolated extended spectrum beta-lacta-mase producers - ESBL(+) and carbapenem resistant strains. Yeast-like fungi comprised 15.5% of positive cultures.
Conclusions: In our study dominated Gram(+) bacteria, comprising 65.5% of isolates. The increased proportion of isolated MDR bacteria to antimicrobial agents may be due to the frequent use of these agents for prophylaxis of bacterial infections in patients. MDR strains can cause severe SSI's in patients after SPKTX.
Keywords: Pancreas Transplantation