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Zhang H, Yang L. Ureaplasma urealyticum infection following organ transplantation: a case report and narrative review. Ren Fail 2024; 46:2395466. [PMID: 39192626 PMCID: PMC11360648 DOI: 10.1080/0886022x.2024.2395466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 08/16/2024] [Accepted: 08/17/2024] [Indexed: 08/29/2024] Open
Abstract
OBJECTIVE One case of Ureaplasma urealyticum (UU) infection after kidney transplantation was reported, and relevant literature was collected to provide a scientific reference basis for clinical diagnosis and treatment. METHODS A case of UU infection after renal transplantation in our hospital was analyzed retrospectively. PubMed, Embase and Cochrane databases were searched for case reports of UU infection after organ transplantation before 30 June 2024. The clinical and laboratory characteristics, treatment and prognosis of UU infection were summarized and analyzed. RESULTS A 65-year-old man underwent renal transplantation on 26 January 2022 due to chronic renal disease (grade 2) caused by focal sclerosing glomerulonephritis. Hyperammonaemia and coma occurred after the operation, and the patient died. A total of 38 case reports or series of cases were included in this study, involving 44 patients. The case reports included 22 cases of kidney transplantation, 11 cases of lung transplantation, 4 cases of heart transplantation,1 case of liver transplantation and 6 cases of multiple organ transplantation. Ureaplasma urealyticum infection occurred in 74.47% of cases within 1 month after transplantation, and the main symptoms after the infection were mental. After the onset of the disease, the most abnormal examination index was the increase of blood ammonia, followed by the increase of white blood cells. Therapeutic drugs included tetracyclines (doxycycline or minocycline), quinolones and azithromycin. The clinical symptoms could be significantly improved after 24 h of taking the fastest-acting medication. The highest mortality rate was in patients infected with Ureaplasma after lung transplantation. CONCLUSION Early identification of UU and timely and correct drug treatment are essential to saving the lives of patients.
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Affiliation(s)
- Hongru Zhang
- Department of Pharmacy, ZhangJiakou First Hospital, Zhangjiakou, Hebei Province, China
| | - Liping Yang
- Department of Pharmacy, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Key Laboratory of Assessment of Clinical Drugs Risk and Individual Application (Beijing Hospital), Beijing, China
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2
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Tadera K, Kitagawa H, Kitano H, Hara T, Kashiyama S, Nomura T, Omori K, Shigemoto N, Yokozaki M, Ohge H. Prevalence of Mycoplasma hominis, Ureaplasma urealyticum, and Ureaplasma parvum detection in urine and respiratory tract samples in Hiroshima, Japan. Heliyon 2023; 9:e14543. [PMID: 36967949 PMCID: PMC10036642 DOI: 10.1016/j.heliyon.2023.e14543] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 03/06/2023] [Accepted: 03/09/2023] [Indexed: 03/16/2023] Open
Abstract
Background Mycoplasma hominis, Ureaplasma parvum, and Ureaplasma urealyticum are commensal bacteria that are associated with colonization and infection of the urogenital tract. However, colonization of the respiratory tract by these microorganisms in adults has not been fully investigated. Methods Urine and respiratory tract samples (sputum, tracheal aspirates, and bronchoalveolar lavage) of patients aged 20-80 years were analyzed to detect the presence of M. hominis, U. parvum, and U. urealyticum using a conventional PCR method. The samples were submitted to the microbiological clinical laboratory of Hiroshima University Hospital from December 1, 2021 to May 31, 2022. Results In total, 334 urine and 238 respiratory tract samples were analyzed. The overall detection rates of M. hominis, U. parvum, and U. urealyticum were 2.9%, 1.7%, and 2.3% in male urine; 7.0%, 13.8%, and 1.9% in female urine; 2.2%, 0%, and 2.2% in male respiratory tract; and 0%, 2.0%, and 0% in female respiratory tract, respectively. In urine samples, the detection rates of M. hominis, U. parvum, and U. urealyticum were significantly higher (p < 0.001) for women (29/159; 18.2%) than for men (10/175; 5.7%); however, in respiratory tract samples, the detection rates were not significantly different (p = 0.70) between women (2/101; 2.0%) and men (5/137; 3.7%). Further, both the urine and respiratory samples of 83 patients were analyzed. Three male samples were positive for M. hominis or U. urealyticum, and M. hominis and U. urealyticum were matched in both the urine and respiratory tract samples: M. hominis (n = 1), U. urealyticum (n = 1), M. hominis + U. urealyticum (n = 1). Conclusion M. hominis, U. parvum, and U. urealyticum were detected in the respiratory tract of not only the young patients, but also of patients aged 50-60 years. Further studies are required to understand the relationship of these microorganisms in urogenital and respiratory tract samples with extra-genital infections.
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3
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Muramatsu E, Sakurai A, Kawabe Y, Ritsuno Y, Sasaki T, Tsutsumi Y, Isobe R, Jinno R, Ide T, Doi Y. Periprosthetic joint infection due to Mycoplasma hominis in a multiple sclerosis patient treated with fingolimod. J Infect Chemother 2022; 28:1672-1676. [PMID: 36064142 DOI: 10.1016/j.jiac.2022.08.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/23/2022] [Accepted: 08/19/2022] [Indexed: 10/14/2022]
Abstract
Mycoplasma hominis is a commensal pathogen normally found in urogenital tract of humans and has been associated with a wide variety of extra-genitourinary infections, such as mediastinitis, bacteremia, and septic arthritis, particularly in immunocompromised patients. Here, we present a case of a 48-year-old male, who had been treated with fingolimod for relapsing multiple sclerosis and presented with fever and right-sided hip pain following total hip arthroplasty. CT scan revealed localized fluid collection in the right quadriceps femoris muscle adjacent to the joint cavity of right hip. The percutaneously aspirated fluid grew M. hominis, which was also isolated from blood culture. With diagnosis of periprosthetic joint infection, the patient underwent surgical debridement with retained prosthesis and was treated with antimicrobial agents. Infected granulation tissues excised from the hip was observed under an electron microscope, which revealed electron-dense rounded structures contained in neutrophils, consistent with Mycoplasma particles. Fingolimod, an immunomodulatory drug that acts on the sphingosine-1-phosphate receptor and prevents the egress of lymphocytes from lymph nodes, might increase host susceptibility to a systemic M. hominis infection.
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Affiliation(s)
- Eriko Muramatsu
- Department of Infectious Diseases and Microbiology, Fujita Health University, School of Medicine, Aichi, Japan
| | - Aki Sakurai
- Department of Infectious Diseases and Microbiology, Fujita Health University, School of Medicine, Aichi, Japan.
| | - Yuka Kawabe
- Department of Pathology, Fujita Health University, School of Medicine, Aichi, Japan
| | - Yoshihiro Ritsuno
- Department of Orthopaedic Surgery, Fujita Health University, School of Medicine, Aichi, Japan; Department of Orthopaedic Surgery, Keio University, School of Medicine, Tokyo, Japan
| | - Toshiharu Sasaki
- Department of Infectious Diseases and Microbiology, Fujita Health University, School of Medicine, Aichi, Japan
| | - Yutaka Tsutsumi
- Diagnostic Pathology Clinic, Pathos Tsutsumi (Tsutsumi Byori Shindanka Clinic), Aichi, Japan
| | - Ryosuke Isobe
- Department of Clinical Microbiology, Fujita Health University Hospital, Aichi, Japan
| | - Rino Jinno
- Department of Clinical Microbiology, Fujita Health University Hospital, Aichi, Japan
| | - Tomihiko Ide
- Research Promotion Headquarters, Open Facility Center, Fujita Health University, School of Medicine, Aichi, Japan
| | - Yohei Doi
- Department of Infectious Diseases and Microbiology, Fujita Health University, School of Medicine, Aichi, Japan
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4
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Chang SY, Price TK, Beaird OE, Gaynor PT, Schaenman JM, Carlson ME, Kubak BM, Yang S, Multani A. Mycoplasma hominis
infections in solid organ transplant recipients: clinical characteristics, treatment outcomes, and comparison of phenotypic and genotypic susceptibility profiles. Transpl Infect Dis 2022; 24:e13822. [DOI: 10.1111/tid.13822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 01/25/2022] [Accepted: 02/22/2022] [Indexed: 12/01/2022]
Affiliation(s)
- Sandy Y. Chang
- Division of Infectious Diseases Department of Medicine David Geffen School of Medicine at UCLA Los Angeles CA USA
- Division of Infectious Diseases Department of Medicine Loma Linda University Loma Linda CA USA
| | - Travis K. Price
- Department of Pathology and Laboratory Medicine David Geffen School of Medicine at UCLA Los Angeles CA USA
| | - Omer E. Beaird
- Division of Infectious Diseases Department of Medicine David Geffen School of Medicine at UCLA Los Angeles CA USA
| | - Pryce T. Gaynor
- Division of Infectious Diseases Department of Medicine David Geffen School of Medicine at UCLA Los Angeles CA USA
| | - Joanna M. Schaenman
- Division of Infectious Diseases Department of Medicine David Geffen School of Medicine at UCLA Los Angeles CA USA
| | - Margrit E. Carlson
- Division of Infectious Diseases Department of Medicine David Geffen School of Medicine at UCLA Los Angeles CA USA
| | - Bernard M. Kubak
- Division of Infectious Diseases Department of Medicine David Geffen School of Medicine at UCLA Los Angeles CA USA
| | - Shangxin Yang
- Department of Pathology and Laboratory Medicine David Geffen School of Medicine at UCLA Los Angeles CA USA
| | - Ashrit Multani
- Division of Infectious Diseases Department of Medicine David Geffen School of Medicine at UCLA Los Angeles CA USA
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Kitagawa H, Shimizu H, Katayama K, Tadera K, Nomura T, Omori K, Shigemoto N, Takasaki T, Ohge H, Takahashi S. Postoperative mediastinitis after cardiac surgery caused by Mycoplasma hominis: a case report. Surg Case Rep 2021; 7:248. [PMID: 34812956 PMCID: PMC8611127 DOI: 10.1186/s40792-021-01326-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 11/07/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mycoplasma hominis is a human commensal bacterium of the urogenital tract, and extragenital infection caused by M. hominis has rarely been reported. The identification of M. hominis is challenging, and surgeons are generally not aware that this bacteria can cause postoperative infection. Here, we report a rare case of postoperative mediastinitis caused by M. hominis after cardiac surgery in an immunocompetent patient. CASE PRESENTATION A 54-year-old man presented with pain and purulent discharge from the wound after aortic valve replacement and patent foramen ovale closure. However, Gram staining and culture of bacteria from the purulent discharge was negative, and empiric sulbactam/ampicillin therapy was not effective. This patient developed mediastinitis and rupture of a pseudoaneurysm of the ascending aorta caused by mediastinitis, and re-operation was performed. Then, postoperative mediastinitis caused by M. hominis or Ureaplasma species was suspected and bacterial cultures targeting these pathogens were performed. M. hominis was identified from abscess and tissue obtained from the surgical site and urine. A final diagnosis of postoperative mediastinitis caused by M. hominis was determined. The patient was initially treated with levofloxacin and then with minocycline for 3 weeks. The patient's clinical condition improved; the patient was transferred to another hospital. CONCLUSION The role of M. hominis as a cause of postoperative infection might be underestimated in cardiac surgery. M. hominis should be considered when culture-negative purulent discharge is observed or there is no response to standard empiric treatment of postoperative infections.
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Affiliation(s)
- Hiroki Kitagawa
- Department of Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan. .,Department of Infectious Diseases, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan. .,Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
| | - Haruna Shimizu
- Department of Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Keijiro Katayama
- Department of Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Kayoko Tadera
- Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.,Section of Infection Diseases Laboratory, Department of Clinical Support, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.,Division of Clinical Laboratory Medicine, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Toshihito Nomura
- Department of Infectious Diseases, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Kietaro Omori
- Department of Infectious Diseases, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Norifumi Shigemoto
- Department of Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.,Department of Infectious Diseases, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.,Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.,Translational Research Center, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Taiichi Takasaki
- Department of Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Hiroki Ohge
- Department of Infectious Diseases, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.,Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Shinya Takahashi
- Department of Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
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6
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Ahmed J, Rawre J, Dhawan N, Khanna N, Dhawan B. Mycoplasma hominis: An under recognized pathogen. Indian J Med Microbiol 2020; 39:88-97. [PMID: 33610259 DOI: 10.1016/j.ijmmb.2020.10.020] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Mycoplasma hominis, a commensal of the genital tract, is a potential underestimated pathogen causing both genitourinary and extragenital infections including neonatal infections. Septic arthritis, prosthetic joint infection, central nervous system (CNS) infections, infective endocarditis and abscess formation are common extragenital infections associated mainly with immunocompromised patients. Mycoplasma hominis lipoproteins play an important role in pathogenicity and directly interact with the host immune system. Polymerase chain reaction (PCR) is the mainstay of diagnosis. Increasing resistance to tetracyclines and quinolones which are used for treatment, is a matter of global concern. We reviewed PubMed literature and Google search engine on the recent developments of association of Mycoplasma hominis with various diseases, pathogenesis, diagnosis and treatment.
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Affiliation(s)
- Jaweed Ahmed
- Department of Microbiology, AIIMS, New Delhi, India
| | - Jyoti Rawre
- Department of Microbiology, AIIMS, New Delhi, India
| | - Neha Dhawan
- Department of Dermatology and Venereology, Gandhi Medical College, Secunderabad, India
| | - Neena Khanna
- Department of Dermatology and Venereology, AIIMS, New Delhi, India
| | - Benu Dhawan
- Department of Microbiology, AIIMS, New Delhi, India.
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7
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Adams M, Bouzigard R, Al-Obaidi M, Zangeneh TT. Perinephric abscess in a renal transplant recipient due to Mycoplasma hominis: Case report and review of the literature. Transpl Infect Dis 2020; 22:e13308. [PMID: 32378787 DOI: 10.1111/tid.13308] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 04/06/2020] [Accepted: 04/25/2020] [Indexed: 11/26/2022]
Abstract
A 42-year-old man presented with nausea, malaise, and pain at his renal graft site 4 months following deceased donor renal transplant. His transplantation had been complicated by urinary leak with delayed wound closure requiring ureteral revision with biologic mesh placement. The initial evaluation in the hospital revealed urinalysis with significant pyuria as well as abdominal CT imaging concerning for abscess formation anterior to the grafted kidney. Interventional radiology (IR) guided drainage of this abscess yielded growth of Enterococcus faecalis treated with intravenous ampicillin/sulbactam. He continued to have pain at his graft site and repeat imaging revealed a persistent abscess despite prolonged antimicrobial therapy. Urine cultures isolated Mycoplasma species. A repeat aspirate of abscess fluid collected and Mycoplasma hominis was identified by molecular test. Patient's symptoms abated and his abscess completely resolved on repeat imaging after completing a course of oral moxifloxacin and doxycycline. His immunosuppression did not require adjustment and the renal graft continued to function well following this therapy. Mycoplasma and Ureaplasma should be considered as a potential etiology for perinephric abscess in renal transplant recipients.
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Affiliation(s)
- Matthew Adams
- Division of Infectious Diseases, Banner University Medical Center, University of Arizona, Tucson, Arizona, USA
| | - Rory Bouzigard
- Department of Medicine, Banner University Medical Center, University of Arizona, Tucson, Arizona, USA
| | - Mohanad Al-Obaidi
- Division of Infectious Diseases, Banner University Medical Center, University of Arizona, Tucson, Arizona, USA
| | - Tirdad T Zangeneh
- Division of Infectious Diseases, Banner University Medical Center, University of Arizona, Tucson, Arizona, USA
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8
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Hulme-Jones JP, Gordon DL, Barbara JA, Li JY. Mycoplasma hominis bursitis in a simultaneous pancreas-kidney transplant recipient: case report and literature review. Transpl Infect Dis 2020; 22:e13392. [PMID: 32603519 DOI: 10.1111/tid.13392] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 02/27/2020] [Accepted: 06/09/2020] [Indexed: 11/28/2022]
Abstract
Mycoplasma hominis can be isolated frequently from the genitourinary tract of some healthy individuals. On rare occasions, it acts as a pathogen in immunocompromised patients such as transplant recipients. Here, we describe the case of a 39-year-old man with end-stage kidney disease secondary to diabetic nephropathy who received a simultaneous pancreas-kidney transplant. He developed pancreatitis and arterial thrombosis 2 weeks post-transplant and required a pancreatectomy. His kidney allograft function remained normal. He developed severe left hip pain 2 weeks post-transplant with a trochanteric bursal effusion detected on magnetic resonance imaging. The effusion grew M. hominis. The patient was treated with 100 mg of doxycycline twice daily for 9 months with full resolution of the effusion at 4 months post-treatment. We also review all previously reported M. hominis infections in transplant recipients.
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Affiliation(s)
| | - David L Gordon
- Department of Microbiology and Infectious Disease, Flinders Medical Centre, Adelaide, SA, Australia.,College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Jeffrey A Barbara
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia.,Department of Renal Medicine, Flinders Medical Centre, Adelaide, SA, Australia
| | - Jordan Y Li
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia.,Department of Renal Medicine, Flinders Medical Centre, Adelaide, SA, Australia
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Alicja E, Małgorzata R, Małgorzata A, Elżbieta SG, Paweł C, Dominika S, Jarosław J, Michał H, Gayane M. Prevalence of urogenital mycoplasmas in women with systemic lupus erythematosus (SLE): preliminary study. Eur J Clin Microbiol Infect Dis 2019; 39:717-721. [PMID: 31832807 DOI: 10.1007/s10096-019-03783-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 11/28/2019] [Indexed: 10/25/2022]
Abstract
The aim of this study was to determine the occurrence of urogenital mycoplasmas in urogenital tract of women with systemic lupus erythematosus (SLE). The study group included 36 women diagnosed with SLE and 100 healthy controls. Mycoplasmas were detected with microculture and PCR in 13/36 (36.1%) women with SLE and in 25/100 (25%) controls. In both groups, U. parvum occurred significantly more frequently. M. genitalium was detected in 3/36 (8.3%) SLE patients and in 3/100 (3%) controls. FVU as a material decreased the number of positive results from 33.3% to 30.6% compared with swabs.Although the incidence of mycoplasmas in urogenital tract of women with SLE and controls did not differ statistically, it is important to consider them as a potential etiology of urogenital infection when clinical symptoms are present, but etiology is unknown or uncertain.
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Affiliation(s)
- Ekiel Alicja
- Department of Medical Microbiology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland.
| | - Romanik Małgorzata
- Department of Medical Microbiology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
| | - Aptekorz Małgorzata
- Department of Medical Microbiology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
| | - Semik-Grabarczyk Elżbieta
- Department of Internal, Autoimmune and Metabolic Diseases, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
| | - Cieślik Paweł
- Department of Internal, Autoimmune and Metabolic Diseases, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
| | - Smolec Dominika
- Department of Medical Microbiology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
| | - Jóźwiak Jarosław
- Department of Histology and Embryology Warsaw Medical University, Warsaw, Poland
| | - Holecki Michał
- Department of Internal, Autoimmune and Metabolic Diseases, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
| | - Martirosian Gayane
- Department of Medical Microbiology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
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10
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Abbo LM, Grossi PA. Surgical site infections: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice. Clin Transplant 2019; 33:e13589. [PMID: 31077619 DOI: 10.1111/ctr.13589] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Accepted: 05/06/2019] [Indexed: 02/06/2023]
Abstract
These guidelines from the Infectious Diseases Community of Practice of the American Society of Transplantation review the diagnosis, prevention, and management of post-operative surgical site infections (SSIs) in solid organ transplantation. SSIs are a significant cause of morbidity and mortality in SOT recipients. Depending on the organ transplanted, SSIs occur in 3%-53% of patients, with the highest rates observed in small bowel/multivisceral, liver, and pancreas transplant recipients. These infections are classified by increasing invasiveness as superficial incisional, deep incisional, or organ/space SSIs. The spectrum of organisms implicated in SSIs in SOT recipients is more diverse than the general population due to other important factors such as the underlying end-stage organ failure, immunosuppression, prolonged hospitalizations, organ transportation/preservation, and previous exposures to antibiotics in donors and recipients that could predispose to infections with multidrug-resistant organisms. In this guideline, we describe the epidemiology, clinical presentation, differential diagnosis, potential pathogens, and management. We also provide recommendations for the selection, dosing, and duration of peri-operative antibiotic prophylaxis to minimize post-operative SSIs.
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Affiliation(s)
- Lilian M Abbo
- Division of Infectious Diseases, Department of Medicine, University of Miami Miller School of Medicine and Jackson Health System, Miami, Florida
| | - Paolo Antonio Grossi
- Infectious Diseases Section, Department of Medicine and Surgery, University of Insubria, Varese, Italy
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