Hospital Acquired Infections Among Solid Organ Transplant Recipients Hospitalized in Intensive Care Unit (2018-2024): A Study of the GiViTI Group.

IF 2.6 4区医学 Q3 IMMUNOLOGY

Transplant Infectious Disease Pub Date : 2025-10-23 DOI:10.1111/tid.70120

Camilla Genovese, Martina Offer, Marta Colaneri, Francesca Dore, Giorgia Montrucchio, Giovanni Scaglione, Gianpaola Monti, Alessandra Bandera, Bruno Viaggi, Andrea Gori, Emanuele Palomba, Andrea Lombardi, Stefano Finazzi

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引用次数: 0

Abstract

Introduction: Limited data exist regarding the burden of intensive care unit (ICU)-acquired infections in the early post-solid organ transplant (SOT) period, particularly in multidrug resistant organisms-endemic settings. This study aims at describing the epidemiology, clinical characteristics, and outcomes of patients who developed an ICU-acquired infection following a SOT procedure in Italy from 2018 to 2024.

Methods: A multicenter, retrospective study was conducted within the Italian PROSAFE project across 31 ICUs from 2018 to 2024. All adult patients admitted to ICU during the same hospitalization as their organ transplant procedure were included. Bloodstream infections, ventilator associated pneumonia, intra-abdominal infections, and urinary tract infections occurring more than 48 h after ICU admission were retrieved.

Results: Among 2210 SOT recipients, 154 (6.9%) developed 193 ICU-acquired infections. Ventilator associated pneumonia was the most frequent (74, 38.3%), followed by bloodstream infections (56, 29%). Multidrug resistant organisms were identified in 34/87 (39%) isolates with available antibiogram. ICU-acquired infections were associated with significantly higher intra-ICU mortality (35/154, 22.4% vs. 49/2056, 2.4%; p < 0.001) and longer ICU stays (24 vs. 4 days; p < 0.001). Patients with infections due to multidrug resistant organisms showed higher mortality and length of stay.

Conclusions: ICU-acquired infections occurred in nearly 7% of SOT recipients admitted to ICU following a SOT procedure, with a significant contribute of multidrug resistant organisms. These infections were associated with striking differences in mortality and length of stay. Finally, this study suggested that patients with MDRO infections showed trends toward higher mortality and length of stay.

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重症监护病房住院实体器官移植受者医院获得性感染（2018-2024）：GiViTI组的研究

关于实体器官移植（SOT）后早期重症监护病房（ICU）获得性感染负担的数据有限，特别是在多药耐药生物流行环境中。本研究旨在描述2018年至2024年意大利SOT手术后发生icu获得性感染的患者的流行病学、临床特征和结果。方法：在意大利PROSAFE项目中，对2018年至2024年31个icu进行了多中心回顾性研究。所有在接受器官移植手术的同一住院期间入住ICU的成年患者均被纳入研究。收集ICU入院后48 h以上发生的血流感染、呼吸机相关性肺炎、腹腔感染和尿路感染。结果：2210例接受SOT者中，154例（6.9%）发生了193例icu获得性感染。呼吸机相关性肺炎是最常见的（74,38.3%），其次是血流感染（56,29%）。87株菌株中有34株（39%）存在多重耐药菌。重症监护病房获得性感染与ICU内死亡率显著升高相关(35/154,22.4% vs. 49/2056, 2.4%； p结论：重症监护病房获得性感染发生在SOT手术后入住ICU的近7%的SOT受者中，其中多药耐药菌占很大比例。这些感染与死亡率和住院时间的显著差异有关。最后，本研究表明，MDRO感染的患者呈现出更高的死亡率和住院时间的趋势。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Transplant Infectious Disease 医学-传染病学

CiteScore

5.30

自引率

7.70%

发文量

210

审稿时长

4-8 weeks

期刊介绍： Transplant Infectious Disease has been established as a forum for presenting the most current information on the prevention and treatment of infection complicating organ and bone marrow transplantation. The point of view of the journal is that infection and allograft rejection (or graft-versus-host disease) are closely intertwined, and that advances in one area will have immediate consequences on the other. The interaction of the transplant recipient with potential microbial invaders, the impact of immunosuppressive strategies on this interaction, and the effects of cytokines, growth factors, and chemokines liberated during the course of infections, rejection, or graft-versus-host disease are central to the interests and mission of this journal. Transplant Infectious Disease is aimed at disseminating the latest information relevant to the infectious disease complications of transplantation to clinicians and scientists involved in bone marrow, kidney, liver, heart, lung, intestinal, and pancreatic transplantation. The infectious disease consequences and concerns regarding innovative transplant strategies, from novel immunosuppressive agents to xenotransplantation, are very much a concern of this journal. In addition, this journal feels a particular responsibility to inform primary care practitioners in the community, who increasingly are sharing the responsibility for the care of these patients, of the special considerations regarding the prevention and treatment of infection in transplant recipients. As exemplified by the international editorial board, articles are sought throughout the world that address both general issues and those of a more restricted geographic import.