193. Donor Derived Bacterial Infections: Report From the Disease Transmission Advisory Committee (DTAC)
Session: Abstracts: Oral Abstract Session: Transplant Associated Infections
Friday, October 22, 2010: 11:45 AM
11-12

Donor Derived Bacterial Infections: Report from the Disease Transmission Advisory Committee (DTAC)

Emily Blumberg,  Michael Green, Shandie Covington, Sarah Taranto, Kimberly Taylor, Kimberly Parker, Peter Chin-Hong, Michael DiMaio, Jon P. Gockerman, Rick Hasz, Bernie Kubak, Dan Lebovitz, Tim Pruett, Alison Smith, Lewis Teperman, Brahm Vasudev, Michael Nalesnik, Michael G. Ison for the OPTN DTAC.  UNOS, Richmond, Virginia

Background: Donor derived bacterial infections (DDBI) are an uncommon but serious complication of organ transplantation, potentially resulting in allograft loss & patient death.

Methods: The DTAC database was reviewed for cases of potential DDBI reported from 2006 to 2009. Cases were analyzed for bacterial pathogen, culture site & risk for infection, organs transplanted, antimicrobials, as well as allograft and patient outcomes.  Mycobacterial infections were excluded from this analysis.

Results: 38 cases of potential DDBI were reported to DTAC.  14 cases of infection resulted in 25 recipients with transmitted DDBI.  2 donors with Ehrlichia resulted in 2/3 recipient transmission; all survived.  1 case of Legionella possibly transmitted infection to 1/6 recipients (lung only). 11 donors with pyogenic bacteria transmitted infections to 22 recipients (see Table 1); none of the affected recipients received appropriate antibiotic prophylaxis. 8 recipients expired, 2 others lost grafts; mycotic aneurysms, were common, especially with Gram negative infection.  There were 16 donors with bacterial infections that did not result in transmission to 34 recipients (including 6 from pyogenic bacteria, 6 with syphilis) following receipt of appropriate antibiotics.

Conclusion: DDBI can be a significant cause of morbidity and mortality in organ transplant recipients, especially when grossly contaminated organs used or in the absence of prompt administration of appropriate prophylactic antimicrobials.


Subject Category: O. Transplant infectious diseases

Speakers:
Emily Blumberg, MD, FIDSA , Department of Medicine, Division of Infectious Diseases, University of Pennsylvania School of Medicine, Philadelphia, PA
Michael Green, MD, FIDSA , Children's Hospital of Pittsburgh, Pittsburgh, PA
Shandie Covington , UNOS, Richmond, VA
Sarah Taranto , UNOS, Richmond, VA
Kimberly Taylor , UNOS, Richmond, VA
Kimberly Parker , UNOS, Richmond, VA
Peter Chin-Hong, MD , UNOS, Richmond, VA
Michael DiMaio, MD , UNOS, Richmond, VA
Jon Gockerman, MD , UNOS, Richmond, VA
Rick Hasz , UNOS, Richmond, VA
Bernard M. Kubak, PhD, MD , Medicine - Infectious Diseases, David Geffen School of Medicine at UCLA, Los Angeles, CA
Dan Lebovitz, MD , UNOS, Richmond, VA
Tim Pruett, MD , UNOS, Richmond, VA
Alison Smith , UNOS, Richmond, VA
Lew Teperman, MD , UNOS, Richmond, VA
Brahm Vasudev, MD , UNOS, Richmond, VA
Michael Nalesnik, MD , UNOS, Richmond, VA
Michael G. Ison, MD, MS , Medicine, Northwestern University, Chicago, IL

Disclosures:

E. Blumberg, None

M. Green, None

S. Covington, None

S. Taranto, None

K. Taylor, None

K. Parker, None

P. Chin-Hong, None

M. DiMaio, None

J. Gockerman, None

R. Hasz, None

B. M. Kubak, None

D. Lebovitz, None

T. Pruett, None

A. Smith, None

L. Teperman, None

B. Vasudev, None

M. Nalesnik, None

M. G. Ison, None


Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 21 with the exception of research findings presented at IDSA press conferences.

 
 
   
 

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