Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy.
Infectious Diseases Unit, Scientific Institute for Research, Hospitalization and Healthcare Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
Transpl Int. 2024 Aug 16;37:13245. doi: 10.3389/ti.2024.13245. eCollection 2024.
Perioperative antibiotic prophylaxis (PAP) in lung transplant recipients (LuTRs) has high heterogeneity between centers. Our aim was to investigate retrospectively the approach to PAP in our center over a 20-year period (2002-2023), and its impact on early post-operative infections (EPOIs) after lung transplantation (LuT). Primary endpoint was diagnosis of EPOI, defined as any bacterial infection including donor-derived events diagnosed within 30 days from LuT. Main exposure variables were type of PAP (combination vs. monotherapy) and PAP duration. We enrolled 111 LuTRs. PAP consisted of single-agent or combination regimens in 26 (25.2%) and 85 (74.8%) LuTR. Median PAP duration was 10 days (IQR 6-13) days. Piperacillin/tazobactam was the most common agent used either as monotherapy (n = 21, 80.7%) or as combination with levofloxacin (n = 79, 92.9%). EPOIs were diagnosed in 30 (27%) patients. At multivariable analysis no advantages were found for combination regimens compared to single-agent PAP in preventing EPOI (OR: 1.57, 95% CI: 0.488-5.068, p:0.448). The impact of PAP duration on EPOIs development was investigated including duration of PAP ≤6 days as main exposure variables, without finding a significantly impact (OR:2.165, 95% CI: 0.596-7.863, p: 0.240). Our results suggest no advantages for combination regimens PAP in preventing EPOI in LuTR.
肺移植受者（LuTR）围手术期抗生素预防（PAP）在各中心之间存在高度异质性。我们的目的是回顾性调查我们中心 20 年来（2002-2023 年）PAP 的方法及其对肺移植（LuT）后早期术后感染（EPOIs）的影响。主要终点是 EPOI 的诊断，定义为 LuT 后 30 天内诊断出的任何细菌感染，包括供体来源的感染。主要暴露变量是 PAP 的类型（联合治疗与单药治疗）和 PAP 的持续时间。我们共纳入 111 例 LuTR。26 例（25.2%）和 85 例（74.8%）LuTR 接受单药或联合方案 PAP。PAP 的中位持续时间为 10 天（IQR 6-13）天。哌拉西林/他唑巴坦是最常用的药物，无论是单独使用（n=21，80.7%）还是与左氧氟沙星联合使用（n=79，92.9%）。30 例（27%）患者诊断为 EPOIs。多变量分析显示，与单药 PAP 相比，联合方案 PAP 在预防 EPOI 方面没有优势（OR：1.57，95%CI：0.488-5.068，p：0.448）。我们还研究了 PAP 持续时间对 EPOIs 发展的影响，将 PAP 持续时间≤6 天作为主要暴露变量，但未发现 PAP 持续时间对 EPOIs 发展有显著影响（OR：2.165，95%CI：0.596-7.863，p：0.240）。我们的结果表明，联合方案 PAP 并不能预防 LuTR 的 EPOI。
