Session Type: ePosters
Session Title: ePosters
Authors(s): P.W. Schreiber (1), B.M. Lang (2), K. Boggian (3), D. Neofytos (4), C. Van Delden (4), A. Egli (5), M. Dickenmann (2), S. Hillinger (6), C. Hirzel (7), O. Manuel (8), F. Desgranges (8), M. Koller (2), S. Rossi (2), S. Stampf (2), M. Wilhelm (9), S. Kuster (1), N. Müller (1)
Authors Affiliations(s): (1) University Hospital Zurich, Division of Infectious Diseases and Hospital Epidemiology and University Zurich, Switzerland, (2) University Hospital Basel, Division of Transplantation Immunology and Nephrology, Switzerland, (3) Cantonal Hospital St. Gallen, Division of Infectious Diseases and Hospital Hygiene, Switzerland, (4) University Hospitals Geneva, Transplant Infectious Diseases, Division of Infectious Diseases and University of Geneva, Switzerland, (5) University Hospital Basel, Division of Clinical Bacteriology and Mycology, Switzerland, (6) University Hospital Zurich, Department of Thoracic Surgery, Switzerland, (7) Bern University Hospital, Department of Infectious Diseases and University of Bern, Switzerland, (8) University Hospital (CHUV), Infectious Diseases Service and University of Lausanne, Switzerland, (9) University Hospital Zurich, Department of Cardiovascular Surgery, Switzerland
Third Party Affiliation: Swiss Transplant Cohort Study
Background:
Surgical site infections (SSI) represent one of the most common hospital-acquired infections (HAI). The occurrence of SSIs in the early post-transplant course poses a relevant threat for heart (HTR) and lung transplant recipients (LTR). Considering the paucity of data, we analyzed HTR and LTR registered within the Swiss Transplant Cohort Study (STCS).
Methods:The STCS dataset was used to identify adult HTR and LTR with a potential follow up of at least 90 days post-transplant between 2008 and 2020. Diagnosis and categorization of SSIs was based on adapted Centers for Disease Control and Prevention (CDC) criteria (extension of the time period for a transplant-related SSI to 90 days post-transplant). Except for the categorization of SSIs, all other data were prospectively collected. Risk factors for SSIs were investigated with logistic regression. Cox proportional hazard models were applied to address the impact of SSIs on patient and graft survival.
Results:Of 356 HTR, 31 (8.7%) individuals with totally 32 transplant-related SSIs were identified: 5 (15.6%) superficial incisional, 17 (53.1%) deep incisional and 10 (31.2%) organ/space SSIs. Among 450 LTR, 23 SSIs occurring in 21 (4.7%) individuals were reported: 3 (13%) superficial incisional, 11 (47.8%) deep incisional SSIs and 7 (30.4%) organ/space SSIs. The majority of SSIs were caused by bacteria, most frequently coagulase-negative staphylococci (HTR 36.4%, LTR 18.5%) and Enteroccus spp (HTR 18.2%, LTR 22.2%). Among HTR, preexisting diabetes mellitus tended to a higher risk for SSI (odds ratio (OR) 2.1, 95% confidence interval (95%CI) 0.923-4.81; P=0.075), whereas male sex was a risk factor for LTR (OR 3.28, 95%CI 1.18, 9.06; P=0.02). Failure-free survival was poorer in LTR with a SSI (Log-rank 10.82, P=0.001) (Figure 1). In multivariable Cox-proportional hazard models, SSIs were associated with an increased risk for patient death and graft loss in LTR (hazard ratio (HR) 2.48, 95%CI 1.46-4.24; P=0.003), whilst we did not detect an association in HTR (Figure 2).
Conclusions:
After both, HTR or LTR, we observed a relatively low incidence of SSIs with a predominance of gram-positive pathogens. LTR with SSI within 90 days post-transplantation were found to experience impaired failure-free survival as compared to those without SSI.
Keyword(s): surgical site infection, heart transplantation, lung transplantationCOI Fees: Yes
COI Other: PWS received travel grants from Pfizer and Gilead, speaker’s honorary from Pfizer outside of the submitted work.PWS is supported by the academic career program ‘Filling the Gap’ of the Medical Faculty of the University of Zurich.
Session Type: ePosters
Session Title: ePosters
Authors(s): P.W. Schreiber (1), B.M. Lang (2), K. Boggian (3), D. Neofytos (4), C. Van Delden (4), A. Egli (5), M. Dickenmann (2), S. Hillinger (6), C. Hirzel (7), O. Manuel (8), F. Desgranges (8), M. Koller (2), S. Rossi (2), S. Stampf (2), M. Wilhelm (9), S. Kuster (1), N. Müller (1)
Authors Affiliations(s): (1) University Hospital Zurich, Division of Infectious Diseases and Hospital Epidemiology and University Zurich, Switzerland, (2) University Hospital Basel, Division of Transplantation Immunology and Nephrology, Switzerland, (3) Cantonal Hospital St. Gallen, Division of Infectious Diseases and Hospital Hygiene, Switzerland, (4) University Hospitals Geneva, Transplant Infectious Diseases, Division of Infectious Diseases and University of Geneva, Switzerland, (5) University Hospital Basel, Division of Clinical Bacteriology and Mycology, Switzerland, (6) University Hospital Zurich, Department of Thoracic Surgery, Switzerland, (7) Bern University Hospital, Department of Infectious Diseases and University of Bern, Switzerland, (8) University Hospital (CHUV), Infectious Diseases Service and University of Lausanne, Switzerland, (9) University Hospital Zurich, Department of Cardiovascular Surgery, Switzerland
Third Party Affiliation: Swiss Transplant Cohort Study
Background:
Surgical site infections (SSI) represent one of the most common hospital-acquired infections (HAI). The occurrence of SSIs in the early post-transplant course poses a relevant threat for heart (HTR) and lung transplant recipients (LTR). Considering the paucity of data, we analyzed HTR and LTR registered within the Swiss Transplant Cohort Study (STCS).
Methods:The STCS dataset was used to identify adult HTR and LTR with a potential follow up of at least 90 days post-transplant between 2008 and 2020. Diagnosis and categorization of SSIs was based on adapted Centers for Disease Control and Prevention (CDC) criteria (extension of the time period for a transplant-related SSI to 90 days post-transplant). Except for the categorization of SSIs, all other data were prospectively collected. Risk factors for SSIs were investigated with logistic regression. Cox proportional hazard models were applied to address the impact of SSIs on patient and graft survival.
Results:Of 356 HTR, 31 (8.7%) individuals with totally 32 transplant-related SSIs were identified: 5 (15.6%) superficial incisional, 17 (53.1%) deep incisional and 10 (31.2%) organ/space SSIs. Among 450 LTR, 23 SSIs occurring in 21 (4.7%) individuals were reported: 3 (13%) superficial incisional, 11 (47.8%) deep incisional SSIs and 7 (30.4%) organ/space SSIs. The majority of SSIs were caused by bacteria, most frequently coagulase-negative staphylococci (HTR 36.4%, LTR 18.5%) and Enteroccus spp (HTR 18.2%, LTR 22.2%). Among HTR, preexisting diabetes mellitus tended to a higher risk for SSI (odds ratio (OR) 2.1, 95% confidence interval (95%CI) 0.923-4.81; P=0.075), whereas male sex was a risk factor for LTR (OR 3.28, 95%CI 1.18, 9.06; P=0.02). Failure-free survival was poorer in LTR with a SSI (Log-rank 10.82, P=0.001) (Figure 1). In multivariable Cox-proportional hazard models, SSIs were associated with an increased risk for patient death and graft loss in LTR (hazard ratio (HR) 2.48, 95%CI 1.46-4.24; P=0.003), whilst we did not detect an association in HTR (Figure 2).
Conclusions:
After both, HTR or LTR, we observed a relatively low incidence of SSIs with a predominance of gram-positive pathogens. LTR with SSI within 90 days post-transplantation were found to experience impaired failure-free survival as compared to those without SSI.
Keyword(s): surgical site infection, heart transplantation, lung transplantationCOI Fees: Yes
COI Other: PWS received travel grants from Pfizer and Gilead, speaker’s honorary from Pfizer outside of the submitted work.PWS is supported by the academic career program ‘Filling the Gap’ of the Medical Faculty of the University of Zurich.