title: Clinical impact of bacterial contamination of perfusion fluid in kidney transplantation.
abstract: Contamination of perfusion fluid (PF) could lead to serious infections in kidney transplant recipients. Preemptive therapy (PE-T) in case of yeast contamination of PF is mandatory. The usefulness of PE-T in presence of bacteria remains unclear. In this study we evaluated the incidence of PF bacterial contamination and the impact of PE-T on clinical outcome. Microbiological data of 290 PF and clinical data of the corresponding recipients collected in our hospital from January 2010 and December 2012 were analyzed. Recipients with bacterial contaminated PF (101) were divided in 3 groups: group 1 (n = 52) PE-T treated bacteria resistant to perioperative antibiotic prophylaxis (PAP), group 2 (n = 28) bacteria sensitive to PAP, group 3 (n = 21) PE-T-untreated bacteria resistant to PAP. Incidence of positive PF was 34.8 %, 50.4 % staphylococci, 9.9 % C. albicans. No significant differences in the rate of PF-related infections between the three groups were found. In conclusion, although PF contamination is frequent, the incidence of PF-related infections is very low. In addition, in this study PE-T did not help to reduce the rate of PF-related infection suggesting that a resonable reduction in the use of antibiotic terapy could be made. However, waiting for largest and prospective clinical trials to confirm our findings, a closely clinical and microbiologic monitoring of the recipient is highly recommended in case of PF contamination.
authors.affiliation: Renal Transplantation Center "A. Vercellone", Division of Nephrology Dialysis and Transplantation, Department of Medical Sciences, Città della Salute e della Scienza Hospital and University of Torino, Corso Dogliotti 14, 10126 Turin, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Ranghino
authors.affiliation: Renal Transplantation Center "A. Vercellone", Division of Nephrology Dialysis and Transplantation, Department of Medical Sciences, Città della Salute e della Scienza Hospital and University of Torino, Corso Dogliotti 14, 10126 Turin, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Diena
authors.affiliation: Renal Transplantation Center "A. Vercellone", Division of Nephrology Dialysis and Transplantation, Department of Medical Sciences, Città della Salute e della Scienza Hospital and University of Torino, Corso Dogliotti 14, 10126 Turin, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Simonato
authors.affiliation: Renal Transplantation Center "A. Vercellone", Division of Nephrology Dialysis and Transplantation, Department of Medical Sciences, Città della Salute e della Scienza Hospital and University of Torino, Corso Dogliotti 14, 10126 Turin, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Messina
authors.affiliation: Renal Transplantation Center "A. Vercellone", Division of Nephrology Dialysis and Transplantation, Department of Medical Sciences, Città della Salute e della Scienza Hospital and University of Torino, Corso Dogliotti 14, 10126 Turin, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Burdese
authors.affiliation: Nephrology and Dialysis Unit, University of Magna Grecia, Catanzaro, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Piraina
authors.affiliation: Renal Transplantation Center "A. Vercellone", Division of Nephrology Dialysis and Transplantation, Department of Medical Sciences, Città della Salute e della Scienza Hospital and University of Torino, Corso Dogliotti 14, 10126 Turin, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Fop
authors.affiliation: Renal Transplantation Center "A. Vercellone", Division of Nephrology Dialysis and Transplantation, Department of Medical Sciences, Città della Salute e della Scienza Hospital and University of Torino, Corso Dogliotti 14, 10126 Turin, Italy.
authors.forename: G P
authors.initials: GP
authors.lastname: Segoloni
authors.affiliation: Renal Transplantation Center "A. Vercellone", Division of Nephrology Dialysis and Transplantation, Department of Medical Sciences, Città della Salute e della Scienza Hospital and University of Torino, Corso Dogliotti 14, 10126 Turin, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Biancone
keywords: Bacterial contamination; Kidney transplant; Perfusion fluid; Perioperative antibiotic prophylaxis; Preemptive therapy