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Antibiotic therapy in case of positive cultures of kidney transplant preservation fluid: a nationwide survey of prescribing practices

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Abstract

Our survey aimed to describe current prescribing practices for perioperative antibiotic prophylaxis in French kidney transplant centers. We conducted a nationwide cross-sectional clinical vignette-based survey that we sent via email to hospital practitioners involved in perioperative management of kidney transplant patients (KTR). Nearly half of practitioners contacted (182/427, 42.6%) were respondents. A total of 167 getting enough kidney transplant activity were eligible for the survey. The response rate was 50.7% (68/134) among interns and 33.8% (99/293) among seniors. Positive perfusion fluids (PF) cultures for methicillin-susceptible Staphylococcus aureus were associated with antibiotic prescribing in 35% of cases, with no difference in prescribing in patients with diabetes, obesity, or delayed graft function. Antibiotic prescribing was most frequent with Pseudomonas aeruginosa (67%) and Klebsiella pneumoniae strains producing extended spectrum β-lactamases (57%). About 77%, 16%, and 13% of respondents, respectively, reported the existence of local practice guidelines for surgical antibiotic prophylaxis, a standardized approach for antibiotic prescribing in case of positive kidney transplant PF cultures, and local practice guidelines for systematical antibiotic prophylaxis in the early post-transplant period. In France, antibiotic prophylaxis practices in the perioperative kidney transplant period are very heterogeneous. To prevent unnecessary prescribing and bacterial resistance, evidence-based practice guidelines should be developed.

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Acknowledgments

The authors would like to thank the participants who answered the survey.

Funding

There was no specific source of funding for this survey. This survey was conducted as part of our routine work.

Author information

Authors and Affiliations

  1. Dialysis and Transplantation Department, Université de Lorraine, CHRU-Nancy, Nephrology, F-54000, Nancy, France

    N. Le Berre, M. Ladrière, A. Corbel & L. Frimat

  2. Plateforme d’Aide à la Recherche Clinique, Université de Lorraine, CHRU-Nancy, F-54000, Nancy, France

    T. Remen & N. Thilly

  3. APEMAC, Université de Lorraine, F-54000, Nancy, France

    T. Remen, N. Thilly & C. Pulcini

  4. Agence de la Biomédecine, Direction Prélèvement Greffe organes – tissus, SRA Nord Est, 59120, Loos, France

    L. Durin

  5. Infectious Diseases Department, Université de Lorraine, CHRU-Nancy, F-54000, Nancy, France

    C. Pulcini

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  1. N. Le Berre
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Contributions

NLB, AC, NT, LF and CP launched the survey and drew up the first version of the protocol and the questionnaire. All other authors reviewed these documents. ML distributed the questionnaire. TR analyzed the results under the supervision of NT. NL and CP drafted the manuscript with the help of all other authors, who revised it critically. All authors approved the final version of the manuscript.

Corresponding author

Correspondence to N. Le Berre.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The survey was entirely anonymous. An authorization from an ethics committee was not needed according to French legislation. The survey complied with guidance for cross-sectional questionnaire surveys.

Informed consent

Consents were not required for this study.

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Le Berre, N., Ladrière, M., Corbel, A. et al. Antibiotic therapy in case of positive cultures of kidney transplant preservation fluid: a nationwide survey of prescribing practices. Eur J Clin Microbiol Infect Dis 39, 915–921 (2020). https://doi.org/10.1007/s10096-019-03808-4

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  • DOI: https://doi.org/10.1007/s10096-019-03808-4

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