Successful use of gentamycin as an antibiotic prophylaxisregimen to reduce the rate of healthcare-associatedinfections after renal transplantation / Successful use of gentamycin as an antibiotic prophylaxis regimen to reduce the rate of healthcare-associated infections after renal transplantation

ABSTRACT

At our institution, we observed an increase in the incidence of healthcare-associated infections(HAI) due to Gram-negative bacilli, including three cases of carbapenem-resistantKlebsiella pneumoniae, among patients who underwent renal transplantation. In additionto strengthening infection control measures, we chose to add gentamycin to the antibioticprophylaxis regimen of patients undergoing renal transplantation. We assessed the numberof HAI occurring within 30 days of renal transplantation during two time periods (1) the preinterventionperiod, between September 2009 and June 2010, and (2) the post-interventionperiod, between July 2010 and April 2011. The intervention consisted of the addition of gentamycinto the surgical antibiotic prophylaxis regimen. The percentage of patients withHAIs was 31% lower during the post-intervention period (p = 0.03), with the greatest reductionsobserved for urinary tract infections (p = 0.024). Carbapenem-resistant K. pneumoniaewas not isolated during this period. The investigated patients did not exhibit worseningrenal function. Further studies are needed to assess antibiotic prophylaxis in renal transplantationpatients at institutions where there is a high prevalence of multidrug-resistantGram-negative bacteria.