Optimal Perioperative Antimicrobial Management Strategies of Kidney Transplant Recipients Guided by Metagenomic Next-Generation Sequencing of Deceased Donors' Microbiology Samples

作者全名："Rao, Zhengsheng; Wang, Zhiling; Tang, Ming; Zhang, Keqin"

作者地址："[Rao, Zhengsheng; Wang, Zhiling; Tang, Ming; Zhang, Keqin] Chongqing Med Univ, Affiliated Hosp 2, Urinary Nephropathy Ctr, Chongqing, Peoples R China"

通信作者："Zhang, KQ (通讯作者)，Chongqing Med Univ, Affiliated Hosp 2, Urinary Nephropathy Ctr, Chongqing, Peoples R China."

来源：INFECTION AND DRUG RESISTANCE

ESI学科分类：IMMUNOLOGY

WOS号：WOS:001077752400001

JCR分区：Q2

影响因子：2.9

年份：2023

卷号：16

期号：　

开始页：6473

结束页：6486

文献类型：Article

关键词：kidney transplantation; metagenomic next-generation sequencing; donor-derived infection; perioperative infection; antimicrobial strategy

摘要："Background: There is no consensus on the optimal use of perioperative antibiotics prophylaxis after kidney transplantation, but there is a common trend to limit the duration of antibiotic use worldwide. Metagenomic next-generation sequencing (mNGS) has emerged as a novel technology for pathogen detection in clinical practice due to its noninvasive, rapid, precise and high susceptibility to detect infectious pathogens. However, data are lacking on whether mNGS analyses could be used to detect pathogens and guide anti-infection regimens in kidney transplant donors and recipients.Methods: We conducted a retrospective study to review all clinic data of mNGS and traditional laboratory methods (TMs) for pathogen detection in kidney transplant recipients and their corresponding deceased donors from August 1, 2021 to October 30, 2022 in our center.Results: A total of 57 donors and 112 of their corresponding recipients were included. The antimicrobial strategy mainly depended on mNGS results combined with traditional pathogen culture and clinical conditions. The percentages of positive pathogen detected by mNGS in blood, urine, bronchoalveolar lavage fluid (BALF) and preservation fluids (PFs) were 50.9% (29/57), 35.1% (20/57), 84.2% (48/57) and 54.4% (31/57) respectively, and were 24.6% (14/57), 15.8% (9/57), 57.9% (33/57) and 14.1% (8/57) respectively when using TMs. mNGS could detected all of pathogens which were detected by TMs. However, samples with negative TMs testing can be additionally detected as positive by mNGS (15/43 in blood, 11/48 in urine, 15/24 in BALF and 23/49 in PFs). Drug resistance genes were detected in 9 donors by mNGS,which were consistent with 6 donors by TMs. There was only one case of donor-derived infection in this study.Conclusion: This study showed that it is effective to combine mNGS with traditional pathogen detection methods and clinical features to develop optimal perioperative antimicrobial management strategies for deceased donor kidney transplantation."

基金机构：　

基金资助正文：