Comparison of Solid Organ Transplant

Study Overview
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Brief Summary
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Solid organ transplant (SOT) recipients have increased incidence of infections with MDRO pathogens. This difference leads to a disparity in antibiograms between SOT recipients and other hospitalized patients.

Detailed Description
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There is limited guidance for empiric antimicrobial therapy in this population. Local epidemiology plays a voluble role in managing infections empirically within the hospital setting. Antibiograms can serve as a critical tool in optimizing empiric antimicrobial decisions. Refining antibiogram data to specific populations such as SOT patients may allow for timelier and appropriate empiric use of antimicrobials, and improve clinical outcomes. Time to appropriate therapy (antimicrobial testing susceptible in vitro to the pathogen identified) is of vital importance in management of serious infections. SOT may have different resistance rates at Methodist Dallas Medical Center making the applicability of the yearly hospital-wide antibiogram unknown for use in this specialized patient population. A SOT-Specific antibiogram may highlight common resistance patterns identified in pathogens seen in this patient population. Additionally, this investigation may further emphasize the importance of antimicrobial stewardship activities such as: appropriate empiric antibacterial decisions, de-escalation, and effective durations of therapy.

Official Title
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Comparison of Solid Organ Transplant Specific and Hospital-wide Gram-Negative Antibiograms

Conditions
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Gram-Negative Bacterial Infections, Gram-negative Bacteremia, Multidrug-Resistant Organism, Hospital-acquired Pneumonia, Healthcare-associated Pneumonia

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 18 years or older Exclusion Criteria: Missing data necessary to determine study outcomes

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Creation of a liver transplant specific antibiogram | Creation of a liver transplant specific antibiogram (cumulative susceptibility rates per bacterial organism for select antibiotics) | Jan 1, 2012 - December 31, 2016 | 
| Creation of a kidney transplant specific antibiogram | Creation of a kidney transplant specific antibiogram (cumulative susceptibility rates per bacterial organism for select antibiotics) | Jan 1, 2012 - December 31, 2016 | 
| Comparison of SOT | Comparison of SOT (liver and kidney) antibiograms with the hospital-wide antibiogram | Jan 1, 2012 - December 31, 2016 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Creation of transplant antibiogram for subgroups | Creation of transplant antibiogram for subgroups of patients including the following: ICU patients, Kidney transplant urinary tract infections (UTI), SOT bloodstream infections (BSI) | Jan 1, 2012 - December 31, 2016 | 
| Identification of risk factors among liver transplant recipients | Identification of risk factors among liver transplant recipients for vancomycin-resistant enterococci infections | Jan 1, 2012 - December 31, 2016 |