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Donor Derived Carbapenem Resistant Gram negative (CRGN) infections in solid organ transplant (SOT)
Universita degli Studi di Palermo
Infectious Diseases IRCCS-ISMETT Via Ernesto Tricomi, 5, 90127 Palermo PA, Italy
Dr. Alessandra Mularoni
Dr. Alessandra Mularoni
Type of Research Project
- Basic science
What is the background of the project?
Donor-derived-infections (DDIs) are a major challenge for transplant safety. In 2015 we published the largest series of MDR-DDI(Multidrugs-resistant/Donor derived infections). Principal reasons for transmission were delayed/inappropriate/incomplete treatment because donor-infection was either unrecognized/underestimated/miscommunicated. We then established an active surveillance system. More recently, reports of patients admitted to the intensive care unit (ICU) and exposed to multidrug-resistant (MDR) bacteria are available and, therefore, potential organ donors can be exposed to these organisms.
What is the aim of the project?
This study will assess the efficiency of the active surveillance system in prevention and management of unexpected DDIs.
What techniques and methods are used?
This study will be performed by implementing an active surveillance and operative protocol to guide pre-emptive treatment of high-risk recipients for Donor-derived-infections, i.e. recipients from donors with unknown blood stream infection (BSI)/infection of transplanted organ. For every transplant performed since Dec-2015, donor’s blood/urine/bronchoalveolar lavage samples are sent to our Institutes and set up for cultures. If positive, an infectious disease physician promptly starts targeted treatment. We will review treatments and outcomes of all high risk-recipients from Dec-2015 to Nov-2017. We will be evaluating patient records (from both donors and recipients), considering the differences between pre- and post-transplant scenarios, assessing whether the active surveillance system put in place has benefited transplant results.
What is the role of the student?
- The student will mainly observe
- The student will observe the practical experiments but will be highly involved in the analysis of the results
- If the project includes “lab work”
- the student will take active part in the practical aspect of the project
- The tasks will be done under supervision
What are the tasks expected to be accomplished by the student?
The student will be introduced to microscopic analysis and, through the help of laboratory coworkers, develop skills that will lead him/her to be able to work independently in such an environment: he/she will be able to conduct microbiological cultivations, using the appropriate culture media, and to perform and evaluate an antibiogram (antibiotic susceptibility testing techniques will be taught). By the end of the experience the student will have acquired, due to in-depth laboratory study, a proper knowledge regarding antibiotic drugs, their classification and the mechanisms of bacteria resistance. Furthermore, the student will review treatments and outcomes of all high risk recipients from Dec-2015 to today.
Will there be any theoretical teaching provided (preliminary readings, lectures, courses, seminars etc)
We will provide some preliminary readings concerning the abstract before the research project starts. Our doctors will involve the student in every step of the project, giving him/her theoretical and practical knowledge.
What is expected from the student at the end of the research exchange? What will be the general outcome of the student?
- No specific outcome is expected
What skills are required of the student? Is there any special knowledge or a certain level of studies needed?
Are there any legal limitations in the student’s involvement
Type of students accepted
This project accepts: - Medical students - Graduated students (less than 6 months)
- Gagliotti C; Morsillo F; Moro ML; Masiero L; Procaccio F; Vespasiano F; Pantosti A; Monaco M; Errico G; Ricci A; Grossi P; Nanni Costa A; SInT Collaborative Study Group. Infections in liver and lung transplant recipients: a national prospective cohort. Eur J Clin Microbiol Infect Dis. 2018 Mar;37(3):399-407.
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