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Journal of Transplantation
Volume 2012, Article ID 135738, 5 pages
Research Article

Targeted Antibiotic Prophylaxis for Lung Transplantation in Cystic Fibrosis Patients Colonised with Pseudomonas aeruginosa Using Multiple Combination Bactericidal Testing

1Institute of Transplantation, The Freeman Hospital, Newcastle upon Tyne NHS Hospitals Trust, High Heaton, Newcastle upon Tyne NE7 7DN, UK
2Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne NE2 4HH, UK
3Department of Medical Microbiology, The Freeman Hospital, Newcastle upon Tyne NHS Hospitals Trust, High Heaton, Newcastle upon Tyne NE7 7DN, UK

Received 27 January 2012; Revised 4 June 2012; Accepted 6 June 2012

Academic Editor: Gaetano Ciancio

Copyright © 2012 Helmy Haja Mydin et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Early infection is a recognised complication after lung transplantation in patients with cystic fibrosis (CF). Our centre uses multiple combination bactericidal testing (MCBT) when determining appropriate peritransplant prophylactic regimens. To evaluate our strategy, we compared the incidence of posttransplant infection in patients whose peritransplant antimicrobial regimens were determined using MCBT versus standard sensitivity testing. Patients with CF who were infected with Pseudomonas aeruginosa and underwent lung transplantations between 2000 and 2010 were included. Data was collected from clinical records and our microbiology database. Microorganisms cultured were mapped against antibiotic resistance, method of sensitivity testing, and antibiotics administered peritransplant. 129 patients were identified (mean age 28, male : female, 63 : 66). Fifty patients (38.8%) had antibiotics determined by MCBT. Two patients in the MCBT group developed septicaemia, 13 in the conventional group ( 𝑃 0 . 0 5 , 2-tailed Fisher's test). Sepsis was attributable to P. aeruginosa in one patient from the MCBT group and seven patients in the conventional group ( 𝑃 = 0 . 1 5 ). P. aeruginosa was recovered from the posttransplant pleural fluid of one patient who received MCBT-guided prophylaxis, six patients in the conventional group ( 𝑃 = 0 . 2 5 ). Patients given antibiotics based on MCBT had significantly lower rates of septicaemia and lower rates of empyema.