INTRODUCTION: Solid organ transplant recipients are especially susceptible to healthcare-associated infections with Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (KPC-Kp-HAIs). The aim of the study was to evaluate risk factors and outcome of these infections in kidney transplant recipients. METHODS: This was a retrospective cohort of kidney transplant (KTx) recipients between January 2009 and December 2013. Cases were defined as patients who developed KPC-Kp-HAI, confirmed by PCR for bla( KPC) gene after KTx during the study period. We analysed variables related to recipient; induction immunosuppressant therapy; delayed graft function; use of invasive devices; SOFA score on the first day of infection; type of therapy; time from positive culture to appropriate antimicrobial therapy; bacteraemia; and concomitant infection. Outcome measures were the occurrence of KPC-Kp-HAI and 30-day mortality after KPC-Kp-HAI. RESULTS: A total of 1,101 were submitted to KTx in the period, 21 patients were classified as infected with KPC-Kp. Another ten patients had KPC-Kp-HAI in the period and were transplanted before 2009. Of those 31 patients, 48.4 % showed evidence of prior colonization and 38.7 % had bacteraemia. The most common site of infection was the surgical wound. Risk factors for KPC-Kp-HAI were multi-organ transplantation and the use of a ureteral stent. Eight of the infected patients experienced recurrence of the infection. The 30-day mortality rate was 41.9 %. Survival was significantly lower among the patients with KPC-Kp-HAI (72 vs. 89.1 %; P = 0.002). The only risk factor independently associated with 30-day mortality was an elevated SOFA score on the first day of infection. CONCLUSIONS: In KTx recipients, the occurrence of KPC-Kp-HAI was related to invasive devices and type of transplant; these infections had a high rate of recurrence and reduced survival after KTx.
INTRODUCTION: Solid organ transplant recipients are especially susceptible to healthcare-associated infections with Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (KPC-Kp-HAIs). The aim of the study was to evaluate risk factors and outcome of these infections in kidney transplant recipients. METHODS: This was a retrospective cohort of kidney transplant (KTx) recipients between January 2009 and December 2013. Cases were defined as patients who developed KPC-Kp-HAI, confirmed by PCR for bla( KPC) gene after KTx during the study period. We analysed variables related to recipient; induction immunosuppressant therapy; delayed graft function; use of invasive devices; SOFA score on the first day of infection; type of therapy; time from positive culture to appropriate antimicrobial therapy; bacteraemia; and concomitant infection. Outcome measures were the occurrence of KPC-Kp-HAI and 30-day mortality after KPC-Kp-HAI. RESULTS: A total of 1,101 were submitted to KTx in the period, 21 patients were classified as infected with KPC-Kp. Another ten patients had KPC-Kp-HAI in the period and were transplanted before 2009. Of those 31 patients, 48.4 % showed evidence of prior colonization and 38.7 % had bacteraemia. The most common site of infection was the surgical wound. Risk factors for KPC-Kp-HAI were multi-organ transplantation and the use of a ureteral stent. Eight of the infectedpatients experienced recurrence of the infection. The 30-day mortality rate was 41.9 %. Survival was significantly lower among the patients with KPC-Kp-HAI (72 vs. 89.1 %; P = 0.002). The only risk factor independently associated with 30-day mortality was an elevated SOFA score on the first day of infection. CONCLUSIONS: In KTx recipients, the occurrence of KPC-Kp-HAI was related to invasive devices and type of transplant; these infections had a high rate of recurrence and reduced survival after KTx.
Authors: L Linares; C Cervera; I Hoyo; G Sanclemente; F Marco; F Cofán; M J Ricart; M Navasa; A Moreno Journal: Transplant Proc Date: 2010-10 Impact factor: 1.066
Authors: Maristela P Freire; Ioannis M Antonopoulos; Affonso Celso Piovesan; Maria L Moura; Flávio Jota de Paula; Fernanda Spadão; Thais Guimarães; Elias David-Neto; William C Nahas; Ligia C Pierrotti Journal: Transplantation Date: 2015-03 Impact factor: 4.939
Authors: S M Garonzik; J Li; V Thamlikitkul; D L Paterson; S Shoham; J Jacob; F P Silveira; A Forrest; R L Nation Journal: Antimicrob Agents Chemother Date: 2011-05-09 Impact factor: 5.191
Authors: E Vidal; J Torre-Cisneros; M Blanes; M Montejo; C Cervera; J M Aguado; O Len; J Carratalá; E Cordero; G Bou; P Muñoz; A Ramos; M Gurguí; N Borrell; J Fortún Journal: Transpl Infect Dis Date: 2012-06-01 Impact factor: 2.228
Authors: M D Bergamasco; M Barroso Barbosa; D de Oliveira Garcia; R Cipullo; J C M Moreira; C Baia; V Barbosa; C S Abboud Journal: Transpl Infect Dis Date: 2011-10-28 Impact factor: 2.228
Authors: G B Orsi; A Bencardino; A Vena; A Carattoli; C Venditti; M Falcone; A Giordano; M Venditti Journal: Infection Date: 2012-10-16 Impact factor: 3.553
Authors: Maristela Pinheiro Freire; Isabel C V S Oshiro; Ligia C Pierrotti; Patricia R Bonazzi; Larissa M de Oliveira; Alice T W Song; Carlos H Camargo; Inneke M van der Heijden; Flavia Rossi; Silvia F Costa; Luiz A C DʼAlbuquerque; Edson Abdala Journal: Transplantation Date: 2017-04 Impact factor: 4.939
Authors: Nenad Macesic; Angela Gomez-Simmonds; Sean B Sullivan; Marla J Giddins; Samantha A Ferguson; Gautam Korakavi; David Leeds; Sarah Park; Kevin Shim; Madeleine G Sowash; Melanie Hofbauer; Ryan Finkel; Yue Hu; Jared West; Nora C Toussaint; William G Greendyke; Benjamin A Miko; Marcus R Pereira; Susan Whittier; Elizabeth C Verna; Anne-Catrin Uhlemann Journal: Clin Infect Dis Date: 2018-08-31 Impact factor: 9.079