Multidrug-resistant bacterial infection in solid organ transplant recipients (original) (raw)
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Bacteremia During the First Year After Solid Organ Transplantation: An Epidemiological Update
Open Forum Infectious Diseases
Background There are limited contemporary data on the epidemiology and outcomes of bacteremia in solid organ transplant recipients (SOTr). Methods Using the Swiss Transplant Cohort Study registry from 2008 to 2019, we performed a retrospective nested multicenter cohort study to describe the epidemiology of bacteremia in SOTr during the first year post-transplant. Results Of 4383 patients, 415 (9.5%) with 557 cases of bacteremia due to 627 pathogens were identified. One-year incidence was 9.5%, 12.8%, 11.4%, 9.8%, 8.3%, and 5.9% for all, heart, liver, lung, kidney, and kidney-pancreas SOTr, respectively (P = .003). Incidence decreased during the study period (hazard ratio, 0.66; P < .001). One-year incidence due to gram-negative bacilli (GNB), gram-positive cocci (GPC), and gram-positive bacilli (GPB) was 5.62%, 2.81%, and 0.23%, respectively. Seven (of 28, 25%) Staphylococcus aureus isolates were methicillin-resistant, 2/67 (3%) enterococci were vancomycin-resistant, and 32/250 (...
Early Bacteremia After Solid Organ Transplantation
Transplantation Proceedings, 2009
Objective. Bloodstream infections (BSI) are a major cause of morbidity and mortality after solid organ transplantation. Our aim was to analyze early BSI after solid organ transplantation. Materials and Methods. A prospective cohort study included patients undergoing a kidney, simultaneous kidney-pancreas (SPK), or orthotopic liver transplantation (OLT) from 2003-2007. We prospectively collected demographic variables, underlying chronic diseases, transplantation procedures, and posttransplant complications. Recorded cases of BSI were defined as significant according to CDC criteria. Early BSIs were considered to be those appearing within 30 days posttransplantation. Results. During the study period, we performed 902 transplantations: 474 renal, 340 liver, and 88 pancreas. Seventy episodes of early BSI were diagnosed in 67 patients (7.4%). The incidences of BSI according to the type of transplantation were: 4.8% in renal, 4.5% in SPK, and 12% in OLT (P Ͻ .001). Sixty-three percent of the bacteria isolated were gram-negative, the most frequent being Escherichia coli, of which 18 (54%) were extended-spectrum beta-lactamase-producing (ESBL), and Pseudomonas aeruginosa, of which 18 (31%) were multidrug-resistant. The most frequent gram-positive bacteria were coagulase-negative staphylococci (20%). The urinary tract was a frequent source of BSI (27%), followed by a catheter (18%). Two patients (3%) died, both liver recipients, but neither death was related to the BSI. Conclusions. In our setting, the incidence of early BSI among solid organ transplant recipients was high, especially liver recipients, but with low associated mortality. The most frequent sources of infection were urinary tract and catheter. Gram-negative BSI showed a high rate of multidrug resistance.
Advances in Clinical and Experimental Medicine
Background. Healthcare-associated infections could affect the rate of morbidity, mortality and postdischarge hospitalization among patients. They are also dangerous to healthcare professionals and generate significant cost to the healthcare system. Objectives. The aim of this study was to evaluate the occurrence rate of colonization with various antibioticresistant (AR) bacteria among patients admitted to the Department of Immunology, Transplantology and Internal Diseases. Material and methods. The study used retrospective analysis of patients (n = 280) with no clinical signs of infection admitted into the department between November 2015 and May 2017. The observational period lasted until January 2019. Collected data included sex, age at admission, location directly prior to current hospitalization, and medical history. Nasal and rectal swabs were collected, and stool and urine samples were obtained on the day of admission. Specimens were cultured according to standard microbiological procedures. In all cases, the appropriate bioMerieux (Marcy-l'Étoile, France) media were used. Isolates were identified using mass spectrometer (Vitek MS; bioMerieux). Results. One-hundred ninety-one (68.2%) of patients were colonized with AR bacteria. The incidence of colonization was not influenced by age or sex. The risk of colonization was associated with admission from another hospital and history of kidney transplantation (p = 0.0136 and p < 0.001, respectively). The number of hospitalizations during the whole observational period was higher in the group of colonized patients compared to non-colonized (2.76 ±2.4 vs 2.07 ±1.68, p = 0.0099). The number of hospitalizations correlated positively with the number of positive cultures obtained from the same patients (rho = 0. 18, p = 0.0274). Conclusions. The rate of colonization at admission to the ward could be high, depending on previous hospitalization and medical history. Colonization significantly increased post-discharge hospitalization rate.
Infections in the solid-organ transplant recipients
Ukrainian Journal of Nephrology and Dialysis, 2021
The advancement in the field of transplant has led to the increasing number of solid-organ transplant recipients (SOTRs). This success leads to novel confronts in communicable infections, which are compound by the emergence of newly contagious and antimicrobial drugs resistant microorganisms. The prevention of infections is a cornerstone of any modern solid organ transplantation program. Understanding the fundamentals of these infections with early detection is crucial for improving the outcomes of such patients and lowers the probable extra complications. The probability of critical infections in SOTRs is established by relations between the patient’s epidemiological exposures and the net condition of immune repression. A timeline was formed to build up a discrepancy diagnosis of infection in SORTs. The improvement in screening, the investigations including imaging and molecular techniques and prophylactic intervention protocols, has made it promising to limit the penalty of infec...
TURKISH JOURNAL OF MEDICAL SCIENCES, 2021
Introduction Infections are still the most important cause of morbidity and mortality in solid-organ transplant (SOT) recipients despite advances in surgical techniques, immunosuppressive therapies, and infection-control precautions. Transplant recipients are at risk for various pathogens including opportunistic infections, reactivation of latent microorganisms, donor-mediated infections and healthcare-associated infections [1]. Bacteremia occurs in 5%-10% of kidney transplant and heart transplant recipients and more commonly in liver transplant and lung transplant recipients with rates of 10%-25%. The sources of bacteremia may include centralline catheters, the pulmonary tract, the urinary tract, and the surgical site [2]. Background/aim: The aim of this study is to evaluate the distribution, sources, clinical features, and mortality rates of bacteremia due to evaluation of extensively drug-resistant (XDR) gram negative among solid-organ transplant (SOT) recipients. Materials and methods: A retrospective study of SOT recipients with bacteremia due to XDR gram-negative pathogens in 11 centers between 2016 and 2018 was conducted. Patients' records were evaluated. Results: Of 171 bacteremia that occurred in 164 SOT recipients, 93 (56.7%) were liver, 46 (28%) kidney, 14 (8.5%) heart, and 11 (6.7%) lung recipients. Bacteremia episodes were recorded in the first year in 63.7% of the patients (n = 109), early-onset bacteremia was recorded in 45% (n = 77) of the episodes. In multivariate analysis, catheter-associated bacteremia was an independent risk factor for 7-day mortality (p = 0.037), and early-onset bacteremia was found as an independent risk factor for 30-day mortality (p = 0.017). Conclusion: Difficult-to-treat infections due to XDR bacteria in SOT recipients shadow the success of transplantation. Central venous catheters seem to be the main risk factor. Judicious use of medical devices is of pivotal importance.
Multidrug-resistant bacteria in solid organ transplant recipients
Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases, 2014
Bacteria are the leading cause of infections after solid organ transplantation. In recent years, a progressive growth in the incidence of multidrug-resistant (MDR) and extensively-drug-reistant (XDR) strains has been observed. While methicillin-resistant Staphylococcus aureus (MRSA) infection is declining in non-transplant and SOT patients worldwide, vancomycin-resistant enterococci, MDR/XDR Enterobacteriaceae and MDR/XDR non-fermenters are progressively growing as a cause of infection in solid organ transplant (SOT) patients and represent a global threat. Some SOT patients develop recurrent infections, related to anatomical defects in many cases, which are difficult to treat and predispose patients to the acquisition of MDR pathogens. As the antibiotics active against MDR bacteria have several limitations for their use, which include less clinical experience, higher incidence of adverse effects and less knowledge of the pharmacokinetics of the drug, and, in most cases, are only ava...
Health care-related infections in solid organ transplants
Brazilian Journal of Infectious Diseases, 2007
The health care-related infections are well-known in a critical care setting, but reports of those infections in solid organ transplanted patients are scarce. We developed a study of retrospective cohort in a tertiary teaching hospital for 14 months. Eighty-one patients underwent solid organ transplants. The global incidence of health care-related infection was 42.0%. Fifteen percent of the cases were occurrences of surgical site infections, 14.0% pneumonias, 9.0% primary blood stream infections, 4.0% urinary tract infections and 2.0% skin infection. The most prevalent etiologic agents were K. pneumoniae (8.6%), P. aeruginosa (7.4%); A. baumannii (5.0%) and S. aureus (2.5%). Mortality was 18.0%, none of then related to health care infections. The high rate of those infections, mainly surgical site infections, suggests a demand for stricter measures to prevent and control health care-related infections.
Influence of multi drug resistance Gram negative bacteria in liver transplant recipient
African journal of microbiology research
Infection is a common cause of morbidity and mortality after liver transplantation, which are often caused by Gram negative bacteria and the most frequently occurring infectious complications after liver transplantation (LT). The aim of this study was to investigate, incidence, pathogenic spectrum, and risk factors for bacteria due to multidrug resistant (MDR) Gram-negative bacteria, and its impact on mortality after LT. In total, 150 consecutive patients who underwent liver transplantation between January 2012 and March 2013, 115 isolates of bacteria and 10 isolates fungal from 80 patients. MicroScan® microbiology and API20 were used to identify the all isolates. Bacterial infections represented the most frequent event (92.0%) and fungal infections (8.0%). The presumed sources of infection were the Urine (41 events, 51%), followed by the bail drain (14 events, 17.5%). Infections of the sputum, ascetic fluid, and blood site accounted for 13.8, 5.0 and 6.3%, respectively. Antibiotics...