13th Congress of the Polish Society of Transplantation: Part IKidney transplantationClinical Significance of Gastrointestinal Carriage of Klebsiella Pneumoniae-Producing Extended-Spectrum Beta-Lactamases in Kidney Graft Recipients
Section snippets
Methods
The study included all KTX patients hospitalized in the Department of Immunology, Transplant Medicine and Internal Diseases between January 2014 and December 2016. During this period 2018 KTX patients were admitted: 605 in 2014, 750 in 2015, and 663 in 2016. Screening for multidrug-resistant Enterobacteriaceae gut carriage was performed in 104 cases (2014), 122 (2015), and 166 (2016). All results of screening tests were analyzed and correlated with UTI episodes due to KP ESBL+.
KP susceptibility
Results
Demographic and clinical data of patients with positive KP ESBL+ gut carriage tests are presented in Table 1. In patients with positive screening tests, KP ESBL+ UTI occurred after median 6.7 (interquartile range: 3.2 to 21.5) months after KTX. In 2014 gut KP ESBL+ carriage screening was performed in 104 KTX cases (17.2% of all KTX hospitalizations); 18 cases (17.3%) had positive test results and 44 (42.3%) KTX cases were diagnosed with KP ESBL+ UTI. In 2015 gut KP ESBL+ carriage screening was
Discussion
In solid organ transplant recipients, urinary tract infections constituted 72% of all KP infections [4]. In a study assessing patients after renal transplantation, urinary tract infections due to KP were diagnosed in 12.3% of patients and ESBL+ phenotype constituted approximately 8% of all KP infections [11]. We have analyzed only patients with GI carriage and urinary tract infection caused by KP ESBL+. In patients who underwent KTX, 2.3% to 11.1% developed KP ESBL+ infection in the early
References (15)
- et al.
Clinical epidemiology of the global expansion of Klebsiella pneumoniae carbapenemases
Lancet Infect Dis
(2013) - et al.
A threat of the Klebsiella pneumoniae carbapenemase-producing strains among transplant recipients
Transpl Proc
(2011) - et al.
Klebsiella pneumoniae infection in solid organ transplant recipients: epidemiology and antibiotic resistance
Transpl Proc
(2010) - et al.
Bacterial infections in renal transplant recipients
Transpl Proc
(2015) - et al.
Extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae in Spanish hospitals: 2nd multicenter study (GEIH-BLEE project, 2006)
Enfem Infecc Microbiol Clin
(2009) - et al.
Increase in bloodstream infections in Finland, 1995-2002
Epidemiol Infect
(2008) - et al.
Epidemiology and outcomes of carbapenem-resistant Klebsiella pneumoniae bacteriuria in kidney transplant recipients
Transpl Infect Dis
(2015)
Cited by (5)
Screening for antimicrobial-resistant Gram-negative bacteria in hospitalised patients, and risk of progression from colonisation to infection: Systematic review
2022, Journal of InfectionCitation Excerpt :Amongst included studies, 27 concerned routine care screenings41, 43, 45, 47, 48, 50, 53–55, 59, 62, 64, 66, 72, 76, 80–83, 85, 90, 99, 100, 104 and 56 screening procedures adopted to respond to a specific research question.34–36, 38–40, 44, 46, 49, 51, 52, 56–58, 60, 61, 63, 65, 67–71, 74, 75, 77–79, 86, 91, 98, 101–103, 105 Screening was performed at hospital admission in 36 studies13, 14, 17, 21, 24, 25, 27, 30, 41, 44, 48, 50, 51, 54, 60–63, 66, 69, 70, 74–76, 78–83, 90, 98, 99, 105 and at admission and repeatedly in 47 studies.16, 18–20, 22, 23, 26, 28, 32–36, 38–40, 43, 45–47, 49, 52, 53, 55–59, 64, 65, 67, 68, 71, 72, 77, 85, 86, 91, 100–104 Screening of all admitted patients was conducted either at the time of arrival to hospital (n = 8; 9.6%)19, 44, 63, 74, 78, 82, 98, 99 or at admission to a specific ward (n = 50; 60.2%).13, 14, 16, 17, 20, 21, 23–26, 28, 32–34, 36, 38–40, 43, 45–47, 51–53, 55, 57–60, 62, 64, 67, 69–72, 75–77, 80, 81, 86, 90, 100–105
Urinary Tract Infections Caused by K. pneumoniae in Kidney Transplant Recipients – Epidemiology, Virulence and Antibiotic Resistance
2022, Frontiers in Cellular and Infection MicrobiologyTemporal trends, risk factors and outcomes of infections due to extended-spectrum β-lactamase producing Enterobacterales in Swiss solid organ transplant recipients between 2012 and 2018
2021, Antimicrobial Resistance and Infection Control