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. 2021 Apr;35(4):e14239.
doi: 10.1111/ctr.14239. Epub 2021 Feb 8.

Impact of pre-transplant carbapenem-resistant Enterobacterales colonization and/or infection on solid organ transplant outcomes

Sarah Taimur  1 , Stephanie M Pouch  2 , Nicole Zubizarreta  1 , Madhu Mazumdar  1 , Meenakshi Rana  1 , Gopi Patel  1 , Maristela Pinnheiro Freire  3 , Rebecca Pellett Madan  4 , Eun Jeong Kwak  5 , Emily Blumberg  6 , Michael J Satlin  7 , Larissa Pisney  8 , Wanessa Trindade Clemente  9 , Marcus J Zervos  10 , Ricardo M La Hoz  11 , Shirish Huprikar  1
Affiliations

Impact of pre-transplant carbapenem-resistant Enterobacterales colonization and/or infection on solid organ transplant outcomes

Sarah Taimur et al. Clin Transplant. 2021 Apr.

Abstract

The impact of pre-transplant (SOT) carbapenem-resistant Enterobacterales (CRE) colonization or infection on post-SOT outcomes is unclear. We conducted a multi-center, international, cohort study of SOT recipients, with microbiologically diagnosed CRE colonization and/or infection pre-SOT. Sixty adult SOT recipients were included (liver n = 30, hearts n = 17). Klebsiella pneumoniae (n = 47, 78%) was the most common pre-SOT CRE species. Median time from CRE detection to SOT was 2.32 months (IQR 0.33-10.13). Post-SOT CRE infection occurred in 40% (n = 24/60), at a median of 9 days (IQR 7-17), and most commonly due to K pneumoniae (n = 20/24, 83%). Of those infected, 62% had a surgical site infection, and 46% had bloodstream infection. Patients with post-SOT CRE infection more commonly had a liver transplant (16, 67% vs. 14, 39%; p =.0350) or pre-SOT CRE BSI (11, 46% vs. 7, 19%; p =.03). One-year post-SOT survival was 77%, and those with post-SOT CRE infection had a 50% less chance of survival vs. uninfected (0.86, 95% CI, 0.76-0.97 vs. 0.34, 95% CI 0.08-1.0, p =.0204). Pre-SOT CRE infection or colonization is not an absolute contraindication to SOT and is more common among abdominal SOT recipients, those with pre-SOT CRE BSI, and those with early post-SOT medical and surgical complications.

Keywords: carbapenem-resistant enterobacterales; multidrug-resistant organisms; solid organ transplantation.

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References

REFERENCES

    1. Pouch SM, Patel G. Multidrug-resistant Gram-negative bacterial infections in solid organ transplant recipients-Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice. Clin Transplant. 2019;33(9):e13594.
    1. Pouch SM, Satlin MJ. Carbapenem-resistant Enterobacteriaceae in special populations: solid organ transplant recipients, stem cell transplant recipients, and patients with hematologic malignancies. Virulence. 2017;8(4):391-402.
    1. Patel G, Huprikar S, Factor SH, Jenkins SG, Calfee DP. Outcomes of carbapenem-resistant Klebsiella pneumoniae infection and the impact of antimicrobial and adjunctive therapies. Infect Control Hosp Epidemiol. 2008;29(12):1099-1106.
    1. Endimiani A, Hujer AM, Perez F, et al. Characterization of blaKPC-containing Klebsiella pneumoniae isolates detected in different institutions in the Eastern USA. J Antimicrob Chemother. 2009;63(3):427-437.
    1. Yuan Y, Li Y, Wang G, et al. Coproduction Of MCR-9 And NDM-1 By Colistin-Resistant Enterobacter hormaechei Isolated From Bloodstream Infection. Infect Drug Resist. 2019;12:2979-2985.

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