Impact of pre-transplant carbapenem-resistant enterobacterales colonization and/or infection on solid organ transplant outcomes
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Universidade Federal de Minas Gerais
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Artigo de periódico
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Membros da banca
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The impact of pre-transplant (SOT) carbapenem-resistant Enterobacterales (CRE) colo nization 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 (livern = 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.
Abstract
Assunto
Klebsiella pneumoniae, Transplante de orgãos
Palavras-chave
Carbapenem-resistant enterobacterales, Multidrug-resistan organisms, Solid organ transplantation
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https://onlinelibrary.wiley.com/doi/10.1111/ctr.14239