Carbapenemase-Producing Klebsiella pneumoniae Colonization and Infection in Solid Organ Transplant Recipients: A Single-Center, Retrospective Study

Microorganisms

Paolo Solidoro¹  Claudia Filippini²  Silvia Corcione³  Silvia Scabini³  Simone Mornese Pinna³  Roberto Angilletta³  Francesco Giuseppe De Rosa³  Nour Shbaklo³  Massimo Boffini⁴  Renato Romagnoli⁵  Tommaso Lupia⁶  Rossana Cavallo⁷  Luigi Biancone⁸  Giovanni Di Perri⁹  Nicole Pagani⁹ 

[1] Cardiovascular and Thoracic Department, Pneumology Unit U, AOU Città Della Salute e Della Scienza di Torino, 10100 Turin, Italy;Clinical Statistics, Department of Surgical Sciences, University of Torino, 10126 Torino, Italy;Department of Medical Sciences, Infectious Diseases, University of Turin, 10100 Turin, Italy;Division of Cardiac Surgery, Department of Surgical Sciences, Città Della Salute e Della Scienza, University of Turin, 10100 Turin, Italy;General Surgery 2U, Liver Transplant Center, AOU Città Della Salute e Della Scienza di Torino, University of Turin, 10100 Turin, Italy;Infectious Disease Unit, Cardinal Massaia Hospital, 14100 Asti, Italy;Microbiology and Virology Unit, University of Turin, 10100 Turin, Italy;S.C. Nefrologia, Dialisi e Trapianto U, AOU Città Della Salute e Della Scienza, 10100 Turin, Italy;St Stephen’s Centre, Chelsea and Westminster Hospital, 252 Fulham Rd., London SW10 9NA, UK;

关键词: carbapenemase;    Klebsiella pneumoniae;    solid organ transplant;    colonization;   

DOI  :  10.3390/microorganisms9112272

来源: DOAJ

【 摘 要 】

Carbapenemase-KPC producing Klebsiella pneumoniae (CP-Kp) infection represents a serious threat to solid organ transplant (SOT). All patients admitted between 1 May 2011 and 31 August 2014 undergoing SOT were included in the retrospective study. The primary outcomes included a description of the association of enteric colonization and invasive infections by CP-Kp with one-year mortality. Secondary outcomes were the study of risk factors for colonization and invasive infections by CP-Kp. Results: A total of 5.4% (45/828) of SOT recipients had at least one positive rectal swab for CP-Kp, with most (88.9%) occurring after transplantation. 4.5% (35/828) of patients developed a CP-Kp-related invasive infection, with 68.6% (24/35) being previously colonized. The 1-year mortality was 31.1% in patients with enteric colonization with CP-Kp and, it was 51.4% among patients with CP-Kp-related invasive infections. At univariate analysis, colonization, invasive infections, sepsis, severe sepsis, and septic shock were significantly associated with 1-year mortality. At multivariate analysis, only invasive infections and the combination of sepsis, severe sepsis, or septic shock were significantly associated with 1-year mortality, whereas gastrointestinal colonization was significantly associated with survival. In this population, the 1-year mortality was significantly associated with invasive infections; otherwise, gastrointestinal colonization was not associated with increased 1-year mortality.

【 授权许可】

Unknown