AI Article Synopsis
- Solid organ transplant recipients, particularly kidney transplant (KTx) patients, are highly vulnerable to infections from a specific bacteria, Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (KPC-Kp), which can lead to serious healthcare-associated infections (HAIs).
- A study looked at kidney transplant patients from 2009 to 2013, identifying risk factors and outcomes related to KPC-Kp infections, revealing that prior colonization and certain medical interventions increased infection risks, with a concerning 30-day mortality rate of 41.9% among those infected.
- The findings highlighted that multi-organ transplants and the use of ureteral stents were significant risk factors, and patients with a high
Article Abstract
Introduction: Solid organ transplant recipients are especially susceptible to healthcare-associated infections with Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (KPC-Kp-HAIs). The aim of the study was to evaluate risk factors and outcome of these infections in kidney transplant recipients.
Methods: This was a retrospective cohort of kidney transplant (KTx) recipients between January 2009 and December 2013. Cases were defined as patients who developed KPC-Kp-HAI, confirmed by PCR for bla( KPC) gene after KTx during the study period. We analysed variables related to recipient; induction immunosuppressant therapy; delayed graft function; use of invasive devices; SOFA score on the first day of infection; type of therapy; time from positive culture to appropriate antimicrobial therapy; bacteraemia; and concomitant infection. Outcome measures were the occurrence of KPC-Kp-HAI and 30-day mortality after KPC-Kp-HAI.
Results: A total of 1,101 were submitted to KTx in the period, 21 patients were classified as infected with KPC-Kp. Another ten patients had KPC-Kp-HAI in the period and were transplanted before 2009. Of those 31 patients, 48.4 % showed evidence of prior colonization and 38.7 % had bacteraemia. The most common site of infection was the surgical wound. Risk factors for KPC-Kp-HAI were multi-organ transplantation and the use of a ureteral stent. Eight of the infected patients experienced recurrence of the infection. The 30-day mortality rate was 41.9 %. Survival was significantly lower among the patients with KPC-Kp-HAI (72 vs. 89.1 %; P = 0.002). The only risk factor independently associated with 30-day mortality was an elevated SOFA score on the first day of infection.
Conclusions: In KTx recipients, the occurrence of KPC-Kp-HAI was related to invasive devices and type of transplant; these infections had a high rate of recurrence and reduced survival after KTx.
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| http://dx.doi.org/10.1007/s15010-015-0743-4 | DOI Listing |
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