Risk factors for colonization and infection by resistant microorganisms in kidney transplant recipients

ABSTRACT Objectives: to assess the prevalence of colonization and infection by multidrug-resistant bacteria in patients undergoing kidney transplantation and identify the rate of infection, morbidity and mortality and associated risk factors. Methods: a prospective cohort of 200 randomly included kidney transplant recipients. Epidemiological surveillance of the studied microorganisms was carried out in the first 24 hours and 7 days after transplantation. Results: ninety (45%) patients were considered colonized. Female sex, hypertension and diabetes (p<0.005), dialysis time (p<0.004), length of stay after transplantation, delayed renal function, and length of stay were identified as risk factors. The microorganisms were isolated from surgical site, bloodstream and urinary tract infections. Conclusions: colonization by resistant microorganisms in kidney transplant patients was frequent and risk factors associated with infection were identified. The results should guide the care team in order to minimize morbidity and mortality related to infectious causes in this population.

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ESBL-producing enterobacteriaceae-related urinary tract infections in kidney transplant recipients: incidence and risk factors for recurrence

Infectious Diseases ◽

10.3109/23744235.2015.1051107 ◽

2015 ◽

Vol 47 (10) ◽

pp. 714-718 ◽

Cited By ~ 18

Author(s):

Benoît Pilmis ◽

Anne Scemla ◽

Olivier Join-Lambert ◽

Marie-France Mamzer ◽

Oliver Lortholary ◽

...

Keyword(s):

Risk Factors ◽

Urinary Tract ◽

Kidney Transplant ◽

Urinary Tract Infections ◽

Transplant Recipients ◽

Kidney Transplant Recipients ◽

Risk Factors For Recurrence ◽

Tract Infections

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Epidemiology, susceptibility, and risk factors for acquisition of MDR/XDR Gram-negative bacteria among kidney transplant recipients with urinary tract infections

Infection and Drug Resistance ◽

10.2147/idr.s163979 ◽

2018 ◽

Vol Volume 11 ◽

pp. 707-715 ◽

Cited By ~ 11

Author(s):

Xiuhong Yuan ◽

Taohua Liu ◽

Di Wu ◽

Qiquan Wan

Keyword(s):

Risk Factors ◽

Urinary Tract ◽

Kidney Transplant ◽

Urinary Tract Infections ◽

Gram Negative Bacteria ◽

Transplant Recipients ◽

Kidney Transplant Recipients ◽

Gram Negative ◽

Tract Infections

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Infectious events in kidney transplant recipients from deceased expanded criteria donors: a prospective cohort

Revista da Escola de Enfermagem da USP ◽

10.1590/1980-220x-reeusp-2021-0255 ◽

2021 ◽

Vol 55 ◽

Author(s):

Sirlei Regina de Sousa ◽

Cassiane Dezoti da Fonseca ◽

Monica Taminato ◽

Maria de Fatima Fernandes Vattimo ◽

Angélica Gonçalves Silva Belasco ◽

...

Keyword(s):

Risk Factors ◽

Kidney Transplantation ◽

Kidney Transplant ◽

Cause Of Death ◽

Prospective Cohort ◽

Cytomegalovirus Infection ◽

Multidrug Resistant ◽

Transplant Recipients ◽

Kidney Transplant Recipients ◽

Expanded Criteria

ABSTRACT Objective: Analyze risk factors for infection in kidney transplant recipients from deceased expanded criteria donors (DECD) in the first two years of follow-up. Method: This is a prospective cohort study with 466 patients from DECD who underwent kidney transplantation in 2015 and 2016 in Brazil. A total of 551 events were recorded. The largest incidence of infectious events occurred in the first month after kidney transplantation. Cytomegalovirus infection was the most common infectious episode. Results: The incidence rate of infections was 57.1%. Among bacterial infections, only 4% were due to multidrug-resistant microorganisms. The death rate was 3.3% (15) patients. The main cause of death was infectious (73.3%). Hospitalization until the first infection (aOR:1.61), Number of infections in 1 year (aOR:40.16), and Cytomegalovirus infection (aOR:13.84) was risk factors for infection by multidrug resistant microorganisms (MDR). Conclusion: Infection incidence with MDR bacteria was high among kidney transplant recipients from DECD, and the main cause of death was infection. Survival was high among patients with infection.

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222. Bloodstream Infections by Gram(−) Bacteria in Kidney Transplant Patients: Risk Factors, Incidence and Outcome; Bloodstream Infections by Gram(−) Bacteria in Kidney Transplant Patients: Risk Factors, Incidence and Outcome

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.297 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S129-S130

Author(s):

Maria Tsikala Vafea ◽

Dimitris Basoulis ◽

Maria Darema ◽

Ioannis Deliolanis ◽

Ioanna Pavlopoulou ◽

...

Keyword(s):

Risk Factors ◽

Kidney Transplant ◽

Bloodstream Infections ◽

Multidrug Resistant ◽

Unfavorable Outcome ◽

Care Hospital ◽

Transplant Recipients ◽

Kidney Transplant Recipients ◽

Transplant Patients ◽

Kidney Transplant Patients

Abstract Background Kidney transplant recipients are at increased risk for infections. The aims of this study were: i) to estimate the incidence of bloodstream infections (BSI) caused by Gram(−) bacteria in kidney transplant recipients, ii) to identify risk factors for BSI by multidrug-resistant Gram(−) bacteria, and iii) to identify predictors for outcome (death/loss of transplanted kidney). Methods We conducted a retrospective cohort study at the renal transplant unit (RTU) of a tertiary care hospital located in Athens, Greece, between September 2008 and September 2018. Kidney transplant recipients with Gram(−) BSIs were identified from the microbiology laboratory electronic records. Patient-, infection-, and treatment-related factors were extracted from the medical records. Species identification and susceptibility testing were performed by MicroScan automated system. The statistical analysis was performed using IBM SPSS Statistics v20. Results During the study period, 1962 kidney transplant patients were followed at our RTU. A total of 195 BSI episodes were recorded in 182 patients (male/female=97/85), with median (25th, 75th) age 57.2 (44, 64.9) years. The incidence of BSI was 1.393/100 patient-years. Median (25th, 75th) time interval between transplantation date and onset of BSI was 67.67 (8.3, 148) months. Escherichia coli was the most common cause (64.3%, 117/182), while the most common source of infection was urinary tract (70.9%, 129/182). 19.2% (53/182) of BSIs were caused by multidrug-resistant organisms (MDR). 6% (11/182) of patients died and 2.2% (4/182) were subjected to nephrectomy. Multivariate logistic regression showed that diabetes mellitus (odds ratio [OR] 7.714; 95% confidence interval [CI] 1.311–45.385), Pseudomonas aeruginosa BSI (OR 35.788; CI 3.3–388.182) and septic shock (OR 74.468; CI 3.513–1578.513) were predictors of an unfavorable outcome. Previous antibiotic use (OR 11.964; CI 2.686–53.293) and previous stay in Intensive Care Unit (OR 18.055; CI 1.046–311.536) were associated with MDR BSIs. Conclusion BSIs in kidney transplant recipients is a critical factor of morbidity and mortality. Recognizing the risk factors for unfavorable outcome and emergence of MDR bacteria could offer a significant advantage in early diagnosis and appropriate treatment. Disclosures All authors: No reported disclosures.

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