Carbapenemase-KPC producing Klebsiella pneumoniae (CP-Kp) infection represents a seri-ous 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 infec-tions, 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.

Carbapenemase-producing klebsiella pneumoniae colonization and infection in solid organ transplant recipients: A single-center, retrospective study

Pagani N.;Corcione S.;Lupia T.;Scabini S.;Filippini C.;Angilletta R.;Shbaklo N.;Romagnoli R.;Biancone L.;Cavallo R.;Di Perri G.;Solidoro P.;Boffini M.;De Rosa F. G.
2021

Abstract

Carbapenemase-KPC producing Klebsiella pneumoniae (CP-Kp) infection represents a seri-ous 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 infec-tions, 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.
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Carbapenemase; Colonization; Klebsiella pneumoniae; Solid organ transplant
Pagani N.; Corcione S.; Lupia T.; Scabini S.; Filippini C.; Angilletta R.; Shbaklo N.; Pinna S.M.; Romagnoli R.; Biancone L.; Cavallo R.; Di Perri G.; Solidoro P.; Boffini M.; De Rosa F.G.
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2318/1816964
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