Outcomes Associated with Carbapenem-Resistant Enterobacteriaceae Infection After Solid Organ Transplantation in a Multicenter Study.
1Mount Sinai, New York
2Univ of Sao Paulo, Sao Paulo, Brazil
3UAB, Birmingham
4Albert Einstein, Bronx
5Oschner, New Orleans
6Cornell, New York
7Drexel, Philadelphia
8Univ Federal de Minas Gerais, Belo Horizonte, Brazil
9Henry Ford, Detroit
10UT Southwestern, Dallas
11Ohio State, Columbus
12U of Michigan, Ann Arbor
13Federal Univ of Rio de Janeiro, Rio de Janeiro, Brazil
14Yale, New Haven
15Rush, Chicago.
Meeting: 2016 American Transplant Congress
Abstract number: 570
Keywords: Bacterial infection, Outcome
Session Information
Session Time: 8:30am-10:00am
Presentation Time: 9:30am-9:45am
Location: Veterans Auditorium
Background
Carbapenem-resistant Enterobacteriaceae infection (CREI) is associated with poor outcomes in solid organ transplant (SOT) recipients but most reports are single center experiences.
Methods
Patients who underwent SOT between 1/1/2007 and 7/31/2013 and later developed CREI were eligible for chart review. The primary outcome was one-year mortality in SOT recipients with CREI within one year of SOT.
Results
Our cohort consists of 164 SOT recipients from 15 sites. The median age was 56; 61% were male. The transplanted organs were as follows: kidney (72), liver (62), liver-kidney (14), other (16). There were 170 CRE isolates: Klebsiella (129), Enterobacter (26) and other (15). 196 sites of CREI were observed: urinary tract (62), bloodstream (40), abdomen (36), lung (26), surgical site (25) and other (7). Surgical complications prior to CREI occurred in 83 (51%).
In the entire cohort, the median intervals from SOT to CREI and from CREI to death were 51 days and 71 days, respectively. CREI occurred within one year of SOT in 140 (85%). The one-year mortality rate was 39/140 (28%) with a median interval from CREI to death of 30 days. The median interval from SOT to CREI in the 24 patients who developed CREI after one year was 812 days. The mortality rate in this group was 10/24 (42%). The median interval from CREI to death in this group was 50 days.
Conclusions
To our knowledge, this is the largest multicenter series of post-SOT CREI and confirms that CREI is usually an early complication. The one-year survival rate of 72% in SOT recipients with CREI in the first year is better than previously described in the literature. Analyses to identify factors associated with mortality and survival are in progress.
CITATION INFORMATION: Huprikar S, Casner L, Camera Pierrotti L, Nellore A, Madan R, Garcia-Diaz J, Jacobs S, Lee D, Trindade Clemente W, Alangaden G, La Hoz R, Theodoropoulos N, Miceli M, Santoro-Lopes G, Banach D, Simon D, Patel G. Outcomes Associated with Carbapenem-Resistant Enterobacteriaceae Infection After Solid Organ Transplantation in a Multicenter Study. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Huprikar S, Casner L, Pierrotti LCamera, Nellore A, Madan R, Garcia-Diaz J, Jacobs S, Lee D, Clemente WTrindade, Alangaden G, Hoz RLa, Theodoropoulos N, Miceli M, Santoro-Lopes G, Banach D, Simon D, Patel G. Outcomes Associated with Carbapenem-Resistant Enterobacteriaceae Infection After Solid Organ Transplantation in a Multicenter Study. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/outcomes-associated-with-carbapenem-resistant-enterobacteriaceae-infection-after-solid-organ-transplantation-in-a-multicenter-study/. Accessed May 21, 2025.« Back to 2016 American Transplant Congress