Importance of Acquisition of Carbapenemase (KPC)-Producing Enterobacteriaceae in Solid Organ Transplant Recipients: A Single-Center Experience.
1Divison of Infectious Disease, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
2Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
3Department of Transplantation Surgery, Severance Hospital, Yonsei University Health System, Seoul, Republic of Korea
Meeting: 2017 American Transplant Congress
Abstract number: 341
Keywords: Infant, Risk factors, Survival
Session Information
Session Name: Concurrent Session: Infectious Pot-Pourri
Session Type: Concurrent Session
Date: Monday, May 1, 2017
Session Time: 4:30pm-6:00pm
Presentation Time: 5:06pm-5:18pm
Location: E265
Background: Among multi-drug resistant bacteria, carbapenem-resistant Enterobacteriaceae (CRE) is recently spreading in several countries. Carbapenemase-producing (CP) Enterobacteriaceae (CPE) has great clinical importance because it could cause outbreak within hospital and affect morbidity and mortality with limitation of available antibiotics in SOT recipients. We analyzed characteristics of colonization and infection by CPE in SOT recipients. Methods: We found 28 SOT recipients whose clinical samples (170 isolates) and/or stools (355 stool colonizers) had CPE verified by KPC PCR between October 2015 and October 2016. We selected 40 control recipients with > 2 of negative result in stool CRE culture and no any CRE isolates. Results: Most frequent transplant organ and CPE-cultured samples were lung and respiratory tract (48.4% and 69.4%). Bacteremia occurred in 6 (21.4%) patients. 19 (61.3%) patients had both clinical isolates and stool colonizers, and 8 (25.8%) had only stool colonizers. The median days between first SOT and first CPE identification was 11 days (IQR 3-46 days). 87.1% of clinical isolates had identical antibiotic susceptibilities with all resistance except only amikacin. The patients with CPE had the significantly higher frequency for existence of VRE and/or C. difficile in stool than control group (46.4% vs. 12.5%, P=0.002). The mortality in patients with CPE was significantly higher compared to control group (25.0% vs. 7.5%, P=0.012). In multivariate logistic regression, previous existence of VRE and/or C. difficile (OR 5.6, P=0.031) and carbapenem use (OR 6.4, P=0.031) before SOT were independent factors associated with acquisition of CPE. The acquisition of CPE (HR 2.9, P<0.001) and total ICU stay after SOT (HR 1.2, P=0.012) were independent factors in relation to all-cause 30-day mortality in Cox's regression model. Conclusions: This study provides CPE acquisition may affect short-term clinical outcome of SOT recipients. The careful screening during early period after SOT will be meaningful in recipients with risk factors.
CITATION INFORMATION: Han S, Lee K, Lee K.-A, Paik H, Lee J, Kim M, Joo D, Choi J, Kim S, Kim Y. Importance of Acquisition of Carbapenemase (KPC)-Producing Enterobacteriaceae in Solid Organ Transplant Recipients: A Single-Center Experience. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Han S, Lee K, Lee K-A, Paik H, Lee J, Kim M, Joo D, Choi J, Kim S, Kim Y. Importance of Acquisition of Carbapenemase (KPC)-Producing Enterobacteriaceae in Solid Organ Transplant Recipients: A Single-Center Experience. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/importance-of-acquisition-of-carbapenemase-kpc-producing-enterobacteriaceae-in-solid-organ-transplant-recipients-a-single-center-experience/. Accessed May 12, 2025.« Back to 2017 American Transplant Congress