Multidrug-resistant Gram-negative bacteria in solid organ transplant recipients with bacteremias

Wan, Qiquan; Ye, Q F; Yuan, Hong

doi:10.1007/s10096-014-2271-z

Cited by 19 publications

(11 citation statements)

References 72 publications

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“…In recent years, a reduction in the incidence of gram-negative (GN) in favor of gram-positive infections and higher rates of multidrug-resistant (MDR) infections in south-eastern versus north-western European regions have been observed [1]. Moreover, MDR GN infections have been recognized as 1 of the leading cause of mortality after solid organ transplantation [2][3][4][5], whereas their epidemiology and impact on patients with hematologic diseases and HSCT recipients have been less studied [6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Risk Factors and Outcomes of Infections by Multidrug-Resistant Gram-Negative Bacteria in Patients Undergoing Hematopoietic Stem Cell Transplantation

Cigana

Dozzo

Lazzarotto

et al. 2017

Biology of Blood and Marrow Transplantation

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The objective of this study was to determine risk factors and outcomes of infections by multidrug-resistant gram-negative (MDR GN) bacteria in 241 recipients of hematopoietic stem cell transplantation (HSCT). The cumulative incidence of infections was 10.5% (95% CI, 12.0% to 25.8%), with 57% of infections occurring during the period of severe neutropenia (neutrophil count < .1 × 10/L). In multivariate analysis, allogeneic transplant and colonization with MDR GN bacteria at admission to the transplant unit were significantly associated with an increased risk of infection. Although we observed neither transplant-related mortality (TRM) nor deaths due to infections by MDR GN bacteria after autologous transplant, in the allogeneic setting a significant difference was reported in terms of overall survival (OS) and TRM between patients who developed infections and those who did not (1-year OS, 39% versus 68%; 1-year TRM, 42% versus 19%). In multivariate analysis, refractory disease and development of grades III to IV graft-versus-host disease (GVHD) were factors that affected both TRM and OS, whereas occurrence of infections by MDR GN pathogens significantly reduced OS. We conclude that eligibility to allogeneic HSCT in MDR GN bacteria carriers should be carefully evaluated together with all other factors that independently influence outcome (disease status, donor, and GVHD risk).

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Section: Introductionmentioning

confidence: 99%

Risk Factors and Outcomes of Infections by Multidrug-Resistant Gram-Negative Bacteria in Patients Undergoing Hematopoietic Stem Cell Transplantation

Cigana

Dozzo

Lazzarotto

et al. 2017

Biology of Blood and Marrow Transplantation

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“…This change was evident among E. coli bloodstream isolates in one study, where resistance to fluoroquinolones and ampicillin antibiotics increased, between 1998 and 2007, from 0% to 44% ( P = .002) and from 50% to 76%, respectively . Multidrug‐resistant Enterobacteriaceae are also growing as a cause of infection in SOT patients and represent a global threat …”

Section: Introductionmentioning

confidence: 99%

“…3 Multidrug-resistant Enterobacteriaceae are also growing as a cause of infection in SOT patients and represent a global threat. 10 Understanding the nature of BSI among SOT recipients and its changing trends is paramount to implement the appropriate preventative and therapeutic strategies. Therefore, the aim of this study was to analyze the epidemiological and microbiological features of BSI among RTR in our center and to assess the potential impact of BSI on renal function.…”

Section: Introductionmentioning

confidence: 99%

Epidemiology and impact of bloodstream infections among kidney transplant recipients: A retrospective single‐center experience

Shendi

Wallis

Painter

et al. 2018

Transplant Infectious Dis

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Urinary tract infection remains the commonest source of systemic infection among kidney transplant recipients and resistance to commonly used frontline antibiotics is common; thus, prevention and early detection are paramount. The appropriate choice of initial empirical antibiotic is vital to improve the outcome. Each unit needs to understand the epidemiology of organisms causing BSI in their transplant patients and their antibiotic susceptibilities.

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“…18 This becomes important due to the high rate of MDR among gram-negative bacteria. 19 One study in China reported that MDR gram-negative bacteria were isolated from 56% of PTIs cases. 7 In line with the aforementioned study, MDR gram-negative bacteria were the most common pathogens in our study.…”

Section: Discussionmentioning

confidence: 99%

<p>Comparison of Ceftizoxime Plus Ampicillin-Sulbactam versus Gentamicin Plus Ampicillin-Sulbactam in the Prevention of Post-Transplant Early Bacterial Infections in Liver Transplant Recipients: A Randomized Controlled Trial</p>

Shafiekhani

Karimzadeh

Nikeghbalian

et al. 2020

IDR

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In this study, we aimed to compare the efficacy of combined ceftizoxime with ampicillin-sulbactam versus combined gentamicin with ampicillin-sulbactam as prophylactic antibiotic regimen in preventing early bacterial PTIs in liver TX recipients at a referral center. Patients and methods: All patients older than 18 years who had undergone liver TX at Abu-Ali Sina transplantation center in Shiraz, Iran from July 2018 to April 2019 were included in this study. In a single-blinded manner, the participants randomly received either combined intravenous ceftizoxime plus ampicillin-sulbactam (ceftizoxime group) or gentamicin plus ampicillin-sulbactam (gentamicin group) as prophylactic antibiotic regimen before the incision of the surgery, which was continued for 48 hrs after liver Tx. The rate and type of bacterial infections, length of hospital and intensive care unit (ICU) stay, mortality rate, and kidney function were assessed during 1 month following liver TX in the two groups. Results: Two hundred and thirty patients were divided into two groups. One patient in the gentamicin group and five in the ceftizoxime group were excluded due to emergency exploratory laparotomy within the first 3 days after transplantation. The rate of bacterial infections during the first month after transplantation was 25.4%. This rate was significantly lower in the gentamicin group (13.16%) in comparison to the ceftizoxime group (38.18%) (P value<0.01), based on the univariate logistic regression analysis. Length of ICU and hospital stay and also mortality rate were significantly lower in the gentamicin group (P value <0.01). There was no significant difference regarding kidney function between the two groups (P value = 0.16). Conclusion: Our results suggested that gentamicin can be considered as a promising agent in prophylactic antibiotic regimen for patients undergoing liver TX. Trial registration: The study was registered at the Iranian Registry of Clinical Trials (IRCT20120731010453N2; http://www.irct.ir/).

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Multidrug-resistant Gram-negative bacteria in solid organ transplant recipients with bacteremias

Cited by 19 publications

References 72 publications

Risk Factors and Outcomes of Infections by Multidrug-Resistant Gram-Negative Bacteria in Patients Undergoing Hematopoietic Stem Cell Transplantation

Risk Factors and Outcomes of Infections by Multidrug-Resistant Gram-Negative Bacteria in Patients Undergoing Hematopoietic Stem Cell Transplantation

Epidemiology and impact of bloodstream infections among kidney transplant recipients: A retrospective single‐center experience

<p>Comparison of Ceftizoxime Plus Ampicillin-Sulbactam versus Gentamicin Plus Ampicillin-Sulbactam in the Prevention of Post-Transplant Early Bacterial Infections in Liver Transplant Recipients: A Randomized Controlled Trial</p>

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