Risk Factors and Outcomes of Bacteremia Caused by Drug-Resistant ESKAPE Pathogens in Solid-Organ Transplant Recipients

Bodro, Marta; Sabé, N.; Tubau, Fé; Lladó, Laura; Baliellas, Carme; Roca, Josep; Cruzado, Josep M.; Carratalà, Jordi

doi:10.1097/tp.0b013e3182a049fd

Cited by 152 publications

(159 citation statements)

References 44 publications

Supporting

Mentioning

144

Contrasting

Unclassified

Order By: Relevance

“…Current data indicate a rising incidence of multidrug-resistant (MDR) strains of urinary pathogens worldwide (4)(5)(6)(7). Infections caused by MDR pathogens have become a therapeutic challenge for clinicians and a threat for immunocompromised patients.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Impact of Antibiotic Resistance on the Development of Recurrent and Relapsing Symptomatic Urinary Tract Infection in Kidney Recipients

Bodro¹,

Sanclemente²,

Lipperheide³

et al. 2015

American Journal of Transplantation

View full text Add to dashboard Cite

(abstract #1302).We sought to determine the frequency, risk factors, and clinical impact of recurrent urinary tract infections (UTI) in kidney transplant recipients. Of 867 patients who received a kidney transplant between 2003 and 2010, 174 (20%) presented at least one episode of UTI. Fifty-five patients presented a recurrent UTI (32%) and 78% of them could be also considered relapsing episodes. Recurrent UTI was caused by extended-spectrum betalactamase (ESBL)-producing Klebsiella pneumoniae (31%), followed by non-ESBL producing Escherichia coli (15%), multidrug-resistant (MDR) Pseudomonas aeruginosa (14%), and ESBL-producing E. coli (13%). The variables associated with a higher risk of recurrent UTI were a first or second episode of infection by MDR bacteria (OR 12; 95%CI 528), age >60 years (OR 2.2; 95%CI 1.15.1), and reoperation (OR 3; 95%CI 1.37.1). In addition, more relapses were recorded in patients with UTI caused by MDR organisms than in those with susceptible microorganisms. There were no differences in acute rejection, graft function, graft loss or 1 year mortality between groups. In conclusion, recurrent UTI is frequent among kidney recipients and associated with MDR organism. Classic risk factors for UTI (female gender and diabetes) are absent in kidney recipients, thus highlighting the relevance of uropathogens in this population.

show abstract

Section: Introductionmentioning

confidence: 99%

“…Few antibiotics are available to treat infections caused by these pathogens, and those that can be prescribed are mostly for parenteral administration and carry a higher risk of adverse effects. Moreover, infections caused by MDR rods are often associated with worse outcomes (7)(8)(9)(10)(11).…”

Section: Introductionmentioning

confidence: 99%

Impact of Antibiotic Resistance on the Development of Recurrent and Relapsing Symptomatic Urinary Tract Infection in Kidney Recipients

Bodro¹,

Sanclemente²,

Lipperheide³

et al. 2015

American Journal of Transplantation

View full text Add to dashboard Cite

show abstract

“…Serious infectious complications such as bloodstream infection (BSI) pose a life-threatening condition in solid organ transplant recipients (1,2). Liver transplantation (LT) patients are highly susceptible to BSI, and the burden of these infections is clearly attributable to the dysfunction of host defense mechanisms resulting from cirrhosis and from the use of immunosuppressive agents to prevent rejection (3,4).…”

Section: Introductionmentioning

confidence: 99%

Fc-Gamma Receptor Polymorphisms Predispose Patients to Infectious Complications After Liver Transplantation

Shimizu

Tanaka

Tazawa

et al. 2016

American Journal of Transplantation

View full text Add to dashboard Cite

We investigated the impact of polymorphisms in host innate immunoregulatory genes on the development of infectious complications after liver transplantation (LT). 3%), of which one third was methicillin-resistant Staphylococcus aureus. No differences were observed in the incidence of fungal infections or in cytomegalovirus infections with respect to the three gene polymorphisms. Our findings indicate that FcgR SNPs are predisposing factors for BSI and can predict mortality after LT. This study provides a foundation for further prospective studies on a larger scale.

show abstract

“…that are responsible for a majority of antimicrobial-resistant hospital-associated infections (11,12). ESKAPE pathogens are known to "escape" the effects of currently marketed antimicrobial agents, are frequently multidrug resistant, and are associated with poor patient outcomes, because patients infected with ESKAPE pathogens often receive inappropriate empirical antimicrobial therapy that leads to unfavorable clinical outcomes, high case fatality rates, and opportunities for the pathogen to spread to other patients (11,(13)(14)(15)(16). Gram-negative ESKAPE pathogens act as important reservoirs and transmitters of resistance and are responsible for the increased reporting of antimicrobial-resistant nosocomial infections worldwide (11)(12)(13)16).…”

mentioning

confidence: 99%

In Vitro Activity of Imipenem-Relebactam against Gram-Negative ESKAPE Pathogens Isolated by Clinical Laboratories in the United States in 2015 (Results from the SMART Global Surveillance Program)

Lob¹,

Hackel²,

Kazmierczak³

et al. 2017

Antimicrob Agents Chemother

128

View full text Add to dashboard Cite

) is an inhibitor of class A and C ␤-lactamases, including Klebsiella pneumoniae carbapenemase (KPC), and is currently in clinical development in combination with imipenem-cilastatin. Using Clinical and Laboratory Standards Institute (CLSI)-defined broth microdilution methodology, we evaluated the in vitro activities of imipenem-relebactam, imipenem, and seven routinely tested parenteral antimicrobial agents against Gramnegative ESKAPE pathogens (including Klebsiella pneumoniae, n ϭ 689; Acinetobacter baumannii, n ϭ 72; Pseudomonas aeruginosa, n ϭ 845; and Enterobacter spp., n ϭ 399) submitted by 21 clinical laboratories in the United States in 2015 as part of the SMART (Study for Monitoring Antimicrobial Resistance Trends) global surveillance program. Relebactam was tested at a fixed concentration of 4 g/ml in combination with doubling dilutions of imipenem. Imipenem-relebactam MICs were interpreted using CLSI imipenem breakpoints. The respective rates of susceptibility to imipenem-relebactam and imipenem were 94.2% (796/845) and 70.3% (594/845) for P. aeruginosa, 99.0% (682/689) and 96.1% (662/689) for K. pneumoniae, and 100% (399/399) and 98.0% (391/399) for Enterobacter spp. Relebactam restored imipenem susceptibility to 80.5% (202/251), 74.1% (20/27), and 100% (8/8) of isolates of imipenem-nonsusceptible P. aeruginosa, K. pneumoniae, and Enterobacter spp. Relebactam did not increase the number of isolates of Acinetobacter spp. susceptible to imipenem, and the rates of resistance to all of the agents tested against this pathogen were Ͼ30%. Further development of imipenem-relebactam is warranted given the demonstrated ability of relebactam to restore the activity of imipenem against current clinical isolates of Enterobacteriaceae and P. aeruginosa that are nonsusceptible to carbapenems and its potential as a therapy for treating patients with antimicrobial-resistant Gramnegative infections.

show abstract

Risk Factors and Outcomes of Bacteremia Caused by Drug-Resistant ESKAPE Pathogens in Solid-Organ Transplant Recipients

Cited by 152 publications

References 44 publications

Impact of Antibiotic Resistance on the Development of Recurrent and Relapsing Symptomatic Urinary Tract Infection in Kidney Recipients

Impact of Antibiotic Resistance on the Development of Recurrent and Relapsing Symptomatic Urinary Tract Infection in Kidney Recipients

Fc-Gamma Receptor Polymorphisms Predispose Patients to Infectious Complications After Liver Transplantation

In Vitro Activity of Imipenem-Relebactam against Gram-Negative ESKAPE Pathogens Isolated by Clinical Laboratories in the United States in 2015 (Results from the SMART Global Surveillance Program)

Contact Info

Product

Resources

About