Risk factors and outcomes of bacteremia caused by drug-resistant ESKAPE pathogens in solid-organ transplant recipients
BACKGROUND: Although infections due to the six ESKAPE pathogens have recently been identified as a serious emerging problem, information regarding bacteremia caused by these organisms in solid-organ transplant (SOT) recipients is lacking. We sought to determine the frequency, risk factors, and outcomes of bacteremia due to drug-resistant ESKAPE (rESKAPE) organisms in liver, kidney, and heart adult transplant recipients.
METHODS: All episodes of bacteremia prospectively documented in hospitalized SOT recipients from 2007 to 2012 were analyzed.
RESULTS: Of 276 episodes of bacteremia, 54 (19.6%) were due to rESKAPE strains (vancomycin-resistant Enterococcus faecium [0], methicillin-resistant Staphylococcus aureus [5], extended-spectrum β-lactamase-producing Klebsiella pneumoniae [10], carbapenem-resistant Acinetobacter baumannii [8], carbapenem- and quinolone-resistant Pseudomonas aeruginosa [26], and derepressed chromosomal β-lactam and extended-spectrum β-lactamase-producing Enterobacter species [5]). Factors independently associated with rESKAPE bacteremia were prior transplantation, septic shock, and prior antibiotic therapy. Patients with rESKAPE bacteremia more often received inappropriate empirical antibiotic therapy than the others (41% vs. 21.6%; P=0.01). Overall case-fatality rate (30 days) was higher in patients with rESKAPE bacteremia (35.2% vs. 14.4%; P=0.001).
CONCLUSIONS: Bacteremia due to rESKAPE pathogens is frequent in SOT recipients and causes significant morbidity and mortality. rESKAPE organisms should be considered when selecting empirical antibiotic therapy for hospitalized SOT recipients presenting with septic shock, particularly those with prior transplantation and antibiotic use.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2013 |
|---|---|
| Erschienen: |
2013 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:96 |
|---|---|
| Enthalten in: |
Transplantation - 96(2013), 9 vom: 15. Nov., Seite 843-9 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Bodro, Marta [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Anti-Bacterial Agents |
|---|
| Anmerkungen: |
Date Completed 27.12.2013 Date Revised 05.11.2013 published: Print Citation Status MEDLINE |
|---|
| doi: |
10.1097/TP.0b013e3182a049fd |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM229439322 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM229439322 | ||
| 003 | DE-627 | ||
| 005 | 20231224082146.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231224s2013 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1097/TP.0b013e3182a049fd |2 doi | |
| 028 | 5 | 2 | |a pubmed24n0764.xml |
| 035 | |a (DE-627)NLM229439322 | ||
| 035 | |a (NLM)23883973 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Bodro, Marta |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Risk factors and outcomes of bacteremia caused by drug-resistant ESKAPE pathogens in solid-organ transplant recipients |
| 264 | 1 | |c 2013 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 27.12.2013 | ||
| 500 | |a Date Revised 05.11.2013 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: Although infections due to the six ESKAPE pathogens have recently been identified as a serious emerging problem, information regarding bacteremia caused by these organisms in solid-organ transplant (SOT) recipients is lacking. We sought to determine the frequency, risk factors, and outcomes of bacteremia due to drug-resistant ESKAPE (rESKAPE) organisms in liver, kidney, and heart adult transplant recipients | ||
| 520 | |a METHODS: All episodes of bacteremia prospectively documented in hospitalized SOT recipients from 2007 to 2012 were analyzed | ||
| 520 | |a RESULTS: Of 276 episodes of bacteremia, 54 (19.6%) were due to rESKAPE strains (vancomycin-resistant Enterococcus faecium [0], methicillin-resistant Staphylococcus aureus [5], extended-spectrum β-lactamase-producing Klebsiella pneumoniae [10], carbapenem-resistant Acinetobacter baumannii [8], carbapenem- and quinolone-resistant Pseudomonas aeruginosa [26], and derepressed chromosomal β-lactam and extended-spectrum β-lactamase-producing Enterobacter species [5]). Factors independently associated with rESKAPE bacteremia were prior transplantation, septic shock, and prior antibiotic therapy. Patients with rESKAPE bacteremia more often received inappropriate empirical antibiotic therapy than the others (41% vs. 21.6%; P=0.01). Overall case-fatality rate (30 days) was higher in patients with rESKAPE bacteremia (35.2% vs. 14.4%; P=0.001) | ||
| 520 | |a CONCLUSIONS: Bacteremia due to rESKAPE pathogens is frequent in SOT recipients and causes significant morbidity and mortality. rESKAPE organisms should be considered when selecting empirical antibiotic therapy for hospitalized SOT recipients presenting with septic shock, particularly those with prior transplantation and antibiotic use | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 7 | |a Anti-Bacterial Agents |2 NLM | |
| 700 | 1 | |a Sabé, Núria |e verfasserin |4 aut | |
| 700 | 1 | |a Tubau, Fe |e verfasserin |4 aut | |
| 700 | 1 | |a Lladó, Laura |e verfasserin |4 aut | |
| 700 | 1 | |a Baliellas, Carme |e verfasserin |4 aut | |
| 700 | 1 | |a Roca, Josep |e verfasserin |4 aut | |
| 700 | 1 | |a Cruzado, Josep Maria |e verfasserin |4 aut | |
| 700 | 1 | |a Carratalà, Jordi |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Transplantation |d 1963 |g 96(2013), 9 vom: 15. Nov., Seite 843-9 |w (DE-627)NLM000023787 |x 1534-6080 |7 nnns |
| 773 | 1 | 8 | |g volume:96 |g year:2013 |g number:9 |g day:15 |g month:11 |g pages:843-9 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1097/TP.0b013e3182a049fd |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 96 |j 2013 |e 9 |b 15 |c 11 |h 843-9 | ||