Molecular characterization of multidrug resistant Enterobacterales strains isolated from liver and kidney transplant recipients in Spain.

Autor:	Fernández-Martínez M; Servicio de Microbiología, Hospital Universitario Marqués de Valdecilla, Santander, Spain. mfernandez@idival.org.; Instituto de Investigación Valdecilla-IDIVAL, Santander, Spain. mfernandez@idival.org., González-Rico C; Instituto de Investigación Valdecilla-IDIVAL, Santander, Spain.; Servicio de Enfermedades Infecciosas, Hospital Universitario Marqués de Valdecilla, Santander, Spain., Gozalo-Margüello M; Servicio de Microbiología, Hospital Universitario Marqués de Valdecilla, Santander, Spain.; Instituto de Investigación Valdecilla-IDIVAL, Santander, Spain., Marco F; Servicio de Microbiología, Centro Diagnóstico Biomédico, Hospital Clínic. ISGlobal, Universidad de Barcelona, Barcelona, Spain., Gracia-Ahufinger I; Unidad de Microbiología, Hospital Universitario Reina Sofía, Córdoba, Spain.; Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain., Aranzamendi M; Servicio de Microbiología, Hospital Universitario de Cruces, Baracaldo, Vizcaya, Spain.; Instituto de Investigación Sanitaria Biocruces, Vizcaya, Spain., Sánchez-Díaz AM; Servicio de Microbiología, Hospital Universitario Ramón y Cajal, Madrid, Spain., Vicente-Rangel T; Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain., Chaves F; Servicio de Microbiología, Hospital Universitario 12 de Octubre, Madrid, Spain., Calvo Montes J; Servicio de Microbiología, Hospital Universitario Marqués de Valdecilla, Santander, Spain.; Instituto de Investigación Valdecilla-IDIVAL, Santander, Spain., Martínez-Martínez L; Unidad de Microbiología, Hospital Universitario Reina Sofía, Córdoba, Spain. luis.martinez.martinez.sspa@juntadeandalucia.es.; Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain. luis.martinez.martinez.sspa@juntadeandalucia.es.; Departamento of Microbiología, Unidad de Microbiología, Hospital Universitario Reina Sofía, IMIBIC, Universidad de Córdoba, Córdoba, Spain. luis.martinez.martinez.sspa@juntadeandalucia.es., Fariñas MC; Instituto de Investigación Valdecilla-IDIVAL, Santander, Spain. mcarmen.farinas@scsalud.es.; Servicio de Enfermedades Infecciosas, Hospital Universitario Marqués de Valdecilla, Santander, Spain. mcarmen.farinas@scsalud.es.
Jazyk:	angličtina
Zdroj:	Scientific reports [Sci Rep] 2021 Jun 04; Vol. 11 (1), pp. 11875. Date of Electronic Publication: 2021 Jun 04.
DOI:	10.1038/s41598-021-90382-5
Abstrakt:	The objective of this study was to analyse the mechanisms of resistance to carbapenems and other extended-spectrum-β-lactams and to determine the genetic relatedness of multidrug-resistant Enterobacterales (MDR-E) causing colonization or infection in solid-organ transplantation (SOT) recipients. Prospective cohort study in kidney (n = 142), liver (n = 98) or kidney/pancreas (n = 7) transplant recipients between 2014 and 2018 in seven Spanish hospitals. We included 531 MDR-E isolates from rectal swabs obtained before transplantation and weekly for 4-6 weeks after the procedure and 10 MDR-E from clinical samples related to an infection. Overall, 46.2% Escherichia coli, 35.3% Klebsiella pneumoniae, 6.5% Enterobacter cloacae, 6.3% Citrobacter freundii and 5.7% other species were isolated. The number of patients with MDR-E colonization post-transplantation (176; 71.3%) was 2.5-fold the number of patients colonized pre-transplantation (71; 28.7%). Extended-spectrum β-lactamases (ESBLs) and carbapenemases were detected in 78.0% and 21.1% of MDR-E isolates respectively. In nine of the 247 (3.6%) transplant patients, the microorganism causing an infection was the same strain previously cultured from surveillance rectal swabs. In our study we have observed a low rate of MDR-E infection in colonized patients 4-6 weeks post-transplantation. E. coli producing bla CTX-M-G1 and K. pneumoniae harbouring bla OXA-48 alone or with bla CTX-M-G1 were the most prevalent MDR-E colonization strains in SOT recipients.
Databáze:	MEDLINE
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