| Autor: |
Freire, Maristela P., de Oliveira Garcia, Doroti, Lima, Stephanie Garcia, Pea, Cláudia Regina Delafiori, Reusing Junior, Jose Otto, Spadão, Fernanda, Cury, Ana Paula, Rossi, Flavia, Nahas, William C., David-Neto, Elias, Pierrotti, Ligia C. |
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| Zdroj: |
Infection; Dec2022, Vol. 50 Issue 6, p1525-1533, 9p, 2 Diagrams, 4 Charts |
| Abstrakt: |
Background: Infection with carbapenem-resistant Enterobacterales (CRE) is associated with a high mortality rate in kidney transplant recipients, and colonization with CRE is one of the major risk factors for CRE infection. There is, therefore, a need to improve the capacity to detect colonization with CRE among inpatients. Methods: In this prospective study, we compared the performance of real-time PCR for carbapenemase directly from rectal swabs with that of conventional CRE surveillance culture in all patients admitted to a kidney transplant ward between February 2019 and March 2020. Surveillance culture and real-time PCR were performed at admission and weekly until hospital discharge. Two perineum-rectal swabs were collected: one for culture and one for PCR. Results: We collected 905 paired samples for CRE surveillance from 399 patients, of whom 347 (87.0%) were kidney transplant recipients and 52 were waiting list patients. CRE was detected by culture and/or PCR in 75 patients (18.8%). Positivity for CRE was identified by PCR in 62 (15.5%) of the 399 patients and by culture in 55 (13.8%); 20 (5.0%) of the patients tested positive only on PCR, and 13 (3.3%) tested positive only on culture. The most common carbapenemase and species were, respectively, blaKPC (in 85.5%) and Klebsiella pneumoniae (in 80.0%). Infection with CRE occurred in 21.6% of the colonized patients, those cases occurred only among kidney transplant recipients. None of the patients who tested negative on culture developed CRE infection. Conclusion: In conclusion, the two methods are complementary and could be useful in a scenario of high CRE prevalence. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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