Colonization and infection due to carbapenemase-producing Enterobacteriaceae in liver and lung transplant recipients and donor-derived transmission: a prospective cohort study conducted in Italy.
Adolescent
Adult
Aged
Aged, 80 and over
Bacterial Proteins
/ metabolism
Carbapenem-Resistant Enterobacteriaceae
Child
Child, Preschool
Cohort Studies
Drug Resistance, Bacterial
Enterobacteriaceae Infections
/ epidemiology
Female
Humans
Infant
Italy
/ epidemiology
Liver Transplantation
/ adverse effects
Lung Transplantation
/ adverse effects
Male
Middle Aged
Prospective Studies
Tissue Donors
Transplant Recipients
Young Adult
beta-Lactamases
/ metabolism
CPE
Colonization
Donor–recipient transmission
Infection
Solid organ transplant
Journal
Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases
ISSN: 1469-0691
Titre abrégé: Clin Microbiol Infect
Pays: England
ID NLM: 9516420
Informations de publication
Date de publication:
Feb 2019
Feb 2019
Historique:
received:
31
01
2018
revised:
05
03
2018
accepted:
01
05
2018
pubmed:
26
5
2018
medline:
11
5
2019
entrez:
26
5
2018
Statut:
ppublish
Résumé
A prospective cohort study was conducted in Italy in order to describe the microbiologic aspects of colonization/infection by carbapenemase-producing Enterobacteriaceae (CPE) in donors and recipients of lung and liver transplants and the possible CPE transmission from donors to recipients. Between 15 January 2014 and 14 January 2015, all recipients of solid organ transplants (SOT) at ten lung and eight liver transplantation centres and the corresponding donors were enrolled. Screening cultures to detect CPE were performed in donors, and screening and clinical cultures in recipients with a 28-day microbiologic follow-up after receipt of SOT. Detection of carbapenemase genes by PCR, genotyping by multilocus sequence typing, and pulsed-field gel electrophoresis and whole-genome sequencing were performed. Of 588 screened donors, 3.4% were colonized with CPE. Of the liver first transplant recipients (n = 521), 2.5% were colonized before receipt of SOT and 5% acquired CPE during follow-up. CPE colonization was higher in lung first transplant recipients (n = 111, 2.7% before SOT and 14.4% after SOT). CPE infections occurred in 1.9% and 5.3% of liver or lung recipients, respectively. CPE isolates were mostly Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae belonging to CG258. Three events of donor-recipient CPE transmission, confirmed by whole-genome sequencing and/or pulsed-field gel electrophoresis, occurred in lung recipients: two involving K. pneumoniae sequence type 512 and one Verona integron-encoded metallo-β-lactamase (VIM)-producing Enterobacter aerogenes. This study showed a low risk of donor-recipient CPE transmission, indicating that donor CPE colonization does not necessarily represent a contraindication for donation unless colonization regards the organ to be transplanted. Donor and recipient screening remains essential to prevent CPE transmission and cross-infection in transplantation centres.
Identifiants
pubmed: 29800674
pii: S1198-743X(18)30409-9
doi: 10.1016/j.cmi.2018.05.003
pii:
doi:
Substances chimiques
Bacterial Proteins
0
beta-Lactamases
EC 3.5.2.6
carbapenemase
EC 3.5.2.6
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
203-209Investigateurs
C Farina
(C)
F Vailati
(F)
G Gesu
(G)
C Vismara
(C)
M Arghittu
(M)
R Colombo
(R)
E Torresani
(E)
L Rossi
(L)
P G Conaldi
(PG)
F Gona
(F)
P Cambieri
(P)
P Marone
(P)
C Venditti
(C)
A Garcia Fernandez
(AG)
C Mancini
(C)
M Cusi
(M)
L Henrici De Angelis
(LH)
L Fossati
(L)
A C Finarelli
(AC)
C De Cillia
(C)
G Sangiorgi
(G)
A D Pinna
(AD)
F Stella
(F)
P Viale
(P)
M Colledan
(M)
M Platto
(M)
M Bonizzoli
(M)
A Peris
(A)
R Torelli
(R)
S Vesconi
(S)
E Cibelli
(E)
L De Carlis
(L)
A De Gasperi
(A)
M Ravini
(M)
R Carrinola
(R)
E Coluccio
(E)
D Dondossola
(D)
G Rossi
(G)
L Santambrogio
(L)
D Tosi
(D)
G Feltrin
(G)
C Rago
(C)
U Cillo
(U)
A Da Riva
(A)
F Rea
(F)
V Sparacino
(V)
A Bertani
(A)
M Canzonieri
(M)
B Gridelli
(B)
A Mularoni
(A)
M Spada
(M)
E Carrara
(E)
A Maria D'Armini
(AM)
P Paladini
(P)
D Adorno
(D)
M Valeri
(M)
M Caprio
(M)
P Di Ciaccio
(P)
F Puoti
(F)
P Berloco
(P)
B D'Auria
(B)
F Maldarelli
(F)
G Paglialunga
(G)
F Pugliese
(F)
M Rossi
(M)
F Venuta
(F)
A Amoroso
(A)
R Giacometti
(R)
M Rinaldi
(M)
M Salizzoni
(M)
Informations de copyright
Copyright © 2018 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.