Carbapenemase-Producing Klebsiella pneumoniae Colonization and Infection in Solid Organ Transplant Recipients: A...

Area of Science:

• Infectious Diseases
• Transplantation Immunology
• Microbiology

Background:

• Carbapenemase-KPC producing Klebsiella pneumoniae (CP-Kp) infections are a significant concern for solid organ transplant (SOT) recipients.
• Enteric colonization and invasive CP-Kp infections can lead to severe outcomes in this vulnerable population.

Purpose of the Study:

• To investigate the association between CP-Kp enteric colonization and invasive infections with one-year mortality in SOT recipients.
• To identify risk factors for CP-Kp colonization and invasive infections in SOT patients.

Main Methods:

• Retrospective study of SOT recipients admitted between May 2011 and August 2014.
• Analysis of rectal swabs for CP-Kp colonization and clinical data for invasive infections and mortality.
• Univariate and multivariate analyses to determine associations with one-year mortality.

Main Results:

• 5.4% of SOT recipients showed CP-Kp enteric colonization, predominantly post-transplant.
• 4.5% developed CP-Kp-related invasive infections, with most originating from colonized patients.
• One-year mortality was 31.1% for colonized patients and 51.4% for those with invasive infections.

Conclusions:

• Invasive CP-Kp infections are significantly associated with increased one-year mortality in SOT recipients.
• Gastrointestinal colonization by CP-Kp was not associated with increased one-year mortality and was linked to improved survival in multivariate analysis.
• Sepsis, severe sepsis, and septic shock were also significantly associated with one-year mortality.