Pretransplant Fecal Carriage of Extended-Spectrum β-Lactamase–producing Enterobacteriaceae and Infection after Liver Transplant, France

Bert, Frédéric; Larroque, Béatrice; Paugam-Burtz, Catherine; Dondero, Federica; Durand, François; Marcon, Estelle; Belghiti, Jacques; Moreau, Richard; Nicolas-Chanoine, Marie-Hélène

doi:10.3201/eid1806.110139

i

Pretransplant Fecal Carriage of Extended-Spectrum β-Lactamase–producing Enterobacteriaceae and Infection after Liver Transplant, France

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Jun 2012
By Bert, Frédéric ; Larroque, Béatrice ; Paugam-Burtz, Catherine ; ...

File Language:

English

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Alternative Title:

Emerg Infect Dis
Personal Author:

Bert, Frédéric ; Larroque, Béatrice ; Paugam-Burtz, Catherine ; Dondero, Federica ; Durand, François ; Marcon, Estelle ; Belghiti, Jacques ; Moreau, Richard ; Nicolas-Chanoine, Marie-Hélène
Description:

Extended-spectrum β-lactamase-producing Enterobacteriaceae isolates (ESBLE) are emerging pathogens that confer resistance to antimicrobial drugs. We conducted a 10-year study in France (January 2001-April 2010) to investigate the incidence of and risk factors for ESBLE infections after liver transplant. Of 710 transplant patients screened preoperatively for ESBLE fecal carriage, 5.5% had ESBLE infection develop within 4 months after surgery; patients with pretransplant ESBLE fecal carriage were more likely to have infection develop than were noncarriers. Typing showed extensive genetic diversity, with a large predominance of CTX-M enzymes. Independent predictors of ESBLE infection were pretransplant fecal carriage, Model for End Stage Liver Disease score >25, and return to surgery. Our results indicate that the influx of preoperatively acquired ESBLE isolates into the hospital outweighs cross-transmission in the epidemiology of ESBLE infections after liver transplant. Transplant candidates should be systematically screened for carriage, and posttransplant infection in carriers should be treated with carbapenems.
Subjects:

Adult Antimicrobial Resistance Bacteria Beta-Lactamases Beta-Lactam Resistance Carbapenems Carrier State Cme Enterobacteriaceae Esbl Escherichia Coli Escherichia Coli Infections Extended-Spectrum Β-Lactamase Fecal Carriage Feces Female France Humans Incidence Infection Intraabdominal Infections Liver Liver Diseases Liver Transplantation Male Middle Aged Molecular Typing Research Risk Factors Transplant Urinary Tract Infections
Source:

Emerg Infect Dis. 18(6):908-916.
Document Type:

Journal Article
Volume:

18
Issue:

6
Collection(s):

Emerging Infectious Diseases
Main Document Checksum:

urn:sha256:46f831462c67ea9258915f3aaad1a7c92037e79f9d0a44ad26b478c0585fe32e
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https://stacks.cdc.gov/view/cdc/23566/cdc_23566_DS1.pdf
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[PDF - 384.65 KB ]

File Language:

English

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