Pretransplant fecal carriage of extended-spectrum [beta]-lactamase--producing enterobacteriaceae and infection after liver transplant, France

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From: Emerging Infectious Diseases(Vol. 18, Issue 6)
Publisher: U.S. National Center for Infectious Diseases
Document Type: Article
Length: 4,995 words
Lexile Measure: 1480L

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Abstract :

Extended-spectrum [beta]-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 [greater than or equal to] 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.

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Gale Document Number: GALE|A292236486