Madeleine S. Tilley, Seth W. Edwards, Matthew L. Brown, Peng Li, Shikha Mehta, Jeremey Walker, Kristofer C. Gutierrez
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Patient outcomes were assessed for 365 days after positive blood cultures.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>The study included 63 patients. Of these, 18 (29%) patients had bacteremia caused by an ESBL-GNR and 45 (71%) patients had bacteremia caused by a non–ESBL-GNR. Patient survival at 90 days was 94% in the ESBL-GNR group and 96% in the non–ESBL-GNR group. Ciprofloxacin was the most common antimicrobial therapy at discharge (68.9%) in the non–ESBL-GNR group whereas ertapenem was the most common in the ESBL-GNR group (44.5%). Median eGFR at discharge was 41 mL/min/1.73 m<sup>2</sup> in the ESBL-GNR group and 48 mL/min/1.73 m<sup>2</sup> in the non–ESBL-GNR group. Ninety-day readmission occurred in 9 (50%) ESBL-GNR patients and 14 (32%) non–ESBL-GNR patients. None of the above comparisons are statistically significant (<i>p</i> > 0.05). Eleven (61%) ESBL-GNR and 2 (4%) non–ESBL-GNR patients used outpatient parenteral antimicrobial therapy (<i>p</i> < 0.001).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Among KTs with ESBL-GNR bacteremia, no significant difference was detected in mortality or allograft function compared to non–ESBL-GNR bacteremia.</p>\n </section>\n </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":null,"pages":null},"PeriodicalIF":1.9000,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ctr.15390","citationCount":"0","resultStr":"{\"title\":\"Assessment of Posttransplant Bacteremia Caused by Extended-Spectrum Beta-Lactamase–Producing Gram-Negative Bacteria Among Kidney Transplant Recipients\",\"authors\":\"Madeleine S. Tilley, Seth W. Edwards, Matthew L. Brown, Peng Li, Shikha Mehta, Jeremey Walker, Kristofer C. Gutierrez\",\"doi\":\"10.1111/ctr.15390\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>Extended-spectrum beta-lactamase–producing gram-negative rods (ESBL-GNR) are a rising cause of bacteremia in kidney transplant recipients (KT). The study purpose was to examine patient mortality, allograft survival, estimated glomerular filtration rate (eGFR) at the end of 1 year, and readmission rates while looking at treatment strategies among KTs with ESBL-GNR and non–ESBL-GNR bacteremia at our institution.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>This study was a retrospective, cohort analysis of KTs with gram-negative bacteremia from January 1, 2020, to December 31, 2021. The primary outcome of the study was mortality. Patient outcomes were assessed for 365 days after positive blood cultures.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>The study included 63 patients. Of these, 18 (29%) patients had bacteremia caused by an ESBL-GNR and 45 (71%) patients had bacteremia caused by a non–ESBL-GNR. Patient survival at 90 days was 94% in the ESBL-GNR group and 96% in the non–ESBL-GNR group. Ciprofloxacin was the most common antimicrobial therapy at discharge (68.9%) in the non–ESBL-GNR group whereas ertapenem was the most common in the ESBL-GNR group (44.5%). Median eGFR at discharge was 41 mL/min/1.73 m<sup>2</sup> in the ESBL-GNR group and 48 mL/min/1.73 m<sup>2</sup> in the non–ESBL-GNR group. Ninety-day readmission occurred in 9 (50%) ESBL-GNR patients and 14 (32%) non–ESBL-GNR patients. None of the above comparisons are statistically significant (<i>p</i> > 0.05). 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Assessment of Posttransplant Bacteremia Caused by Extended-Spectrum Beta-Lactamase–Producing Gram-Negative Bacteria Among Kidney Transplant Recipients
Background
Extended-spectrum beta-lactamase–producing gram-negative rods (ESBL-GNR) are a rising cause of bacteremia in kidney transplant recipients (KT). The study purpose was to examine patient mortality, allograft survival, estimated glomerular filtration rate (eGFR) at the end of 1 year, and readmission rates while looking at treatment strategies among KTs with ESBL-GNR and non–ESBL-GNR bacteremia at our institution.
Methods
This study was a retrospective, cohort analysis of KTs with gram-negative bacteremia from January 1, 2020, to December 31, 2021. The primary outcome of the study was mortality. Patient outcomes were assessed for 365 days after positive blood cultures.
Results
The study included 63 patients. Of these, 18 (29%) patients had bacteremia caused by an ESBL-GNR and 45 (71%) patients had bacteremia caused by a non–ESBL-GNR. Patient survival at 90 days was 94% in the ESBL-GNR group and 96% in the non–ESBL-GNR group. Ciprofloxacin was the most common antimicrobial therapy at discharge (68.9%) in the non–ESBL-GNR group whereas ertapenem was the most common in the ESBL-GNR group (44.5%). Median eGFR at discharge was 41 mL/min/1.73 m2 in the ESBL-GNR group and 48 mL/min/1.73 m2 in the non–ESBL-GNR group. Ninety-day readmission occurred in 9 (50%) ESBL-GNR patients and 14 (32%) non–ESBL-GNR patients. None of the above comparisons are statistically significant (p > 0.05). Eleven (61%) ESBL-GNR and 2 (4%) non–ESBL-GNR patients used outpatient parenteral antimicrobial therapy (p < 0.001).
Conclusions
Among KTs with ESBL-GNR bacteremia, no significant difference was detected in mortality or allograft function compared to non–ESBL-GNR bacteremia.
期刊介绍：
Clinical Transplantation: The Journal of Clinical and Translational Research aims to serve as a channel of rapid communication for all those involved in the care of patients who require, or have had, organ or tissue transplants, including: kidney, intestine, liver, pancreas, islets, heart, heart valves, lung, bone marrow, cornea, skin, bone, and cartilage, viable or stored.
Published monthly, Clinical Transplantation’s scope is focused on the complete spectrum of present transplant therapies, as well as also those that are experimental or may become possible in future. Topics include:
Immunology and immunosuppression;
Patient preparation;
Social, ethical, and psychological issues;
Complications, short- and long-term results;
Artificial organs;
Donation and preservation of organ and tissue;
Translational studies;
Advances in tissue typing;
Updates on transplant pathology;.
Clinical and translational studies are particularly welcome, as well as focused reviews. Full-length papers and short communications are invited. Clinical reviews are encouraged, as well as seminal papers in basic science which might lead to immediate clinical application. Prominence is regularly given to the results of cooperative surveys conducted by the organ and tissue transplant registries.
Clinical Transplantation: The Journal of Clinical and Translational Research is essential reading for clinicians and researchers in the diverse field of transplantation: surgeons; clinical immunologists; cryobiologists; hematologists; gastroenterologists; hepatologists; pulmonologists; nephrologists; cardiologists; and endocrinologists. It will also be of interest to sociologists, psychologists, research workers, and to all health professionals whose combined efforts will improve the prognosis of transplant recipients.
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