Author(s):
Caria, João ; Gonçalves, Ana C. ; Cristóvão, Gonçalo ; Carlos, Maria ; Magalhães, Sara ; Almeida, Vasco ; Moreno, Fernanda ; Mateus, Élia ; Pinheiro, Hélder ; Póvoas, Diana ; Maltez, Fernando M.T. ; Perdigoto, Rui ; Cardoso, Filipe S. ; Marques, Hugo P.
Date: 2024
Persistent ID: http://hdl.handle.net/10362/169966
Origin: Repositório Institucional da UNL
Subject(s): Carbapenem; Colonization; Colonização; Infection; Infecção; Liver transplantation; Multidrug resistance; Multirresistência; Transplante de fígado; Gastroenterology
Description
Publisher Copyright: © 2024 The Author(s). Published by S. Karger AG, Basel.
Introduction: Carbapenem-resistant Enterobacteriaceae (CRE) epidemiology among liver transplant (LT) recipients is variable. We studied the impact of CRE colonization and infection on LT recipients' outcomes. Methods: This observational cohort study included consecutive adult LT recipients between January 2019 and December 2020 at Curry Cabral Hospital, Lisbon, Portugal. Primary exposures were CRE colonization (rectal swabs under a screening program) and infection within 1 year of index LT. Primary endpoint was graft failure within 1 year of the index LT. Results: Among 209 patients, the median (interquartile range [IQR]) age was 57 (47-64) years and 155 (74.2%) were male. CRE colonization was identified in 28 (13.4%) patients during the first year posttransplant (median [IQR] number of rectal swabs per patient of 4 [2-7]). CRE resistance genes identified were OXA48 in 8 (3.6%) patients, KPC in 19 (67.9%) patients, and VIM in 1 (3.6%) patient. Any bacterial/fungal and CRE infections were diagnosed in 88 (42.1%) and 6 (2.9%) patients, respectively, during the first year posttransplant. After adjusting for confounders, neither CRE colonization (aOR [95% CI] = 1.83 [0.71-4.70]; p = 0.21) nor infection (aOR [95% CI] = 1.35 [0.17-11.06]; p = 0.78) was associated with graft failure within 1 year of index LT. Discussion/Conclusion: Under a screening program, CRE colonization and infection prevalence was low and neither was associated with graft failure.
