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>Journals >Revista Cubana de Medicina >Year 2016, Issue 1


Cruz ARE, Camacho RSI, Hernández POA, Hernández FME, Batista HR
Experience in the treatment of bacterial infection in renal transplant recipients
Rev cubana med 2016; 55 (1)

Language: Español
References: 45
Page: 6-19
PDF: 180.92 Kb.


Full text




ABSTRACT

Introduction: renal transplantation is the therapy of choice in the treatment of chronic kidney disease, but specifically bacterial infectious complications maintain high rates of morbidity and mortality and it is a problem difficult to solve. At "Arnaldo Milian Castro" University, eight year-experience has been gained in the treatment of bacterial infection in renal transplant recipients.
Objective: characterize the bacterial infection behavior in renal transplant recipients.
Methods: a descriptive, longitudinal and prospective study was conducted from June 2001 to December 2009, in 102 patients receiving renal transplantation and who were diagnosed with bacterial infections; and 192 bacterial infections confirmed by microbiological education.
Results: nine infectious processes were located in the pulmonary parenchyma with clinic, X-ray images and antimicrobial answer with no positiveness in the specimens gathered and processed in the laboratory. The most affected age group was 31 to 40 years with 32 infectious processes. There were no differences in gender or sex-age relationship. White skin subjects prevailed (74.5 %) (x2 BA = 0.064 p = 0.936). Those who exhibited a single infection were overrepresented (50 %) and urine culture was more positive specimen, 94 for an index of 0.92. Patient groups one and two infectious episodes had 2 deaths each at discharge (p = 0.278). The wound and urinary tract infections prevailed in the immediate postoperative period, with 16 cases, respectively, although the latter was more likely at different evolutive periods. Acinetobacter spp was the most resistant microorganism in urine culture in 3 patients (10.34 %) and the less effective antimicrobial was amoxicillin-sulbactam, in 8 (21.05 %).
Conclusions: the timely and specific selection of the antimicrobial drug at the recommended dose for each patient has been the main tool in our experience.


Key words: renal transplantation, bacterial infection, antimicrobial therapy.


REFERENCIAS

  1. Levey A, Eckardt KU, Tsukamoto Y. Definition and classification of chronic kidney disease. A position statement from Kidney Disease Improving Global Outcomes (KDIGO). Kidney Int. 2005;67:1098-2100.

  2. Helanterä I, Saha H, Koskinen P. The follow-up of kidney transplant patients. Duodecim. 2010;126(22):2601-8.

  3. Wavamunno MD, Harris DCH. The need for early nephrology referral. Kidney Int. 2005;67(Suppl 94):S128-32.

  4. Parasuraman R, Samarapungavan D, Venkat KK. Updated principles and clinical caveats in the management of infection in renal transplant recipients. Transplant Rev (Orlando). 2010;24(2):43-51.

  5. Dalinkevičienė E, Kuzminskis V, Petrulienė K, Skarupskienė I, Bagdonavičiūtė G, Bumblytė IA. Ten-year experience of kidney transplantation at the Hospital of Kaunas University of Medicine: demography, complications, graft and patient survival. Medicina (Kaunas). 2010;46(8):538-43.

  6. Remuzzi G, Remuzzi A. Is regression of chronic nephropathies a therapeutic target? J Am Soc Nephrol. 2005;16:840-2.

  7. Mainis MF, Mahorter SD, Jain A, Shrestha NK, Avery RK, van Duin D. Staphylococcus aureus bacteremia in solid organ transplant recipients: evidence for improved survival when compared with nontransplant patients. Transplantation. 2012;93(10):1045-50.

  8. Florescu DF, Qiu F, West SB, Richards S, Florescu MC, Stevens B, et al. Staphylococcus aureus infections in kidney transplantation: a matched case controlled study. Scand J Infect Dis. 2012;44(6):427-32.

  9. Cockroft DW, Gault MH. Prediction of creatinine clearance from serum creatinine. Nephrol. 1976;16:31-41.

  10. Kamath NS, John GT, Neelakantan N, Kirubakaran MG, Jacob CK. Acute graft pyelonephritis following renal transplantation. Transpl Infect Dis. 2006;8(3):140-7.

  11. Ingsathit A, Avihingsanonc Y, Rattanasirib S, Premasathiand N, Pongskule C, Jittikanontf S, et al. Different etiologies of graft loss and death in Asian kidney transplant recipients: A report from Thai Transplant Registry. Transplant Proc. 2010;42(10);4014-6.

  12. Lee S, Kim J, Shin M, Kim E, Moon J, Jung G, et al. Comparison of outcomes of living and deceased donor kidney grafts surviving longer than 5 years in Korea. Transplant Proc. 2010;42(3):775-7.

  13. Borroto G, Barceló M, Guerrero C, Ponce P. Infecciones en el trasplante renal. Rev Cubana Med. (online) 2002;41(3):162-6.

  14. Linares L, Cofán F, Cervera C, Ricart MJ, Oppenheimer F, Campistol JM, et al. Infection-related mortality in a large cohort of renal transplant recipients. Transpl Proc. 2007;39(7):2225-7.

  15. Splendiania G, Cipriani S, Tisone G, Iorio B, Condo S, Vega A, et al. Infectious complications in renal transplant recipients. Transplant Proc. 2005;37(6):2497-9.

  16. Valera B, Gentil MA, Cabello V, Fijo J, Cordero E, Cisneros JM. Epidemiology of urinary infections in renal transplant recipients. Transpl Proc. 2006;38(8):2414-5.

  17. Gupta G, Unruh ML, Nolin TD, Hasley PB. Primary care of the renal transplant patient. J Gen Intern Med. 2010;25(7):731-40.

  18. Lopes JA, Fernandes P, Jorge S, Resina C, Santos C, Pereira A, et al. Long-term risk of mortality after acute kidney injury in patients with sepsis: A contemporary analysis. BMC Nephrol. 2010;11:9.

  19. Veroux M, Giuffrida G, Corona D, Gagliano M, Scriffignano V, Vizcarra D, et al. Infective complications in renal allograft recipients: Epidemiology and outcome. Transplant Proc. 2008;40(6):1873-6.

  20. Peleg AY, Hooper DC. Hospital-acquired infections due to gram-negative bacteria. N Engl J Med. 2010;362:1804-13.

  21. Linares L, Cervera C, Hoyo I, Sanclemente G, Marco F, Cofán F, et al. Klebsiella pneumoniae infection in solid organ transplant recipients: epidemiology and antibiotic resistance. Transplant Proc. 2010;42(8):2941-3.

  22. Gołębiewska J, Dębska-Ślizień A, Komarnicka J, Samet A, Rutkowski B. Urinary tract infections in renal transplant recipients. Transplant Proc. 2011;43(8):2985-90.

  23. Barbouch S, Cherif M, Ounissi M, Karoui C, Mzoughi S, Hamida FB, et al. Urinary tract infections following renal transplantation: a single-center experience. Saudi J Kidney Dis Transpl. 2012;23(6):1311-4.

  24. Linares L, García-Goez JF, Cervera C, Almela M, Sanclemente G, Cofán F, et al. Early bacteremia after solid organ transplantation. Transplant Proc. 2009;41(6):2262-4.

  25. Fishman JA. Infection in solid-organ transplant recipients. N Engl J Med. 2007;357:2601-14.

  26. Bromberg JS, Fairchild RL, Feng S, Kaplan B, Bar ML, Grady JO, et al. Acute graft pyelonephritis following renal transplantation. Urinary tract infection. Am J Transpl. 2009;9(Suppl 3):S59-S62.

  27. Fortun J, Martin-Davila P, Pascual J, Cervera C, Moreno A, Gavalda J, et al. Immunosuppressive therapy and infection after kidney transplantation. Transpl Infect Dis. 2010;12(5):397-405.

  28. Vidal E, Torre-Cisneros J, Blanes M, Montejo M, Cervera C, Aguado JM, et al. Bacterial urinary tract infection after solid organ transplantation in the RESITRA cohort. Transpl Infect Dis. 2012;14(6):595-603.

  29. Khanna P, Abraham G, Mohamed Ali AA, Miriam PE, Mathew M, Lalitha MK, et al. Urinary tract infections in the era of newer immunosuppressant agents: a tertiary care center study. Saudi J Kidney Dis Transpl. 2010;21(5):876-80.

  30. Rivera R, Delgado D, Flores RR, García EE, Espinosa R, Bazan AA, et al. Prospective study of urinary tract infection surveillance after kidney transplantation. BMC Infect Dis. 2010;10:245.

  31. Lyerová L, Viklický O, Nemcová D, Teplan V. The incidence of infectious diseases after renal transplantation: a single-centre experience. Int J Antimicrob Agents. 2008;31(Suppl1):S58-62.

  32. Lopau K, Syamken K, Rubenwolf P, Riedmiller H, Wanner C. Impact of mycophenolate mofetil on wound complications and lymphoceles after kidney transplantation. Kidney Blood Press Res. 2010;33(1):52-9.

  33. Hoyo I, Linares L, Cervera C, Almela M, Marcos MA, Sanclemente G, et al. Epidemiology of pneumonia in kidney transplantation. Transplant Proc. 2010;42(8):2938-40.

  34. Johnson JR, Johnston B, Clabots C, Kuskowski MA, Pendyala S, Debroy C, et al. Escherichia coli sequence type ST131 as an emerging fluoroquinolone-resistant uropathogen among renal transplant recipients. Antimicrob Agents Chemother. 2010;54(1):546-50.

  35. Diomedi A. Infecciones por Acinetobacter baumannii pan-resistente. Consideraciones epidemiológicas y de manejo antimicrobiano actualizado. Rev Chil Infect. 2005;22(4):298-320.

  36. Rodríguez CH, Bombicino K, Granados G, Vay C, Famiglietty A. Evaluación microbiológica y epidemiológica de los clones de Acinetobacter baumannii resistentes a los carbapenemes aislados en la unidad de cuidados intensivos de un Hospital Universitario de la ciudad de Buenos Aires. Rev Argent Microbiol. 2009;41(3):151-5.

  37. Barreto S, Zambrano M, Araque M. Variaciones fenotípicas de susceptibilidad en cepas de Klebsiella pneumoniae de origen nosocomial y su asociación con la formación de biopelículas. Invest Clin. 2009;50(2):221-9.

  38. van Hal SJ, Jensen SO, Vaska VL, Espedido BA, Paterson DL, Gosbell IB. Predictors of mortality in Staphylococcus aureus Bacteremia. Clin Microbiol Rev. 2012;25(2):362-86.

  39. Reddy P, Zembower TR, Ison MG, Baker TA, Stosor V. Carbapenem-resistant Acinetobacter baumannii infections after organ transplantation. Transpl Infect Dis. 2010;12(1):87-93.

  40. Johnson JR, Johnston B, Clabots C, Kuskowski MA, Pendyala S, Debroy C, et al. Escherichia coli sequence type ST131 as an emerging fluoroquinolone-resistant uropathogen among renal transplant recipients. Antimicrob Agents Chemother. 2010;54(1):546-50.

  41. Jung JY, Park MS, Kim SE, Park BH, Son JY, Kim EY, et al. Risk factors for multi-drug resistant Acinetobacter baumannii bacteremia in patients with colonization in the intensive care unit. BMC Infect Dis. 2010;10:228.

  42. Tacconelli E, Cataldo MA, De Pascale G, Manno D, Spanu T, Cambieri A, et al. Prediction models to identify hospitalized patients at risk of being colonized or infected with multidrug-resistant Acinetobacter baumannii calcoaceticus complex. J Antimicrob Chemother. 2008;62(5):1130-7.

  43. Rodríguez CH, Bombicino K, Granados G, Vay C, Famiglietty A. Evaluación microbiológica y epidemiológica de los clones de Acinetobacter baumannii resistentes a los carbapenemes aislados en la unidad de cuidados intensivos de un Hospital Universitario de la ciudad de Buenos Aires. Rev Argent Microbiol. 2009;41(3):151-5.

  44. Linares L, Cervera C, Hoyo I, Sanclemente G, Marco F, Cofán F, et al. Klebsiella pneumoniae infection in solid organ transplant recipients: epidemiology and antibiotic resistance. Transplant Proc. 2010;42(8):2941-3.

  45. Winters HA, Parbhoo RK, Schafer JJ, Goff DA. Extended-spectrum betalactamase- producing bacterial infections in adult solid organ transplant recipients. Ann Pharmacother. 2011;45(3):309-16.






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