Impact of enterococcal colonization and infection in solid organ transplantation recipients from the Swiss Transplant Cohort Study.

Détails

ID Serval
serval:BIB_D5221F95634F
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Impact of enterococcal colonization and infection in solid organ transplantation recipients from the Swiss Transplant Cohort Study.
Périodique
Transplant Infectious Disease : An Official Journal of the Transplantation Society
Auteur(s)
Bucheli E., Kralidis G., Boggian K., Cusini A., Garzoni C., Manuel O., Meylan P.R., Mueller N.J., Khanna N., van Delden C., Berger C., Koller M.T., Weisser M.
Collaborateur(s)
Swiss Transplant Cohort Study
ISSN
1399-3062 (Electronic)
ISSN-L
1398-2273
Statut éditorial
Publié
Date de publication
2014
Peer-reviewed
Oui
Volume
16
Numéro
1
Pages
26-36
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't Publication Status: ppublish
Résumé
BACKGROUND: The burden of enterococcal infections has increased over the last decades with vancomycin-resistant enterococci (VRE) being a major health problem. Solid organ transplantation is considered as a risk factor. However, little is known about the relevance of enterococci in solid organ transplantation recipients in areas with a low VRE prevalence.
METHODS: We examined the epidemiology of enterococcal events in patients followed in the Swiss Transplant Cohort Study between May 2008 and September 2011 and analyzed risk factors for infection, aminopenicillin resistance, treatment, and outcome.
RESULTS: Of the 1234 patients, 255 (20.7%) suffered from 392 enterococcal events (185 [47.2%] infections, 205 [52.3%] colonizations, and 2 events with missing clinical information). Only 2 isolates were VRE. The highest infection rates were found early after liver transplantation (0.24/person-year) consisting in 58.6% of Enterococcus faecium. The highest colonization rates were documented in lung transplant recipients (0.33/person-year), with 46.5% E. faecium. Age, prophylaxis with a betalactam antibiotic, and liver transplantation were significantly associated with infection. Previous antibiotic treatment, intensive care unit stay, and lung transplantation were associated with aminopenicillin resistance. Only 4/205 (2%) colonization events led to an infection. Adequate treatment did not affect microbiological clearance rates. Overall mortality was 8%; no deaths were attributable to enterococcal events.
CONCLUSIONS: Enterococcal colonizations and infections are frequent in transplant recipients. Progression from colonization to infection is rare. Therefore, antibiotic treatment should be used restrictively in colonization. No increased mortality because of enterococcal infection was noted.
Pubmed
Web of science
Création de la notice
11/09/2014 17:42
Dernière modification de la notice
20/08/2019 16:54
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