Cross-transmission of vancomycin-resistant Enterococcus in patients undergoing dialysis and kidney transplant

Fram, Dayana Souza; Castrucci, Fernanda Marques da Silva; Taminato, Mônica; Godoy-Martínez, Patricio; Freitas, Maria Cecília de Santos; Belasco, Angélica Gonçalves Silva; Sesso, Ricardo; Pacheco-Silva, Álvaro; Pignatari, Antônio Carlos Campos; Barbosa, Dulce Aparecida

doi:10.1590/s0100-879x2009007500023

Cited by 11 publications

(11 citation statements)

References 14 publications

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“…A study conducted with 280 transplant patients at the Universidade Federal de Sao Paulo showed that colonization by Vancomycin-resistant Enterococcus in this population was 14.5% (23) . And recently demonstrated by molecular typing of isolated bacteria from this population that crosstransmission of multi-resistant bacteria happens among these patients (24) . Added to this, the number of patients on the waiting list for a kidney transplant is large and annually presents an increasing trend, this is due to progressive improvement in the quality and life expectancy afforded by dialysis interventions (25)(26) .…”

Section: Discussionmentioning

confidence: 94%

Prevalence of infection in kidney transplantation from living versus deceased donor: systematic review and meta-analysis

Taminato

Fram

Grothe

et al. 2015

Rev. esc. enferm. USP

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Objective: To verify if the type of donor is a risk factor for infection in kidney transplant recipients. Methods: Systematic Review of Literature with Meta-analysis with searches conducted in the databases MEDLINE, LILACS, Embase, Cochrane, Web of Science, SciELO and CINAHL. Results: We selected 198 studies and included four observational studies describing infections among patients distinguishing the type of donor. Through meta-analysis, it was shown that in patients undergoing deceased donor transplant, the outcome infection was 2.65 higher, than those who received an organ from a living donor. Conclusion:The study showed that deceased kidney donor recipients are at an increased risk for developing infections and so the need for establishing and enforcing protocols from proper management of ischemic time to the prevention and control of infection in this population emerges. Prevalence of infection in kidney transplantation from living versus deceased donor: systematic review and meta-analysis Prevalência de infecção em transplante renal de doador vivo versus falecido: revisão sistemática e metanálise Prevalencia de infección en trasplante renal de donante vivo versus fallecido: revisión sistemática y metanálisis

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Section: Discussionmentioning

confidence: 94%

Prevalence of infection in kidney transplantation from living versus deceased donor: systematic review and meta-analysis

Taminato

Fram

Grothe

et al. 2015

Rev. esc. enferm. USP

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“…With regard to resistance profiles, microorganisms such as MRSA and VRE have been isolated in surveillance cultures collected from patients on dialysis treatment [29,34,35]. Aktas et al .…”

Section: Discussionmentioning

confidence: 99%

Risk factors for bloodstream infection in patients at a Brazilian hemodialysis center: a case–control study

et al. 2015

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BackgroundInfection is the leading cause of morbidity and the second leading cause of mortality in patients on renal replacement therapy. The rates of bloodstream infection in hemodialysis patients vary according to the type of venous access used. Gram-positive bacteria are most frequently isolated in blood cultures of hemodialysis patients. This study evaluated risk factors for the development of bloodstream infections in patients undergoing hemodialysis.MethodsRisk factors associated with bloodstream infections in patients on hemodialysis were investigated using a case–control study conducted between January 2010 and June 2013. Chronic renal disease patients on hemodialysis who presented with positive blood cultures during the study were considered as cases. Controls were hemodialysis patients from the same institution who did not present with positive blood cultures during the study period. Data were collected from medical records. Logistic regression was used for statistical analysis.ResultsThere were 162 patients included in the study (81 cases and 81 controls). Gram-positive bacteria were isolated with the highest frequency (72%). In initial logistic regression analysis, variables were hypertension, peritoneal dialysis with previous treatment, type and time of current venous access, type of previous venous access, previous use of antimicrobials, and previous hospitalization related to bloodstream infections. Multiple regression analysis showed that the patients who had a central venous catheter had an 11.2-fold (CI 95%: 5.17–24.29) increased chance of developing bloodstream infections compared with patients who had an arteriovenous fistula for vascular access. Previous hospitalization increased the chance of developing bloodstream infections 6.6-fold (CI 95%: 1.9–23.09).ConclusionsInfection prevention measures for bloodstream infections related to central venous catheter use should be intensified, as well as judicious use of this route for vascular access for hemodialysis. Reducing exposure to the hospital environment through admission could contribute to a reduction in bloodstream infections in this population.

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“…(3) From the epidemiological point of view, the Gram-positive cocci have emerged as key players, especially Staphylococcus aureus, coagulase-negative staphylococci and enterococci. (3,4,5) Although coagulase-negative staphylococci are frequently isolated in blood cultures, they are clinically significant in less than 15.0% of cases. By being part of the skin microbia and submitting a relatively low virulence, they are usually considered contaminants of blood cultures.…”

Section: Introductionmentioning

confidence: 99%

Microrganismos isolados de pacientes em hemodiálise por cateter venoso central e evolução clínica relacionada

et al. 2013

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Objective: To identify the microorganisms isolated on the pericatheter skin, catheter tip and blood stream of patients on hemodialysis by central venous catheter, to verify the profile of sensitivity of these microorganisms to antimicrobials and to assess the clinical evolution and mortality related to these microorganisms. Methods: A cross sectional study. The strains were isolated from the patients on hemodialysis by central venous catheter that, in a previous study, presented pericatheter skin, catheter tip and blood stream infection and were analyzed for microbiological profile and lethality related. Results: 128 microorganisms were isolated in the bloodstream in the 94 patients studied. There were 35 cases of septicemia and 27 of endocarditis. The mortality in cases of endocarditis due to methicillin-resistant Staphylococcus aureus was 100%. Conclusion: Infection in the bloodstream and endocarditis caused by methicillin-resistant Staphylococcus aureus was predictive of mortality and lethality. ResumoObjetivo: Identificar os microrganismos isolados da pele pericateter, ponta do cateter e corrente sanguínea de pacientes em hemodiálise por cateter venoso central, verificar o perfil de sensibilidade destes microrganismos aos antimicrobianos e avaliar a evolução clínica e a mortalidade relacionada a estes microrganismos. Métodos: Estudo transversal. As cepas isoladas de pacientes em hemodiálise por cateter venoso central que em estudo prévio apresentaram infecção na pele pericateter, ponta do cateter e corrente sanguínea foram analisadas quanto ao perfil microbiológico e letalidade relacionada. Resultados: Foram isolados 128 microrganismos em corrente sanguínea nos 94 pacientes estudados. Ocorreram 35 casos de septicemia e 27 de endocardite. A letalidade nos casos de endocardite por Staphylococcus aureus resistente à meticilina foi 100%. Conclusão: Infecção em corrente sanguínea e endocardite por Staphylococcus aureus resistente à meticilina são preditivas de alta mortalidade e letalidade.

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Cross-transmission of vancomycin-resistant Enterococcus in patients undergoing dialysis and kidney transplant

Cited by 11 publications

References 14 publications

Prevalence of infection in kidney transplantation from living versus deceased donor: systematic review and meta-analysis

Prevalence of infection in kidney transplantation from living versus deceased donor: systematic review and meta-analysis

Risk factors for bloodstream infection in patients at a Brazilian hemodialysis center: a case–control study

Microrganismos isolados de pacientes em hemodiálise por cateter venoso central e evolução clínica relacionada

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