Is Multiresistant Klebsiella pneumoniae New Delhi Metallo-beta-Lactamase (NDM-1) a New Threat for Kidney Transplant Recipients?

Karczewski, Marek; Tomczak, Hanna; Piechocka-Idasiak, I.; Cichańska, L.; Adamska, Z.; Stronka, M.

doi:10.1016/j.transproceed.2014.06.050

Cited by 8 publications

(6 citation statements)

References 10 publications

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“…This incidence is of concern because kidney transplantation limits the use of nephrotoxic antimicrobials such as aminoglycosides reducing the available therapeutic options. There are no guidelines for the correct choice of antimicrobial agent and treatment duration, but there are reported cases of resolution of infection after treatment with phosphomycin alone or in combination with carbapenems lasting 14 days in these patients [14][15][16] . Although new antimicrobials such as ceftazidime-avibactam are good options for the therapy of infections caused by KPC-producing strains, they have no action against NDM-1 strains.…”

Section: Discussionmentioning

confidence: 99%

“…Immunosuppressed patients are particularly susceptible to infection by multidrug-resistant bacteria, including solid-organ transplant patients, perhaps because this population is frequently exposed to health facilities, invasive devices, and antimicrobial agents [10][11][12][13] . However, there are few published reports of NDM-producing bacterial infections in kidney transplant recipients [14][15][16] .…”

Section: Introductionmentioning

confidence: 99%

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Challenges of Multidrug-resistant New Delhi Metallo-beta-Lactamase (NDM-1)-producing Enterobacteriaceae in Kidney Transplant Patients

Foresto¹,

Menezes²,

Nishimura³

et al. 2021

J. Bras. Nefrol.

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Background: The emergence of multidrug-resistant NDM-1-producing enterobacteriaceae strains has become a threat to inpatients, especially to immunosuppressed ones, such as kidney transplant recipients. NDM-1 is a carbapenemase that makes gram-negative bacteria resistant to many types of antibiotics. The incidence of carbapenemase-producing enterobacteria infection in solid organ transplant recipients is around 3 to 10%, with a mortality rate of up to 30%. Methods: We present a case series of 4 patients with NDM-1-producing enterobacteria isolated in urine cultures or rectal swabs. We also conducted a cross-sectional study 30 days after patient identification, collecting surveillance cultures (rectal swab) from all inpatients to assess the extent of spread of this resistance mechanism; a total of 101 patients were included. Results: Two patients were adequately treated with negative control cultures. The other two patients were not treated because they were asymptomatic and had subsequent negative urine cultures. No new colonization was identified in the cross-sectional screening, and no new cases of urinary NDM-1 infection were recorded after a 4-year follow-up. Conclusion: Surveillance for infections caused by multidrug-resistant strains in hospitals treating immunosuppressed patients should be continued and prompt action should be taken in cases of outbreaks of multidrug-resistant infections.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Challenges of Multidrug-resistant New Delhi Metallo-beta-Lactamase (NDM-1)-producing Enterobacteriaceae in Kidney Transplant Patients

Foresto¹,

Menezes²,

Nishimura³

et al. 2021

J. Bras. Nefrol.

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“…An estimated, approximately 100 million of the Indian population are carriers of the NDM-1-producing Enterobacteriaceae strains [15]. Although the carriage does not require eradication, it can cause difficult to treat systemic infections [27]. Statistics show that 25,000 people die in Europe due to infections caused by MDRO (Multidrug Resistance Organism) [28].…”

Section: Discussionmentioning

confidence: 99%

Carbapenemase-producing Enterobacteriaceae in a group of Polish travelers returning from South and South-East Asia, June 2017 – June 2018. Environment- or healthcare-associated?

Kłudkowska¹,

Pielok²,

Wrońska³

et al. 2019

Ann Agric Environ Med.

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Introduction. Carbapenemase-producing Enterobacteriaceae have spread rapidly through the countries and continents to become a global concern. One of the main reservoirs of NDM-1 positive strains from the Enterobacteriaceae family is the Indian subcontinent (Bangladesh, Pakistan, India). Materials and method. During June 2017 -June 2018, rectal swab samples were collected routinely in all patients returning to Poland from South and South-East Asia. During molecular examinations gene bla NDM-1 encoding NDM-1 carbapenemase was detected. Results. 31 patients were examined after returning to Poland from a trip to South and South-East Asia. The presence of New Delhi Metallo-β-lactamase-1 producing Escherichia coli and Klebsiella pneumoniae was confirmed in three patients (9.7%) returning to Poland from travels to India. All the positive patients were hospitalized during the trip in a New Delhi hospital. Conclusions. Digestive tract carriage of NDM in a group of Polish travelers is a significant health and epidemiological problem. The study confirms the necessity for screening for carbapenemase-producing Enterobacteriaceae (CPE), particularly among travellers. Rectal swabs should be collected in every case of patients returning from international trips, and the possibility of environment-associated infections should be emphasized.

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“…In contrast, Varotti et al [37] identified a significantly lower renal graft survival in CRKP infected patients. Karczewski et al [38] also reported refractory NDM-1 producing Klebsiella infection leading to renal graft failure. Thus, the impact on transplant graft survival may not be fully known.…”

Section: Clinical Impact Of Carbapenem-resistant Enterobacteriaceae I...mentioning

confidence: 99%

Carbapenemase-producing organisms in solid organ transplantation

Wong

Duin

2019

Current Opinion in Organ Transplantation

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Purpose of reviewCarbapenem-resistant enterobacteriaceae (CRE) are a critical healthcare threat. Infections caused by CRE disproportionately affect transplant patients. Retrospective case studies suggest that up to 10% of transplant recipients develop a CRE infection. The current literature is reviewed with a particular focus on transplantspecific implications. Recent findingsThere are specific risks inherent to transplant recipients that result in an elevated risk for CRE carriage and subsequent infection. Additionally, the manifestations of these infections are dependent on the specific transplant type. The optimal treatment of CRE infections in transplant recipients has not been defined. SummaryA reduction in the regional community CRE burden can lead to a secondary reduction in their occurrence within vulnerable transplant populations. Therefore, core principles of antibiotic stewardship and infection control within all levels of the healthcare system remains the most effective strategy for addressing the current health crisis. Simultaneously, an integrated approach to risk stratification and an approach to treatment is postulated for management of CRE infection within the solid-organ transplant population.

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Is Multiresistant Klebsiella pneumoniae New Delhi Metallo-beta-Lactamase (NDM-1) a New Threat for Kidney Transplant Recipients?

Cited by 8 publications

References 10 publications

Challenges of Multidrug-resistant New Delhi Metallo-beta-Lactamase (NDM-1)-producing Enterobacteriaceae in Kidney Transplant Patients

Challenges of Multidrug-resistant New Delhi Metallo-beta-Lactamase (NDM-1)-producing Enterobacteriaceae in Kidney Transplant Patients

Carbapenemase-producing Enterobacteriaceae in a group of Polish travelers returning from South and South-East Asia, June 2017 – June 2018. Environment- or healthcare-associated?

Carbapenemase-producing organisms in solid organ transplantation

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