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dc.contributor.author | Sanclemente, Gemma |
---|---|
dc.contributor.author | Bodro, Marta |
dc.contributor.author | Cervera, Carlos |
dc.contributor.author | Linares, Laura |
dc.contributor.author | Cofán Pujol, Federico |
dc.contributor.author | Marco Reverté, Francesc |
dc.contributor.author | Bosch, Jordi |
dc.contributor.author | Oppenheimer Salinas, Federico |
dc.contributor.author | Dieckmann, Fritz |
dc.contributor.author | Moreno Camacho, Ma. Asunción |
dc.date | 2019-09-02T09:55:56Z |
dc.date | 2019-09-02T09:55:56Z |
dc.date | 2019-07-22 |
dc.date | 2019-08-02T18:00:56Z |
dc.identifier | 1471-2369 |
dc.identifier | 693626 |
dc.identifier | 31331289 |
dc.identifier.uri | http://hdl.handle.net/2445/138983 |
dc.description | Backgound: In recent years we have witnessed an increase in infections due to multidrug-resistant organisms in kidney transplant recipients (KTR). In our setting, we have observed a dramatic increase in infections caused by extended-spectrum betalactamase-producing (ESBL) Enterobacteriaceae in KTR. In 2014 we changed surgical prophylaxis from Cefazolin 2 g to Ertapenem 1 g. Methods: We compared bacterial infections and their resistance phenotype during the first post-transplant month with an historical cohort collected during 2013 that had received Cefazolin. Results: During the study period 110 patients received prophylaxis with Cefazolin and 113 with Ertapenem. In the Ertapenem cohort we observed a non-statistically significant decrease in the percentage of early bacterial infection from 57 to 47%, with urine being the most frequent source in both. The frequency of infections caused by Enterobacteriaceae spp. decreased from 64% in the Cefazolin cohort to 36% in the Ertapenem cohort (p = 0.005). In addition, percentage of ESBL-producing strains decreased from 21 to 8% of all Enterobacteriaceae isolated (p = 0.015). After adjusted in multivariate Cox regression analysis, male sex (HR 0.16, 95%CI: 0.03–0.75), cefazolin prophylaxis (HR 4.7, 95% CI: 1.1–22.6) and acute rejection (HR 14.5, 95% CI: 1.3–162) were associated to ESBL- producing Enterobacteriaceae infection. Conclusions: Perioperative antimicrobial prophylaxis with a single dose of Ertapenem in kidney transplant recipients reduced the incidence of early infections due to ESBL-producing Enterobacteriaceae without increasing the incidence of other multidrug-resistant microorganisms or C. difficile. |
dc.format | 10 p. |
dc.format | application/pdf |
dc.language | eng |
dc.publisher | BioMed Central |
dc.relation | Reproducció del document publicat a: http://dx.doi.org/10.1186/s12882-019-1461-4 |
dc.relation | BMC Nephrology, 2019, vol. 20 |
dc.relation | http://dx.doi.org/10.1186/s12882-019-1461-4 |
dc.rights | cc by (c) Sanclemente et al., 2019 |
dc.rights | http://creativecommons.org/licenses/by/3.0/es/ |
dc.rights | info:eu-repo/semantics/openAccess |
dc.subject | Trasplantament renal |
dc.subject | Enterobacteriàcies |
dc.subject | Kidney transplantation |
dc.subject | Enterobacteriaceae |
dc.title | Perioperative prophylaxis with ertapenem reduced infections caused by extended-spectrum betalactamase-producting Enterobacteriaceae after kidney transplantation |
dc.type | info:eu-repo/semantics/article |
dc.type | info:eu-repo/semantics/publishedVersion |