The etiology of agents of infectious complications after transplantation of liver and kidneys and their resistance to antibiotics

Abstract

The study was carried out to investigate etiology and rate of prevalence of nosocomial strains of microbes in biosubstrates of patients in case of development of infectious complications and level of their resistance to various groups of antibiotics. The retrospective analysis of agents of post-operational infectious complications and their sensitivity to antibiotics in 99 patients after operations of transplantation of liver and kidneys in 2013. The patients were allocated on three groups: group I - patients of department of reanimation and intensive therapy after mentioned operations (17 individuals); group II (42 individuals) - after orthotopic transplantation of liver (19 patients) and orthotopic transplantation of kidneys (23 patients); group III (57 patients) - after kindred transplantation of hepatic lobe from living relative donor. The retrospective analysis of agents of post-operational infectious complications in patients underwent transplantation of liver and kidneys demonstrated that out of 1285 identified strains of microbes, 60.8% were presented by Gram-positive microflora with predominance of coagulase-negative staphylococci and enterococci. Among Gram-negative microflora, enterobacteria comprised the largest percentage (61%). The analysis of antibioticgrams of agents of infectious complications established low level of sensitivity of strains of both Gram-positive and Gram-negative microbes isolated from patients of department of reanimation and intensive therapy and to carbapenems and average level of sensitivity to Tigacil. In overall, poly-resistance of strains was established. The differences in antibiotics resistance for strains of pathogens isolated in department of reanimation and intensive therapy and specialized departments were established. The received data can be used for correction of application of antibiotics in prevention and therapy of post-operational infectious complications.

Keywords

transplantation of liver / transplantation of kidneys / infectious complications / nosocomial infections / poly-resistance

References

[1] Готье С.В., ред. Инфекции в трансплантологии. Москва-Тверь: Издательство «Триада»; 2010.

[2] Габриэлян Н.И. Гнойно-септические осложнения в транспланологии и кардиохирургии: эпидемиология и профилактика. В кн.: Готье С.В., ред. Трансплантология: итоги и перспективы. 2011 год. Том III. М.; 2012: 68-114.

[3] Narciso-Schiavon J.L., Borgonovo A., Marques P.C., Tonon D., Bansho E.T., Maggi D.C. et al. Enterococcus casselifl avus and Enterococcus gallinarum as causative agents of spontaneous bacterialperitonitis. Ann. Hepatol. 2015; 14(2): 270-2.

[4] Martin-Gandul C., Mueller N.J., Pascual M., Manuel O. The Impact of Infection on Chronic Allograft Dysfunction and Allograft Survival After Solid Organ Transplantation. Am. J. Transplant. 2015; 15(12): 3024-40.

[5] Aguiar E.B., Maciel L.C., Halpern M., de Lemos A.S., Ferreira A.L., Basto S.T. et al. Outcome bacteremia caused by extended - spectrum β - lactamase-producing Enterobacteriaceae after solis organ transplantation. Transplant. Proc. 2014; 45(6): 1753-6.

[6] Gallagher L.A., Ramage E., Weiss E.J., Radey M., Hayden H.S., Held K.G. et al. Resources for Genetic and Genomic Analysis of Emerging Pathogen Acinetobacter baumannii. J. Bacteriol. 2015; 197(12): 2027-35.

[7] Габриэлян Н.И., Горская Е.М., Драбкина И.В., Спирина Т.С., Цирульникова О.М. Возбудители бактериемий и микробиота толстого кишечника у реципиентов донорской печени. Вестник трансплантологии и искусственных органов. 2014; (4): 20-4.

[8] Lee C.S., Vasoo S., Hu F., Patel R., Doi Y. Klebsiella pneumoniae ST147 coproducing NDM-7 carbapenemase and RmtF 16S rRNAmethyltransferase in Minnesota. J. Clin. Microbiol. 2014; 52(11): 4109-10.

[9] Lanini S., Costa A.N., Puro V., Procaccio F., Grossi P.A., Vespasiano F. et al. Incidence of carbapenem-resistant gram negatives in Ita lian transplant recipients: a nationwidesurveillance study. PLoS One. 2015; 10(4): e0123706.

[10] Linares L., Cervera C., Cofan F., Ricart M.J., Esforzado N., Torregrosa V. et al. Epidemiology and out comes of multiple antibiotic-resistant bacterial infection in renal transplantation. Transplant. Proc. 2007; 39(7): 2222-4.

[11] 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.

[12] Magiorakos A.P., Srinivasan A., Carey R.B., Carmeli Y., Falagas M.E., Giske C.G. et al. Multidrug-resistant, extensively drugresistant and pandrug-resistant bacteria:an international expert proposal for interim standard defi nitions for acquired risistance. Clin. Microbiol. Infect. 2012; 18(3): 268-81.

[13] Hamandi B., Holbrook A.M., Humar A., Brunton J., Papadimitropoulos E.A., Wong G.G. et al. Delay of adequate empiric antibiotic therapy is associated with increased mortality among solid-organ transplant patients. Am. J. Transplant. 2009; 9(7): 1657-65.

[14] Li H., Liu F., Zhang Y., Wang X., Zhao C., Chen H. et al.Evolution of carbapenem-resistant Acinetobacter baumannii revealed through whole-genomesequencing and comparative genomic analysis. Antimicrob. Agents Chemother. 2015; 59(2): 1168-76.

[15] Levesque E., Suet G., Merle J.C., Compagnon P., Amathieu R., Feray C. et al. Candida vascular complication in a liver transplant recipient due to yeast contamination of preservationsolution. Transpl. Infect. Dis. 2014; 16(5): 827-9.

[16] Kawecki D., Pacholczyk M., Lagiewska B., Sawicka-Grzelak A., Durlik M., Mlynarczyk G. et al. Bacterial and fungal infections in the early post-transplantation period after liver transplantation: etiologic agents and their susceptibility. Transplant. Proc. 2014; 46(8): 2777-81.

RIGHTS & PERMISSIONS

Eco-Vector