¿Son las Enterobacterias multirresistentes una amenaza para los pacientes con trasplante renal y hepático?

Abstract

BACKGROUND AND OBJECTIVE: Infection is a major cause of morbimortality in solid organ transplant recipients (SOT) and these patients more often develop infections from multidrug-­‐resistant (MDR) bacteria. The aim of this study was to analyse whether pre-­‐transplant colonization with MDR bacteria is a major risk factor for infection with those bacteria in the immediate post-­‐transplant period. MATERIAL AND METHODS: Prospective cohort study, including all liver and/or kidney SOT recipients in HUM Valdecilla from October-­‐2014 to December-­‐2016. Clinical, epidemiological and microbiological data were recorded. Mann-­‐Whitney test, Fisher’s exact test and Chi-­‐square test were used for comparisons. A p-­‐value< 0.05 was considered statistically significant. RESULTS: One hundred and twenty six SOT recipients were included: 66 kidney transplants, 47 liver transplants, 10 kidney-­‐pancreas transplants and 3 liver-­‐kidney transplants. Fourteen patients were colonized before transplantation and 35 afterwards, being ESBL-­‐E. coli the most frequent colonizing MDR Enterobacteriaceae (46%). Infections by MDR Enterobacteriaceae were observed in 3 colonized and in 1 non-­‐colonized patient. The rehospitalization rate was the same in both groups. CONCLUSIONS: Although MDR Enterobacteriaceae colonization rate was high, few patients developed infections due to these bacteria. There was a similar number of post-­‐transplantation complications in both colonized and non-­‐colonized patients.