¿Son las Enterobacterias multirresistentes una amenaza para los pacientes con trasplante renal y hepático?
Are multidrug resistant Enterobacteriaceae a threat to renal and liver transplant recipients?
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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.