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Challenges of Multidrug-resistant New Delhi Metallo-beta-Lactamase (NDM-1)-producing Enterobacteriaceae in Kidney Transplant Patients.
Foresto, Renato Demarchi; Menezes, Lucas Marengo; Nishimura, Laura Tomoko; Cristelli, Marina Pontello; Viana, Laila Almeida; Santos, Daniel Wagner de Castro Lima; Requião-Moura, Lúcio R; Tedesco-Silva, Helio; Medina-Pestana, Jose.
Afiliação
  • Foresto RD; Hospital do Rim, São Paulo, SP, Brasil.
  • Menezes LM; Universidade Federal de São Paulo, Divisão de Nefrologia, São Paulo, SP, Brasil.
  • Nishimura LT; Universidade Federal de São Paulo, Divisão de Nefrologia, São Paulo, SP, Brasil.
  • Cristelli MP; Hospital do Rim, São Paulo, SP, Brasil.
  • Viana LA; Hospital do Rim, São Paulo, SP, Brasil.
  • Santos DWCL; Hospital do Rim, São Paulo, SP, Brasil.
  • Requião-Moura LR; Hospital do Rim, São Paulo, SP, Brasil.
  • Tedesco-Silva H; Universidade Federal de São Paulo, Divisão de Nefrologia, São Paulo, SP, Brasil.
  • Medina-Pestana J; Hospital do Rim, São Paulo, SP, Brasil.
J Bras Nefrol ; 45(1): 116-120, 2023.
Article em En, Pt | MEDLINE | ID: mdl-34694315
ABSTRACT

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.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Transplante de Rim / Enterobacteriaceae Tipo de estudo: Observational_studies / Risk_factors_studies Limite: Humans Idioma: En / Pt Revista: J Bras Nefrol Assunto da revista: NEFROLOGIA Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Brasil

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Transplante de Rim / Enterobacteriaceae Tipo de estudo: Observational_studies / Risk_factors_studies Limite: Humans Idioma: En / Pt Revista: J Bras Nefrol Assunto da revista: NEFROLOGIA Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Brasil