Evaluation of extensively drug-resistant gram-negative bacteremia among solid-organ transplant recipients: a multicenter study

Authors: TUĞBA YANIK YALÇIN, ÖZLEM AZAP, ADEM KÖSE, YAŞAR BAYINDIR, ELİF MUKİME SARICAOĞLU, GÜLE ÇINAR, YEŞİM UYGUN KIZMAZ, EBRU KURŞUN, HİKMET EDA ALIŞKAN, AYŞE YASEMİN TEZER TEKÇE, OYA ÖZLEM EREN KUTSOYLU, TUFAN EGELİ, ALPAY ARI, YURDAGÜL ALBAYRAK, HATİCE ÇABADAK, SUNA SEÇİL ÖZTÜRK DENİZ, KÜBRA DEMİR ÖNDER, FİLİZ KIZILATEŞ, HASAN SELÇUK ÖZGER, ÖZLEM GÜZEL TUNÇCAN, MEHMET HABERAL

Abstract: Background/aim: The aim of this study is to evaluate the distribution, sources, clinical features, and mortality rates of bacteremia due to evaluation of extensively drug-resistant (XDR) gram negative among solid-organ transplant (SOT) recipients. Materials and methods: A retrospective study of SOT recipients with bacteremia due to XDR gram-negative pathogens in 11 centers between 2016 and 2018 was conducted. Patients' records were evaluated. Results: Of 171 bacteremia that occurred in 164 SOT recipients, 93 (56.7%) were liver, 46 (28%) kidney, 14 (8.5%) heart, and 11 (6.7%) lung recipients. Bacteremia episodes were recorded in the first year in 63.7% of the patients (n = 109), early-onset bacteremia was recorded in 45% (n = 77) of the episodes. In multivariate analysis, catheter-associated bacteremia was an independent risk factor for 7-day mortality (p = 0.037), and early-onset bacteremia was found as an independent risk factor for 30-day mortality (p = 0.017). Conclusion: Difficult-to-treat infections due to XDR bacteria in SOT recipients shadow the success of transplantation. Central venous catheters seem to be the main risk factor. Judicious use of medical devices is of pivotal importance.

Keywords: Solid-organ transplant recipients, drug-resistant, bacteremia

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