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Abstract Details
Carbapenem-Resistant Enterobacteriaceae Colonization or Infection Was Not Associated with Post-Liver Transplant Graft Failure: An Observational Cohort Study.
Caria, João (J);Gonçalves, Ana C (AC);Cristóvão, Gonçalo (G);Carlos, Maria (M);Magalhães, Sara (S);Almeida, Vasco (V);Moreno, Fernanda (F);Mateus, Élia (É);Pinheiro, Hélder (H);Póvoas, Diana (D);Maltez, Fernando M T (FMT);Perdigoto, Rui (R);S Cardoso, Filipe (F);P Marques, Hugo (H);
INTRODUCTION: Carbapenem-resistant Enterobacteriaceae (CRE) epidemiology among liver transplant (LT) recipients is variable. We studied the impact of CRE colonization and infection on LT recipients' outcomes.
METHODS: This observational cohort study included consecutive adult LT recipients between January 2019 and December 2020 at Curry Cabral Hospital, Lisbon, Portugal. Primary exposures were CRE colonization (rectal swabs under a screening program) and infection within 1 year of index LT. Primary endpoint was graft failure within 1 year of the index LT.
RESULTS: Among 209 patients, the median (interquartile range [IQR]) age was 57 (47-64) years and 155 (74.2%) were male. CRE colonization was identified in 28 (13.4%) patients during the first year posttransplant (median [IQR] number of rectal swabs per patient of 4 [2-7]). CRE resistance genes identified were OXA48 in 8 (3.6%) patients, KPC in 19 (67.9%) patients, and VIM in 1 (3.6%) patient. Any bacterial/fungal and CRE infections were diagnosed in 88 (42.1%) and 6 (2.9%) patients, respectively, during the first year posttransplant. After adjusting for confounders, neither CRE colonization (aOR [95% CI] = 1.83 [0.71-4.70]; = 0.21) nor infection (aOR [95% CI] = 1.35 [0.17-11.06]; = 0.78) was associated with graft failure within 1 year of index LT.
DISCUSSION/CONCLUSION: Under a screening program, CRE colonization and infection prevalence was low and neither was associated with graft failure.
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