Challenges of Multidrug-resistant New Delhi Metallo-beta-Lactamase (NDM-1)-producing Enterobacteriaceae in Kidney Transplant Patients

Detalhes bibliográficos
Autor(a) principal: Foresto,Renato Demarchi
Data de Publicação: 2021
Outros Autores: 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
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Jornal Brasileiro de Nefrologia
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002021005072301
Resumo: 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.
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spelling Challenges of Multidrug-resistant New Delhi Metallo-beta-Lactamase (NDM-1)-producing Enterobacteriaceae in Kidney Transplant PatientsDrug ResistanceBacterial InfectionsDrug Resistance, BacterialKidney TransplantationAbstract 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.Sociedade Brasileira de Nefrologia2021-01-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002021005072301Brazilian Journal of Nephrology n.ahead 2021reponame:Jornal Brasileiro de Nefrologiainstname:Sociedade Brasileira de Nefrologia (SBN)instacron:SBN10.1590/2175-8239-jbn-2021-0033info:eu-repo/semantics/openAccessForesto,Renato DemarchiMenezes,Lucas MarengoNishimura,Laura TomokoCristelli,Marina PontelloViana,Laila AlmeidaSantos,Daniel Wagner de Castro LimaRequião-Moura,Lúcio R.Tedesco-Silva,HelioMedina-Pestana,Joseeng2021-10-13T00:00:00Zoai:scielo:S0101-28002021005072301Revistahttp://www.bjn.org.br/ONGhttps://old.scielo.br/oai/scielo-oai.php||jbn@sbn.org.br2175-82390101-2800opendoar:2021-10-13T00:00Jornal Brasileiro de Nefrologia - Sociedade Brasileira de Nefrologia (SBN)false
dc.title.none.fl_str_mv Challenges of Multidrug-resistant New Delhi Metallo-beta-Lactamase (NDM-1)-producing Enterobacteriaceae in Kidney Transplant Patients
title Challenges of Multidrug-resistant New Delhi Metallo-beta-Lactamase (NDM-1)-producing Enterobacteriaceae in Kidney Transplant Patients
spellingShingle Challenges of Multidrug-resistant New Delhi Metallo-beta-Lactamase (NDM-1)-producing Enterobacteriaceae in Kidney Transplant Patients
Foresto,Renato Demarchi
Drug Resistance
Bacterial Infections
Drug Resistance, Bacterial
Kidney Transplantation
title_short Challenges of Multidrug-resistant New Delhi Metallo-beta-Lactamase (NDM-1)-producing Enterobacteriaceae in Kidney Transplant Patients
title_full Challenges of Multidrug-resistant New Delhi Metallo-beta-Lactamase (NDM-1)-producing Enterobacteriaceae in Kidney Transplant Patients
title_fullStr Challenges of Multidrug-resistant New Delhi Metallo-beta-Lactamase (NDM-1)-producing Enterobacteriaceae in Kidney Transplant Patients
title_full_unstemmed Challenges of Multidrug-resistant New Delhi Metallo-beta-Lactamase (NDM-1)-producing Enterobacteriaceae in Kidney Transplant Patients
title_sort Challenges of Multidrug-resistant New Delhi Metallo-beta-Lactamase (NDM-1)-producing Enterobacteriaceae in Kidney Transplant Patients
author Foresto,Renato Demarchi
author_facet 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
author_role author
author2 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
author2_role author
author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv 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
dc.subject.por.fl_str_mv Drug Resistance
Bacterial Infections
Drug Resistance, Bacterial
Kidney Transplantation
topic Drug Resistance
Bacterial Infections
Drug Resistance, Bacterial
Kidney Transplantation
description 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.
publishDate 2021
dc.date.none.fl_str_mv 2021-01-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002021005072301
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002021005072301
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 10.1590/2175-8239-jbn-2021-0033
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv text/html
dc.publisher.none.fl_str_mv Sociedade Brasileira de Nefrologia
publisher.none.fl_str_mv Sociedade Brasileira de Nefrologia
dc.source.none.fl_str_mv Brazilian Journal of Nephrology n.ahead 2021
reponame:Jornal Brasileiro de Nefrologia
instname:Sociedade Brasileira de Nefrologia (SBN)
instacron:SBN
instname_str Sociedade Brasileira de Nefrologia (SBN)
instacron_str SBN
institution SBN
reponame_str Jornal Brasileiro de Nefrologia
collection Jornal Brasileiro de Nefrologia
repository.name.fl_str_mv Jornal Brasileiro de Nefrologia - Sociedade Brasileira de Nefrologia (SBN)
repository.mail.fl_str_mv ||jbn@sbn.org.br
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