Molecular characterization of multidrug resistant Enterobacterales strains isolated from liver and kidney transplant recipients in Spain

Abstract The objective of this study was to analyse the mechanisms of resistance to carbapenems and other extended-spectrum-β-lactams and to determine the genetic relatedness of multidrug-resistant Enterobacterales (MDR-E) causing colonization or infection in solid-organ transplantation (SOT) recipi...

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Autores principales:	Marta Fernández-Martínez, Claudia González-Rico, Mónica Gozalo-Margüello, Francesc Marco, Irene Gracia-Ahufinger, Maitane Aranzamendi, Ana M. Sánchez-Díaz, Teresa Vicente-Rangel, Fernando Chaves, Jorge Calvo Montes, Luis Martínez-Martínez, Maria Carmen Fariñas, ENTHERE Study Group, the Group for Study of Infection in Transplantation of the Spanish Society of Infectious Diseases and Clinical Microbiology (GESITRA-SEIMC) and the Spanish Network for Research in Infectious Diseases (REIPI)
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/f0e1fe83d9a848daaa442c3f765f0f64
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spelling	oai:doaj.org-article:f0e1fe83d9a848daaa442c3f765f0f642021-12-02T17:50:41ZMolecular characterization of multidrug resistant Enterobacterales strains isolated from liver and kidney transplant recipients in Spain10.1038/s41598-021-90382-52045-2322https://doaj.org/article/f0e1fe83d9a848daaa442c3f765f0f642021-06-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-90382-5https://doaj.org/toc/2045-2322Abstract The objective of this study was to analyse the mechanisms of resistance to carbapenems and other extended-spectrum-β-lactams and to determine the genetic relatedness of multidrug-resistant Enterobacterales (MDR-E) causing colonization or infection in solid-organ transplantation (SOT) recipients. Prospective cohort study in kidney (n = 142), liver (n = 98) or kidney/pancreas (n = 7) transplant recipients between 2014 and 2018 in seven Spanish hospitals. We included 531 MDR-E isolates from rectal swabs obtained before transplantation and weekly for 4–6 weeks after the procedure and 10 MDR-E from clinical samples related to an infection. Overall, 46.2% Escherichia coli, 35.3% Klebsiella pneumoniae, 6.5% Enterobacter cloacae, 6.3% Citrobacter freundii and 5.7% other species were isolated. The number of patients with MDR-E colonization post-transplantation (176; 71.3%) was 2.5-fold the number of patients colonized pre-transplantation (71; 28.7%). Extended-spectrum β-lactamases (ESBLs) and carbapenemases were detected in 78.0% and 21.1% of MDR-E isolates respectively. In nine of the 247 (3.6%) transplant patients, the microorganism causing an infection was the same strain previously cultured from surveillance rectal swabs. In our study we have observed a low rate of MDR-E infection in colonized patients 4–6 weeks post-transplantation. E. coli producing bla CTX-M-G1 and K. pneumoniae harbouring bla OXA-48 alone or with bla CTX-M-G1 were the most prevalent MDR-E colonization strains in SOT recipients.Marta Fernández-MartínezClaudia González-RicoMónica Gozalo-MargüelloFrancesc MarcoIrene Gracia-AhufingerMaitane AranzamendiAna M. Sánchez-DíazTeresa Vicente-RangelFernando ChavesJorge Calvo MontesLuis Martínez-MartínezMaria Carmen FariñasENTHERE Study Group, the Group for Study of Infection in Transplantation of the Spanish Society of Infectious Diseases and Clinical Microbiology (GESITRA-SEIMC) and the Spanish Network for Research in Infectious Diseases (REIPI)Nature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Marta Fernández-Martínez Claudia González-Rico Mónica Gozalo-Margüello Francesc Marco Irene Gracia-Ahufinger Maitane Aranzamendi Ana M. Sánchez-Díaz Teresa Vicente-Rangel Fernando Chaves Jorge Calvo Montes Luis Martínez-Martínez Maria Carmen Fariñas ENTHERE Study Group, the Group for Study of Infection in Transplantation of the Spanish Society of Infectious Diseases and Clinical Microbiology (GESITRA-SEIMC) and the Spanish Network for Research in Infectious Diseases (REIPI) Molecular characterization of multidrug resistant Enterobacterales strains isolated from liver and kidney transplant recipients in Spain
description	Abstract The objective of this study was to analyse the mechanisms of resistance to carbapenems and other extended-spectrum-β-lactams and to determine the genetic relatedness of multidrug-resistant Enterobacterales (MDR-E) causing colonization or infection in solid-organ transplantation (SOT) recipients. Prospective cohort study in kidney (n = 142), liver (n = 98) or kidney/pancreas (n = 7) transplant recipients between 2014 and 2018 in seven Spanish hospitals. We included 531 MDR-E isolates from rectal swabs obtained before transplantation and weekly for 4–6 weeks after the procedure and 10 MDR-E from clinical samples related to an infection. Overall, 46.2% Escherichia coli, 35.3% Klebsiella pneumoniae, 6.5% Enterobacter cloacae, 6.3% Citrobacter freundii and 5.7% other species were isolated. The number of patients with MDR-E colonization post-transplantation (176; 71.3%) was 2.5-fold the number of patients colonized pre-transplantation (71; 28.7%). Extended-spectrum β-lactamases (ESBLs) and carbapenemases were detected in 78.0% and 21.1% of MDR-E isolates respectively. In nine of the 247 (3.6%) transplant patients, the microorganism causing an infection was the same strain previously cultured from surveillance rectal swabs. In our study we have observed a low rate of MDR-E infection in colonized patients 4–6 weeks post-transplantation. E. coli producing bla CTX-M-G1 and K. pneumoniae harbouring bla OXA-48 alone or with bla CTX-M-G1 were the most prevalent MDR-E colonization strains in SOT recipients.
format	article
author	Marta Fernández-Martínez Claudia González-Rico Mónica Gozalo-Margüello Francesc Marco Irene Gracia-Ahufinger Maitane Aranzamendi Ana M. Sánchez-Díaz Teresa Vicente-Rangel Fernando Chaves Jorge Calvo Montes Luis Martínez-Martínez Maria Carmen Fariñas ENTHERE Study Group, the Group for Study of Infection in Transplantation of the Spanish Society of Infectious Diseases and Clinical Microbiology (GESITRA-SEIMC) and the Spanish Network for Research in Infectious Diseases (REIPI)
author_facet	Marta Fernández-Martínez Claudia González-Rico Mónica Gozalo-Margüello Francesc Marco Irene Gracia-Ahufinger Maitane Aranzamendi Ana M. Sánchez-Díaz Teresa Vicente-Rangel Fernando Chaves Jorge Calvo Montes Luis Martínez-Martínez Maria Carmen Fariñas ENTHERE Study Group, the Group for Study of Infection in Transplantation of the Spanish Society of Infectious Diseases and Clinical Microbiology (GESITRA-SEIMC) and the Spanish Network for Research in Infectious Diseases (REIPI)
author_sort	Marta Fernández-Martínez
title	Molecular characterization of multidrug resistant Enterobacterales strains isolated from liver and kidney transplant recipients in Spain
title_short	Molecular characterization of multidrug resistant Enterobacterales strains isolated from liver and kidney transplant recipients in Spain
title_full	Molecular characterization of multidrug resistant Enterobacterales strains isolated from liver and kidney transplant recipients in Spain
title_fullStr	Molecular characterization of multidrug resistant Enterobacterales strains isolated from liver and kidney transplant recipients in Spain
title_full_unstemmed	Molecular characterization of multidrug resistant Enterobacterales strains isolated from liver and kidney transplant recipients in Spain
title_sort	molecular characterization of multidrug resistant enterobacterales strains isolated from liver and kidney transplant recipients in spain
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/f0e1fe83d9a848daaa442c3f765f0f64
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Molecular characterization of multidrug resistant Enterobacterales strains isolated from liver and kidney transplant recipients in Spain

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