In renal transplant recipients, the urinary tract is the most common site of infections that might be caused by pathogens while on immunosuppressive therapy.
The spread of enterobacteria resistant to carbapenem is worrying, as it is generally used as this agent is the first-line therapy for infections caused by Enterobacteriaceae producing extended spectrum β-lactamases. The most frequently encountered class A carbapenemases are the Klebsiella pneumoniae carbapenemase (KPC) enzymes. We describe the treatment and outcomes of 6 renal transplant patients who had urinary tract infections (UTIs) with blaKPC-2-producing K pneumoniae, confirmed by polymerase chain reaction amplification, namely 13.33% of renal transplant patients in the study period. Four patients survived, including 1 with reinfections and relapse, and 2 patients died. The antibiotics used for treatment, alone or combined, were colistin (n = 6, 42.8%), tigecycline (n = 5, 35.7%), doxycycline (n = 3, 21.4%), meropenem (n = 3, 21.4%), and fosfomycyn (n = 1, 7%). UTIs caused by carbapenemase-producing K pneumoniae are life-threatening. In the cases presented, favorable results were achieved with monotherapies using colistin, doxycycline, or meropenem.
Written by:
Cicora F, Mos F, Paz M, Allende NG, Roberti J. Are you the author?
Hospital Alemán of Buenos Aires, Buenos Aires, Argentina; Foundation for Research and Assistance to Renal Disease (FINAER), Buenos Aires, Argentina.
Reference: Transplant Proc. 2013 Nov;45(9):3389-93.
doi: 10.1016/j.transproceed.2013.07.064
PubMed Abstract
PMID: 24182822
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