1. Recurrent Outbreak of Carbapenem‐Resistant IMP‐1‐Producing Pseudomonas aeruginosa in Kidney Transplant Recipients: The Impact of Prolonged Patient Colonization.
- Author
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Freire, Maristela P., Camargo, Carlos Henrique, Bubach, Laina, Yamada, Amanda Yaeko, Spadão, Fernanda, Lopes, Carolina Andrade, Sacchi, Claudio Tavares, Campos, Karoline Rodrigues, Santos, Marlon Benedito Nascimento, Junior, Jose Otto Reusing, Cury, Ana Paula, Rossi, Flavia, Araujo, Evangelina da Motta P. A., Levin, Anna Sara, Nahas, William Carlos, David‐Neto, Elias, and Pierrotti, Ligia C.
- Abstract
ABSTRACT Background Objectives Methods Results Conclusion Infections by carbapenem‐resistant
Pseudomonas aeruginosa (CRPA) have been associated with high morbidity and mortality among solid organ recipients.To delineate the epidemiological and molecular characteristics of a recurrent outbreak of imipenem (IMP)‐producingP. aeruginosa (CRPA) among kidney transplant (KT) recipientWe described a recurring CRPA outbreak in a KT ward, divided into two periods: before unit closure (Feb 2019–2020) and after reopening (Aug 2020–Dec 2023). Routine surveillance cultures (SCs) were performed using axillary‐perineum‐rectal swabs with immunochromatographic tests. A case‐control study identified risk factors for CRPA acquisition. Pulsed‐field gel electrophoresis and whole genome sequencing characterized the strains.After reopening, new cases arose from patients previously colonized, peaking 18 months later. A total of 67 KT recipients with CRPA‐IMP‐producing strains were identified. All except one sequenced strain belonged to the ST446 clone, differing by a maximum of 110 single nucleotide polymorphisms. Forty‐five (67.2%) cases were identified through SC, with 45.7% showing intermittent SC positivity. Patients remained colonized for up to 623 days. Twenty‐four (35.8%) patients had infections, with the most common site being the urinary tract. Identified risk factors included older age, deceased donor, re‐transplantation, reoperation, carbapenem or quinolone use, lymphopenia, hospital stay >10 days, and the first 60 days post‐KT.KT recipients can harbor CRPA for extended periods, and detecting CRPA‐colonized patients is challenging. These characteristics highlight the patient as the major source and a critical point in outbreak control. [ABSTRACT FROM AUTHOR]- Published
- 2024
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