Infection and Drug Resistance (Nov 2022)

Effect of Carbapenem-Resistant Klebsiella pneumoniae Infection on the Clinical Outcomes of Kidney Transplant Recipients

  • Zheng MM,
  • Guo MX,
  • Shang LM,
  • Zhang J,
  • Lin J,
  • Tian Y,
  • Cui XL,
  • Zhu YC

Journal volume & issue
Vol. Volume 15
pp. 6471 – 6483

Abstract

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Meng-Meng Zheng,1,* Ming-Xing Guo,2,* Li-Min Shang,1,* Jian Zhang,1 Jun Lin,1 Ye Tian,1 Xiang-Li Cui,2,* Yi-Chen Zhu1,* 1Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, People’s Republic of China; 2Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, Beijing, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xiang-Li Cui, Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong’an Road, Xicheng District, Beijing, 100050, People’s Republic of China, Email [email protected] Yi-Chen Zhu, Department of Urology, Capital Medical University, Beijing Friendship Hospital, No. 95 Yong’an Road, Xicheng District, Beijing, 100050, People’s Republic of China, Email [email protected]: Carbapenem-resistant Klebsiella pneumoniae (CRKP) infection has proven to be difficult to control and typically presents with devastating effects.Methods: This retrospective study was conducted on the renal recipients at our institution between January 2021 to January 2022. Clinical data was collected to identify factors associated with CRKP infection and clinical outcomes.Results: There were 104 cases out of 186 total renal recipients who presented with at least one infection within 3 months after KT, and 14 cases developed unfavorable clinical outcomes. We identified 16 confirmed CRKP infected cases with the incidence of 8.60%. Possible donor derived infection (DDI) (OR = 6.743; 95% CI: 1.477– 30.786; P = 0.014) were independent risk factors for the occurrence of CRKP infection of renal recipients in our analysis, CRKP infection (OR = 20.723; 95% CI: 3.448– 124.547; P = 0.001) and pneumonia (OR = 28.458; 95% CI: 1.956– 413.984 P = 0.014) were independent risk factors for the occurrence of unfavorable clinical outcomes following KT, and the occurrence of unfavorable clinical outcomes following KT were significantly associated with CRKP infection (r = 0.535; P < 0.001) and antibiotic regimen containing ceftazidime/avibactam (CZA) (r = − 0.655; P = 0.006). The use of CZA was significantly different in the comparison of antibiotic regimens between the CRKP infected renal recipients with unfavorable outcomes and CRKP infected patients with favorable outcomes.Conclusion: It is possible that DDI can lead to CRKP infection, and CRKP infection and pneumonia were closely correlated with poor prognosis. The use of CZA may play a role in avoiding the unfavorable outcomes of CRKP infected recipients.Keywords: kidney transplant, carbapenem-resistant Klebsiella pneumoniae, early infections, risk factors, clinical outcomes

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