Pagani Nicole, Corcione Silvia, Lupia Tommaso, Scabini Silvia, Filippini Claudia, Angilletta Roberto, Shbaklo Nour, Mornese Pinna Simone, Romagnoli Renato, Biancone Luigi, Cavallo Rossana, Di Perri Giovanni, Solidoro Paolo, Boffini Massimo, De Rosa Francesco Giuseppe
St Stephen's Centre, Chelsea and Westminster Hospital, 252 Fulham Rd., London SW10 9NA, UK.
Department of Medical Sciences, Infectious Diseases, University of Turin, 10100 Turin, Italy.
Microorganisms. 2021 Oct 31;9(11):2272. doi: 10.3390/microorganisms9112272.
Carbapenemase-KPC producing (CP-Kp) infection represents a serious threat to solid organ transplant (SOT). All patients admitted between 1 May 2011 and 31 August 2014 undergoing SOT were included in the retrospective study. The primary outcomes included a description of the association of enteric colonization and invasive infections by CP- with one-year mortality. Secondary outcomes were the study of risk factors for colonization and invasive infections by CP-. Results: A total of 5.4% (45/828) of SOT recipients had at least one positive rectal swab for CP-, with most (88.9%) occurring after transplantation. 4.5% (35/828) of patients developed a CP--related invasive infection, with 68.6% (24/35) being previously colonized. The 1-year mortality was 31.1% in patients with enteric colonization with CP-Kp and, it was 51.4% among patients with CP--related invasive infections. At univariate analysis, colonization, invasive infections, sepsis, severe sepsis, and septic shock were significantly associated with 1-year mortality. At multivariate analysis, only invasive infections and the combination of sepsis, severe sepsis, or septic shock were significantly associated with 1-year mortality, whereas gastrointestinal colonization was significantly associated with survival. In this population, the 1-year mortality was significantly associated with invasive infections; otherwise, gastrointestinal colonization was not associated with increased 1-year mortality.
产碳青霉烯酶-KPC（CP-Kp）感染对实体器官移植（SOT）构成严重威胁。本回顾性研究纳入了2011年5月1日至2014年8月31日期间所有接受SOT的住院患者。主要结局包括描述CP-引起的肠道定植与侵袭性感染和1年死亡率之间的关联。次要结局是研究CP-引起的定植和侵袭性感染的危险因素。结果：共有5.4%（45/828）的SOT受者至少有一次直肠拭子检测CP-呈阳性，其中大多数（88.9%）发生在移植后。4.5%（35/828）的患者发生了与CP-相关的侵袭性感染，其中68.6%（24/35）此前已被定植。CP-Kp肠道定植患者的1年死亡率为31.1%，而与CP-相关的侵袭性感染患者的1年死亡率为51.4%。单因素分析显示，定植、侵袭性感染、脓毒症、严重脓毒症和感染性休克与1年死亡率显著相关。多因素分析显示，只有侵袭性感染以及脓毒症、严重脓毒症或感染性休克的组合与1年死亡率显著相关，而胃肠道定植与生存显著相关。在该人群中，1年死亡率与侵袭性感染显著相关；否则，胃肠道定植与1年死亡率增加无关。
