ESBL-Producing Microbes in Post-Transplant Bacteremia Do Not Up ... - Renal and Urology News
Kidney transplant recipients who experience post-transplant bacteremia are not significantly more likely to die or lose their allograft if the infection is caused by bacteria that produce extended-spectrum beta-lactamases (ESBL), investigators reported at the 2023 American Transplant Congress in San Diego, California.
The finding is from a single center, retrospective study of 63 kidney transplant recipients with post-transplant ESBL gram-negative bacteremia. A team led by Madeleine Tilley, PharmD, of the University of Alabama in Birmingham, followed patients for 1 year after they received positive blood culture results.
"Patient survival, graft survival, and readmission rates were not significantly different between the groups," Dr Tilley told Renal & Urology News. "Allograft function was decreased on admission but rose steadily by discharge. Patients with ESBL infection did require more outpatient parenteral antibiotic therapy. Delayed graft function was the only risk factor identified for infection with an ESBL organism."
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Of the 63 patients, 18 (28.6%) had bacteremia due to ESBL-producing bacteremia[WU1] and 45 (71.4%) did not. The patient survival rate at 1 year, the study's primary outcome, was 77.8% in the ESBL group and 91.1% in the non-ESBL group. A significantly higher proportion of patients in the ESBL than non-ESBL group required outpatient parenteral antimicrobial therapy (61.1% vs 4.4%). In addition, delayed graft function was significantly more common in the ESBL than non-ESBL group (35.3% vs 4.4%).
Overall, 50% of the ESBL group and 31.8% of the non-ESBL group were readmitted within 90 days.
The most common empiric antibiotic used was piperacillin-tazobactam, and ciprofloxacin was the most common antibiotic at discharge.
"Future directions for research at our institution include exploring delayed graft function as a risk factor and analyzing our new ESBL surveillance culture monitoring at the time of transplant," Dr Tilley said.
Reference
Tilley M, Edwards S, Brown M, James A, Li P, Gutierrez K. Assessment of post-transplant bacteremia by extended-spectrum beta-lactamase-producing (ESBL) bacteria among kidney transplant recipients. Presented at: ATC 2023, San Diego, California, June 3-7. Abstract B088.
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