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  • Rosa Emilia Moraes

Study analyzes the demographics of KPC infections in kidney transplant recipients



Mapping of infections in hospitals caused by Klebsiella pneumoniae, a carbapenemase

producer (KPC), alerts to the need for a well-established surveillance program to deal

with resistant bacteria and helps to define a systematic protocol for the control and

prevention of mortality among kidney transplant recipients.

 

Article: Campos Júnior SA, Foresto RD, Viana LA, Requião-Moura LR, Tedesco-Silva Junior H, Medina-Pestana J. Carbapenemase-producing Klebsiella pneumoniae infection in kidney transplant recipients. BJT, 25(3):e0122, 2022. https://doi.org/10.53855/bjt.v25i3.436_in

 

Fighting the “superbug”: Study analyzes the demographics of KPC infections in kidney transplant recipients


Infection with resistant bacteria is usually associated with the hospital environment, with patients hospitalized for prolonged periods, requiring the use of devices and antibiotics. This poses a greater risk for immunosuppressed patients undergoing solid organ transplantation.


Klebsiella pneumoniae, popularly known as KPC, is one of these superbugs. The production of a beta-lactamase called carbapenemase makes it resistant to the action of carbapenem antibiotics, reducing therapeutic options and making treatment difficult. The incidence of KPC infection is 3-10% in the literature, and the 30-day mortality can reach 42% (FREIRE et al., 2015).


The Brazilian Journal of Transplantation (v.25 n.3) presents in an original article, the work developed by researchers from the Federal University of São Paulo in an observational study carried out at Hospital do Rim, a Brazilian reference center where most transplants are performed in the world (PESTANA, 2016). The objective was to describe the incidence and demographics of nosocomial KPC infections in that health center and evaluate the main control and prevention measures introduced.

From November 2009 to December 2015, data were collected from kidney transplant recipients who were infected/colonized by KPC. The information was organized in a table and a comparative chart regarding the origin of infections and the mortality rate.


In addition to the results indicated in the research, the authors carried out a literature review seeking information on infections and colonization caused by carbapenem-resistant Enterobacteriaceae in different countries, detected on all continents, as the findings of Nordmann et al. (2017). The Brazilian study on screen confirmed these data at the national level, finding an overall 30-day mortality rate similar to international rates. In a local analysis of the State of São Paulo, where the research was carried out, a survey of relevant articles through the scientific portals PubMed and SciELO identified two hospitals in cities in the countryside and eight in the

capital of the State.


But, despite the good references, the article recognizes that the lack of a specific protocol for the surveillance of infections caused by multidrug-resistant bacteria makes the available data somewhat scarce and imprecise, alerting to the need for a well-established structure, with laboratories specialized in to identify the mechanisms of resistance of these bacteria and investment in new drugs capable of controlling and combating these episodes.


 

Read more (References):


Freire MP, Abdala E, Moura ML, de Paula FJ, Spadão F, Caiaffa-Filho HH, et al. Risk factors and outcome of infections with Klebsiella pneumoniae carbapenemase-producing K. pneumoniae in kidney transplant recipients. Infection. 2015;43(3):315-23.


Nordmann P, Naas T, Poirel L. Global Spread of Carbapenemase-producing Enterobacteriaceae. Emerging Infectious Diseases. 2011;17(10):1791-1798. https://doi.org/10.3201/eid1710.110655


Pestana JM. A pioneering healthcare model applying large-scale production concepts: Principles and performance after more than 11,000 transplants at Hospital do Rim. Rev Assoc Med Bras (1992). 2016;62(7):664-71. https://doi.org/10.1590/1806-9282.62.07.664

 

Links


Universidade Federal de São Paulo


Hospital do Rim-Fundação Oswaldo Ramos


Brazilian Journal of Transplantation

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