دورية
Treatment of Donor-derived Carbapenem-resistant Klebsiella pneumoniaeInfection after Renal Transplantation with Tigecycline and Extended-infusion Meropenem
| العنوان: | Treatment of Donor-derived Carbapenem-resistant Klebsiella pneumoniaeInfection after Renal Transplantation with Tigecycline and Extended-infusion Meropenem |
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| المؤلفون: | Wang, Zhi-qiang, Guo, Zhi-liang, Feng, Hao, Fu, Cheng, Zhao, Guang-yuan, Ma, Ke, Zhu, Lan, Chen, Gang |
| المصدر: | Current Medical Science; August 2021, Vol. 41 Issue: 4 p770-776, 7p |
| مستخلص: | Objective: Donor-derived carbapenem-resistant Klebsiella pneumoniae(CRKP) infection has recently emerged as a critical early complication after renal transplantation. Although CRKP is usually sensitive to tigecycline, monotherapy with this drug is often less than effective. We investigated the efficacy of a combined regimen of tigecycline with high-dose, extended-infusion meropenem in the treatment of donor-derived CRKP infection after kidney transplantation. Methods: From Jan. 2016 to Dec. 2017, a total of 12 CRKP isolates were detected from cultures of the organ preservation solution used for soaking the donor kidneys at our institute. Probable or possible donor-derived infection (DDI) was identified in 8 transplant recipients. Clinical data were retrospectively analyzed. Results: Klebsiella pneumoniaecarbapenemase-2 (KPC-2)-producing CRKP was reported to be positive in organ preservation solution cultures at 3.5±0.9 days after transplantation, leading to surgical site (n=3), urinary tract (n=4), and/or bloodstream (n=2) infections in 8 recipients. The drug susceptibility tests showed that CRKP was sensitive to tigecycline, but resistant to meropenem. In 7 patients who received tigecycline combined with high-dose extended-infusion meropenem, DDIs were successfully cured. The length of hospital stay was 31 (18–129) days, and the serum creatinine at discharge was 105.8±16.7 µmol/L. The one remaining patient who received tigecycline combined with intravenous-drip meropenem died of septic shock. A median follow-up of 43 months (33–55) showed no recurrence of new CRKP infection in the 7 surviving recipients. Conclusion: It was suggested that a prompt and appropriate combination therapy using tigecycline with high-dose extended-infusion meropenem is effective in treating donor-derived KPC-2-producing CRKP infection after renal transplantation. |
| قاعدة البيانات: | Supplemental Index |
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Full Text Finder | تدمد: | 20965230 2523899X |
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| DOI: | 10.1007/s11596-021-2397-z |