Abstract

Objectives: A prospective cohort study was conducted in Italy in order to describe the microbiologic aspects of colonization/infection by carbapenemase-producing Enterobacteriaceae (CPE) in donors and recipients of lung and liver transplants and the possible CPE transmission from donors to recipients. Methods: Between 15 January 2014 and 14 January 2015, all recipients of solid organ transplants (SOT) at ten lung and eight liver transplantation centres and the corresponding donors were enrolled. Screening cultures to detect CPE were performed in donors, and screening and clinical cultures in recipients with a 28-day microbiologic follow-up after receipt of SOT. Detection of carbapenemase genes by PCR, geno-typing by multilocus sequence typing, and pulsed-field gel electrophoresis and whole-genome sequencing were performed. Results: Of 588 screened donors, 3.4n = 521), 2.5up. CPE colonization was higher in lung first transplant recipients (n = 111, 2.74.4. CPE infections occurred in 1.9.3 respectively. CPE isolates were mostly Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae belonging to CG258. Three events of donor-recipient CPE transmission, confirmed by whole-genome sequencing and/or pulsed-field gel electrophoresis, occurred in lung recipients: two involving K. pneumoniae sequence type 512 and one Verona integron-encoded metallo-beta-lactamase (VIM)-producing Enterobacter aerogenes. Conclusions: This study showed a low risk of donor-recipient CPE transmission, indicating that donor CPE colonization does not necessarily represent a contraindication for donation unless colonization regards the organ to be transplanted. Donor and recipient screening remains essential to prevent CPE transmission and cross-infection in transplantation centres. (C) 2018 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
Original languageEnglish
Pages (from-to)203-209
Number of pages7
JournalClinical Microbiology and Infection
Volume25
Issue number2
DOIs
Publication statusPublished - Feb 1 2019

Keywords

  • Colonization
  • CPE
  • Donor-recipient transmission
  • Infection
  • Solid organ transplant

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