ESBL-producing Klebsiella pneumoniae

Status:

Ready to upload

Record number:

1803

Adverse Occurrence type:

Klebsiella

MPHO Type:

Liver

Estimated frequency:

Rare

Time to detection:

48 hours

Alerting signals, symptoms, evidence of occurrence:

The recipient presented fever and hemodynamic instability within 24 hours after procedure while on antibiotic prophylaxis with amoxicillin-clavulanate

Demonstration of imputability or root cause:

All samples (endotracheal aspirate from the donor, preservation fluid, blood and surgical site from the recipient) were positive for the same extended-spectrum beta-lactamse-producing Klebsiella as demosntrated by pulsed-field gel electrophoresis.

Imputability grade:

3 Definite/Certain/Proven

Groups audience:

Infections

Infections -- Bacteria

Keywords:

Klebsiella

Klebsiella pneumoniae

ESBL (extended spectrum beta lactamase)

MDR (multiple drug resistance)

liver

liver transplant

References:

Successful liver transplantation despite donor-transmitted ESBL-producing Klebsiella pneumoniae infection: Case report and review of the literature.

Organ transplantation from a donor colonized with a multidrug-resistant organism: a case report.

Outcomes of transplantation using organs from a donor infected with Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae.

Multidrug-resistant bacteria in solid organ transplant recipients.

Cross-infection of solid organ transplant recipients by a multidrug-resistant Klebsiella pneumoniae isolate producing the OXA-48 carbapenemase, likely derived from a multiorgan donor.

Suggest new keywords:

multidrug resistant microorganism, ESBL-producing Gram negative rod, Klebsiella pneumoniae, donor dereived infection

Reference attachment:

ESBL K pneumoniae, Escola Verge, 2017.pdf

Suggest references:

Successful liver transplantation despite donor-transmitted ESBL-producing Klebsiella pneumoniae infection: Case report and review of the literature. Escolà-Vergé L et al. Transpl Infect Dis. 2017 Jul 10

Note:

Please see records 1688 and 1793 (also 1305 and 1475) before deciding what to do for thgis record. Thank you (Ines) I could not find record 1305. The other references are included in this one as it is not only the communication of a new episode but a compilation of all the literature available on the topic. MG: Please merge this and records 1304 and 1688 - putting all the liver cases together. Separately, please add this to 1793 so that kidney is together. Thanks!

Expert comments for publication:

There is a growing concern on the raising of colonization by multidrug resistant microorganisms in the donors. This pathogens may be transmitted to the recipient as well as non-resistant microorganisms could. However, their low susceptibility to antibiotics pose a challenge to administer the right antibiotic treatment from the very beginning. Thus, it is crucial to know the local epidemiology of each center to design the best preoperative antibiotic strategy. It is also very important to have all the information related to perioperative culture samples as soon as possible in order to detect quickly the possible transmission and, if so, to prescribe the adequate antibiotic.