Diagnosis and treatment in 9 cases of donor-derivedcarbapenem-resistant Klebsiella pneumoniae Infection after kidney transplantation
10.3760/cma.j.issn.0254-1785.2019.06.004
- VernacularTitle:肾移植术后供肾来源耐碳青霉烯类肺炎克雷伯菌感染九例诊疗经验
- Author:
Jiajin WU
1
;
Dawei LI
;
Ming ZHANG
;
Liang YING
;
Chen ZHONG
;
Ruoyang CHEN
;
Feng QIU
;
Shaoyong ZHUANG
;
Haoyu WU
;
Xiaodong YUAN
Author Information
1. 上海交通大学医学院附属仁济医院肾移植中心 200120
- Keywords:
Renal transplantation;
infection;
resistant organism
- From:
Chinese Journal of Organ Transplantation
2019;40(6):334-338
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the rapid diagnosis and clinic treatment of donor-derived carbapenem-resistant Klebsiella pneumoniae (CRKP) infection in renal transplant recipients .Methods Retrospective analysis was performed for clinical data and the diagnosis and treatment of 9 renal transplant recipients with donor-derived CRKP infection from March 2017 to May 2019 .Results Among 526 renal transplant recipients ,nine were diagnosed with donor-derived CRKP infection by bacterial culture or KPC enzyme gene test .The infection rate was 1 .71％ .One recipient receiving carbapenem and tigecycline died while the remainders survived after a treatment of ceftazidime-avibactam and carbapenem . One recipient underwent graft resection . Among 8 recipients on ceftazidime-avibactam ,5 cases received a standard dose of 3 .75 g/d while another 3 cases had a high dose of 7 .5 g/d .One patient in standard-dose group underwent graft resection due to an arteriorrhexis of artery anastomosis .After graft resection ,the patient received a high dose of ceftazidime-avibactam and survived to date .The grafts of three patients in high-dose treatment group survived .Conclusions KPC enzyme gene detection plus injecting lavage fluid into blood culture bottle for bacterial culture is rapid and accurate for diagnosing donor-derived CRKP infection . A combination of ceftazidime-avibactam plus carbapenem is effective for donor-derived CRKP infection .A high dose of ceftazidime-avibactam may improve the efficacy without obvious side effects .
