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DC Field | Value | Language |
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dc.contributor | Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP | |
dc.contributor.author | FREIRE, Maristela P. | |
dc.contributor.author | GARCIA, Doroti de Oliveira | |
dc.contributor.author | CURY, Ana Paula | |
dc.contributor.author | FRANCISCO, Gabriela R. | |
dc.contributor.author | SANTOS, Nathamy F. dos | |
dc.contributor.author | SPADAO, Fernanda | |
dc.contributor.author | BUENO, Maria Fernanda Campagnari | |
dc.contributor.author | CAMARGO, Carlos Henrique | |
dc.contributor.author | PAULA, Flavio J. de | |
dc.contributor.author | ROSSI, Flavia | |
dc.contributor.author | NAHAS, Willian C. | |
dc.contributor.author | DAVID-NETO, Elias | |
dc.contributor.author | PIERROTTI, Ligia C. | |
dc.date.accessioned | 2019-05-30T13:17:52Z | |
dc.date.available | 2019-05-30T13:17:52Z | |
dc.date.issued | 2019 | |
dc.identifier.citation | EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES, v.38, n.4, p.755-765, 2019 | |
dc.identifier.issn | 0934-9723 | |
dc.identifier.uri | https://observatorio.fm.usp.br/handle/OPI/31579 | |
dc.description.abstract | Kidney transplant recipients are at risk for infections due to carbapenem-resistant Enterobacteriaceae (CRE). Polymyxin-resistant CRE (PR-CRE) infections are especially difficult to treat. The aim of this study was to characterize PR-CRE infections among kidney transplant recipients and identify risk factors for treatment failure. This retrospective cohort study involved all kidney transplant recipients with PR-CRE infection between 2013 and 2017 at our center. Minimal inhibitory concentrations for polymyxin B were determined by broth microdilution. Carbapenem-resistant genes (bla(KPC), bla(NDM), and bla(OXA-48)), aminoglycoside-resistance genes, and polymyxin-resistant gene mcr-1 were identified by polymerase chain reaction. All but one of the 47PR-CRE infections identified were due to Klebsiella pneumoniae. The most common type of infection (in 54.3%) was urinary tract infection (UTI). Monotherapy was used in 10 cases. Combined treatment regimens included double-carbapenem therapy in 19 cases, oral fosfomycin in 19, and amikacin in 13. Treatment failure occurred in 21 cases (45.7%). Clinical success was achieved 78.9% of patients who used aminoglycosides versus 37.0% of those who not used this drug (p=0.007). Multivariate analysis showed diabetes mellitus to be a risk factor for treatment failure; amikacin use and UTI were found to be protective. Nine strains were RmtB producers. Although aminoglycosides constitute an important therapeutic option for PR-CRE infection, the emergence of aminoglycoside resistance could have a major impact on the management of CRE infection. | eng |
dc.language.iso | eng | |
dc.publisher | SPRINGER | eng |
dc.relation.ispartof | European Journal of Clinical Microbiology & Infectious Diseases | |
dc.rights | restrictedAccess | eng |
dc.subject | Polymyxin resistance | eng |
dc.subject | Kidney transplant | eng |
dc.subject | Fosfomycin | eng |
dc.subject | Double carbapenem | eng |
dc.subject | Mortality | eng |
dc.subject | Treatment | eng |
dc.subject.other | klebsiella-pneumoniae infections | eng |
dc.subject.other | liver-transplantation | eng |
dc.subject.other | risk-factors | eng |
dc.subject.other | fosfomycin | eng |
dc.subject.other | colistin | eng |
dc.subject.other | combination | eng |
dc.subject.other | gentamicin | eng |
dc.subject.other | bacteremia | eng |
dc.title | The role of therapy with aminoglycoside in the outcomes of kidney transplant recipients infected with polymyxin- and carbapenem-resistant Enterobacteriaceae | eng |
dc.type | article | eng |
dc.rights.holder | Copyright SPRINGER | eng |
dc.identifier.doi | 10.1007/s10096-019-03468-4 | |
dc.identifier.pmid | 30680569 | |
dc.subject.wos | Infectious Diseases | eng |
dc.subject.wos | Microbiology | eng |
dc.type.category | original article | eng |
dc.type.version | publishedVersion | eng |
hcfmusp.author.external | GARCIA, Doroti de Oliveira:Adolfo Lutz Inst, Bacteriol Ctr, Sao Paulo, Brazil | |
hcfmusp.author.external | FRANCISCO, Gabriela R.:Adolfo Lutz Inst, Bacteriol Ctr, Sao Paulo, Brazil | |
hcfmusp.author.external | SANTOS, Nathamy F. dos:Adolfo Lutz Inst, Bacteriol Ctr, Sao Paulo, Brazil | |
hcfmusp.author.external | BUENO, Maria Fernanda Campagnari:Adolfo Lutz Inst, Bacteriol Ctr, Sao Paulo, Brazil | |
hcfmusp.author.external | CAMARGO, Carlos Henrique:Adolfo Lutz Inst, Bacteriol Ctr, Sao Paulo, Brazil | |
hcfmusp.description.beginpage | 755 | |
hcfmusp.description.endpage | 765 | |
hcfmusp.description.issue | 4 | |
hcfmusp.description.volume | 38 | |
hcfmusp.origem | WOS | |
hcfmusp.origem.id | WOS:000461781100019 | |
hcfmusp.origem.id | 2-s2.0-85060757426 | |
hcfmusp.publisher.city | NEW YORK | eng |
hcfmusp.publisher.country | USA | eng |
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dc.description.index | MEDLINE | eng |
dc.identifier.eissn | 1435-4373 | |
hcfmusp.citation.scopus | 12 | - |
hcfmusp.scopus.lastupdate | 2024-03-29 | - |
Appears in Collections: | Artigos e Materiais de Revistas Científicas - FM/MCG Artigos e Materiais de Revistas Científicas - HC/ICESP Artigos e Materiais de Revistas Científicas - HC/ICHC Artigos e Materiais de Revistas Científicas - LIM/03 Artigos e Materiais de Revistas Científicas - LIM/47 Artigos e Materiais de Revistas Científicas - LIM/55 Artigos e Materiais de Revistas Científicas - ODS/03 |
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