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Title: Outbreak of IMP-producing carbapenem-resistant Enterobacter gergoviae among kidney transplant recipients
Authors: FREIRE, Maristela PinheiroGARCIA, Doroti de OliveiraCURY, Ana PaulaSPADAO, FernandaGIOIA, Thais S. R. DiFRANCISCO, Gabriela RodriguesBUENO, Maria Fernanda CampagnariTOMAZ, MariamaPAULA, Flavio Jota deFARO, Lorena Brito dePIOVESAN, Affonso C.ROSSI, FlaviaLEVIN, Anna SaraDAVID NETO, EliasNAHAS, William C.PIERROTTI, Ligia Camera
Citation: JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY, v.71, n.9, p.2577-2585, 2016
Abstract: The objective of this study was to investigate a prolonged outbreak of carbapenem-resistant Enterobacter gergoviae (CREG) involving kidney transplant recipients (KTRs) between 2009 and 2014. A case-control study was undertaken. Controls (naEuroS=aEuroS52) were selected from CREG-negative KTRs. Surveillance cultures for CREG were collected weekly. Colonization was defined as isolation of CREG from surveillance samples or from clinical specimens, with no evidence of infection. We also investigated infection control practices at the facility. Of 26 identified cases, 13 had had no known contact with another CREG-positive patient before the first positive culture. Seven patients (27%) developed infection. The site most often colonized was the urinary tract. During the study period two clusters were identified, one in 2009 and another in 2013-14. DNA sequencing revealed bla(IMP-1) in all CREG tested. No environmental or hand cultures tested positive for CREG. An audit of infection control practices detected flaws in the handling and cleaning of urinary tract devices. Multivariate analysis identified advanced age, ureteral stent use, retransplantation and male gender as risk factors for CREG acquisition. An outbreak among KTRs caused by an unusual species of MDR bacteria may have resulted from a common source of contamination related to urinary tract devices.
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Artigos e Materiais de Revistas Científicas - FM/MCG
Departamento de Cirurgia - FM/MCG

Artigos e Materiais de Revistas Científicas - FM/MIP
Departamento de Moléstias Infecciosas e Parasitárias - FM/MIP

Artigos e Materiais de Revistas Científicas - HC/ICESP
Instituto do Câncer do Estado de São Paulo - HC/ICESP

Artigos e Materiais de Revistas Científicas - HC/ICHC
Instituto Central - HC/ICHC

Artigos e Materiais de Revistas Científicas - LIM/03
LIM/03 - Laboratório de Medicina Laboratorial

Artigos e Materiais de Revistas Científicas - LIM/47
LIM/47 - Laboratório de Hepatologia por Vírus

Artigos e Materiais de Revistas Científicas - LIM/54
LIM/54 - Laboratório de Bacteriologia

Artigos e Materiais de Revistas Científicas - LIM/55
LIM/55 - Laboratório de Urologia

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