Etiologic agents of bacteremia in the early period after simultaneous pancreas-kidney transplantation.
BACKGROUND
Bacteremia is among the known complications in simultaneous pancreas-kidney transplantation (SPKT). This study evaluated the frequency of microbial isolates and their susceptibility profiles among cultures of clinical samples obtained from blood and from the tips of blood vessel catheters of 26 SPKT recipients suspected of bacteremia in the early posttransplant period.


METHODS
Data on microbiologic blood cultures of 26 adult patients undergoing SPKT were collected prospectively from 2001 to the end of 2006. The isolation and identification of cultured microorganisms were performed according to standard microbiological procedures and commercially available tests. The susceptibility of the strains to antibacterial agents was established by the Clinical and Laboratory Standards Institute guidelines.


RESULTS
All patients were followed prospectively for the first 4 weeks after surgery. Among 66 clinical samples, there were 23 microbial isolates from blood samples of 17 recipients and catheter tips of 12 recipients. The most common isolates were Gram-positive bacteria (73.9%) with domination of staphylococci (64.7%) and MRCNS strains (81.8%). Gram-negative bacteria comprised 17.4% of positive cultures, whereas yeast-like fungi, 8.7% with a predominance of Candida glabrata.


CONCLUSIONS
Our study showed predominately Gram-positive bacteria in 73.9% of isolates. The increased proportion of multi-drug-resistant bacteria and fungi to antimicrobial agents may be due to the frequent use of these agents for prophylaxis of bacterial infections in patients.
Department of Medical Microbiology, Transplantation Institute, Medical University of Warsaw, 5 Chalubinskiego Street, 02-004 Warsaw, Poland. dkawecki@o2.pl
D
D
Kawecki
A
A
Kwiatkowski
G
G
Michalak
A
A
Sawicka-Grzelak
A
A
Mlynarczyk
B
B
Sokol-Leszczynska
K
K
Kot
J
J
Czerwinski
W
W
Lisik
M
M
Bieniasz
M
M
Wszola
P
P
Domagala
W
W
Rowinski
M
M
Durlik
M
M
Luczak
A
A
Chmura
G
G
Mlynarczyk
D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D016470:Bacteremia / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006094:Gram-Positive Bacteria / Q000302:isolation & purification; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000627:therapeutic use; D016035:Pancreas Transplantation / Q000009:adverse effects*; D011184:Postoperative Period; D012189:Retrospective Studies; D013210:Staphylococcus / Q000187:drug effects
D000900:Anti-Bacterial Agents; D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid