title: Multidrug-resistant Klebsiella pneumoniae acquisition in lung transplant recipients.
abstract: BACKGROUND
  Carbapenem-resistant Klebsiella pneumoniae (CRKP) is a pathogen that emerged in the late twentieth century and was associated with significant morbidity and mortality. We report for the first time the outcomes of lung transplant recipients infected with CRKP or extended spectrum-β lactamases K. pneumoniae (ESBL-KP).
  
  
  METHODS
  Retrospective review of 136 lung transplant recipients who underwent transplantation between 2004 and 2007 in Rabin Medical Center, Israel.
  
  
  RESULTS
  There were 52 episodes of positive cultures for K. pneumoniae (KP) in 136 recipients - of them 11 (8.1%) with CRKP, 12 (8.8%) with ESBL-KP, and 29 (21.3%) with carbapenem-sensitive ESBL-negative KP. Isolation of CRKP/ESBL-KP was associated with death in the cohort (p < 0.0001) as well as recipients' age at transplantation (p < 0.005). Time-dependent age-adjusted CRKP or ESBL-KP acquisition was an independent factor for death in patients after lung transplant, compared to patients without KP isolation or carbapenem-sensitive ESBL-negative KP (p < 0.0001).
  
  
  CONCLUSIONS
  CRKP and KP-ESBL acquisition was associated with reduced survival among lung transplant recipients.
authors.affiliation: Pulmonary Institute, Rabin Medical Center, Petah Tiqwa, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. ravivyy@zahav.net.il
authors.forename: Yael
authors.initials: Y
authors.lastname: Raviv
authors.forename: David
authors.initials: D
authors.lastname: Shitrit
authors.forename: Anat
authors.initials: A
authors.lastname: Amital
authors.forename: Benjamin
authors.initials: B
authors.lastname: Fox
authors.forename: Ilana
authors.initials: I
authors.lastname: Bakal
authors.forename: Renana
authors.initials: R
authors.lastname: Tauber
authors.forename: Jihad
authors.initials: J
authors.lastname: Bishara
authors.forename: Mordechai R
authors.initials: MR
authors.lastname: Kramer
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D024881:Drug Resistance, Bacterial; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007710:Klebsiella Infections / Q000188:drug therapy / Q000382:microbiology / Q000401:mortality*; D007711:Klebsiella pneumoniae / Q000302:isolation & purification* / Q000472:pathogenicity; D008171:Lung Diseases / Q000150:complications* / Q000601:surgery; D016040:Lung Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D062606:Tertiary Care Centers; D055815:Young Adult; D001618:beta-Lactamases / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D001618:beta-Lactamases