title: Extended spectrum β-lactamase-producing Enterobacteriaceae infection in heart and lung transplant recipients and in mechanical circulatory support recipients.
abstract: BACKGROUND
  Extended spectrum β-lactamase (ESBL)-producing gram-negative bacilli are increasingly reported in patients with a variety of risk factors including prior cephalosporin and antibiotic usage, prolonged hospitalizations, existence of comorbid conditions, and critical illness.
  
  
  METHODS
  Retrospective review of infections caused by ESBL-producing Enterobacteriaceae was performed in heart transplant (HTx), lung transplant (LTx), and mechanical circulatory support (MCS) device recipients at a large transplant center.
  
  
  RESULTS
  Among 1065 patients transplanted/implanted, the incidence of ESBL-related infections (bacteremia, urinary tract infections, pneumonia, central venous catheter-associated infection, and wound infections) in HTx, LTx, and MCS device recipients was reported at 2.2%, 5.5%, and 10.7%, respectively, caused by ESBL-producing Klebsiella pneumoniae, Escherichia coli, Klebsiella oxytoca, and Citrobacter freundii.
  
  
  CONCLUSIONS
  Early detection and adequate duration of therapy for ESBL-producing Enterobacteriaceae in solid organ transplants and MCS device recipients are essential in successful patient outcomes including prevention of recurrent infection.
authors.affiliation: 1 Division of Infectious Diseases, Department of Medicine, David Geffen School of Medicine at UCLA. Ronald Reagan UCLA Medical Center, Los Angeles, CA. 2 Heart/Lung Transplant. Ronald Reagan UCLA Medical Center, Los Angeles, CA. 3 Division of Pulmonary & Critical Care, Department of Medicine, David Geffen School of Medicine at UCLA. Ronald Reagan UCLA Medical Center, Los Angeles, CA. 4 Dvision of Cardiothoracic Surgery, Department of Surgery, David Geffen School of Medicine at UCLA. Ronald Reagan UCLA Medical Center, Los Angeles, CA. 5 Address correspondence to: Bernard M. Kubak, Ph.D., M.D., David Geffen School of Medicine at UCLA, Transplant Infectious Diseases, Heart/Lung Transplant, Ronald Reagan UCLA Medical Center, 757 Westwood Plaza, Suite 7501A, Los Angeles, CA 90095.
authors.forename: Kevin T
authors.initials: KT
authors.lastname: Bui
authors.forename: Seema
authors.initials: S
authors.lastname: Mehta
authors.forename: Tam H
authors.initials: TH
authors.lastname: Khuu
authors.forename: David
authors.initials: D
authors.lastname: Ross
authors.forename: Margrit
authors.initials: M
authors.lastname: Carlson
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Leibowitz
authors.forename: Joanna M
authors.initials: JM
authors.lastname: Schaenman
authors.forename: Rajan
authors.initials: R
authors.lastname: Saggar
authors.forename: Joseph P
authors.initials: JP
authors.lastname: Lynch
authors.forename: Abbas
authors.initials: A
authors.lastname: Ardehali
authors.forename: Bernard M
authors.initials: BM
authors.lastname: Kubak
mesh_terms: D000328:Adult; D000368:Aged; D004755:Enterobacteriaceae / Q000378:metabolism*; D004756:Enterobacteriaceae Infections / Q000453:epidemiology* / Q000401:mortality; D004927:Escherichia coli Infections / Q000453:epidemiology / Q000401:mortality; D005260:Female; D016027:Heart Transplantation / Q000706:statistics & numerical data*; D006353:Heart-Assist Devices / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007710:Klebsiella Infections / Q000453:epidemiology / Q000401:mortality; D016040:Lung Transplantation / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D014180:Transplantation / Q000706:statistics & numerical data*; D001618:beta-Lactamases / Q000378:metabolism*
chemical_list: D001618:beta-Lactamases