title: The Distribution and Resistance of Pathogens Among Solid Organ Transplant Recipients with Pseudomonas aeruginosa Infections.
abstract: BACKGROUND
  Pseudomonas aeruginosa infection remains a life-threatening complication after solid organ transplantation (SOT). We aimed to investigate the distribution and drug susceptibility of pathogens, and clinical characteristics of SOT recipients with Pseudomonas aeruginosa infections.
  
  
  METHODS
  A total of 55 SOT recipients who developed 61 episodes of Pseudomonas aeruginosa infections between January 1, 2003 and July 31, 2015 were retrospectively analyzed. The distribution and the drug susceptibility of Pseudomonas aeruginosa were reviewed.
  
  
  RESULTS
  The most common site from which 61 Pseudomonas aeruginosa rods were isolated were the lungs (57.4%, n=37), followed by the blood (27.9%, n=17). There were 35, 18, and 9 recipients accompanied with a serum creatinine level of >1.5 mg/dL, lymphocyte count of <300/mm(3), and a serum albumin level of <30 g/L, respectively. Seven patients each presented with white blood cell count of >15,000/mm(3) and platelet count of <50,000/mm(3). There were 6 (10.9%) cases of septic shocks and 18 (32.7%) deaths. Antibiotic resistance rate of all Pseudomonas aeruginosa to 4 of 10 antibiotics investigated was more than 50%. Of these 61 Pseudomonas aeruginosa isolates, 47.5% were carbapenem-resistant. The rods were relatively sensitive to piperacillin-tazobactam, levofloxacin, amikacin, and cefoperazone-sulbactam (resistance rate <40%).
  
  
  CONCLUSIONS
  The clinical presentation of Pseudomonas aeruginosa infections included high body temperature, decreased platelet count, elevated white blood cell count, a high nosocomial origin and mortality, and onset in the late period after transplantation. According to our findings, piperacillin-tazobactam, levofloxacin, amikacin, and cefoperazone-sulbactam, alone or combination, are recommended to treat SOT recipients with Pseudomonas aeruginosa infections.
authors.affiliation: Key Laboratory of Medical Information Research (Central South University), College ofHunan Province, Changsha, China (mainland).
authors.forename: Aijing
authors.initials: A
authors.lastname: Luo
authors.affiliation: Department of nursing, The Third Xiangya Hospital, Central South University, Changsha, China (mainland).
authors.forename: Zhuqing
authors.initials: Z
authors.lastname: Zhong
authors.affiliation: Department of Transplant Surgery, the Third Xiangya Hospital, Central South University, Changsha, China (mainland).
authors.forename: Qiquan
authors.initials: Q
authors.lastname: Wan
authors.affiliation: Department of Transplant Surgery, The Third Xiangya Hospital, Central South University, Changsha, China (mainland).
authors.forename: Qifa
authors.initials: Q
authors.lastname: Ye
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D003710:Demography; D004352:Drug Resistance, Microbial / Q000187:drug effects; D005260:Female; D006801:Humans; D008297:Male; D011552:Pseudomonas Infections / Q000382:microbiology*; D011550:Pseudomonas aeruginosa / Q000187:drug effects / Q000302:isolation & purification / Q000502:physiology*; D066027:Transplant Recipients; D014180:Transplantation
chemical_list: D000900:Anti-Bacterial Agents