Carbapenemase-producing Enterobacterales in solid organ transplantation: Tip of the iceberg?

Kyle C Molina; Valida Bajrovic; Robert A Bonomo

doi:10.1111/tid.13780

Carbapenemase-producing Enterobacterales in solid organ transplantation: Tip of the iceberg?

Transpl Infect Dis. 2022 Apr;24(2):e13780. doi: 10.1111/tid.13780. Epub 2022 Jan 31.

Authors

Kyle C Molina^{1

2

3}, Valida Bajrovic³, Robert A Bonomo^{4

5

6

7}

Affiliations

¹ Department of Pharmacy Services, University of Colorado Hospital, Aurora, Colorado, USA.
² Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, Colorado, USA.
³ Division of Infectious Disease, Department of Medicine, University of Colorado, Aurora, Colorado, USA.
⁴ Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.
⁵ Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, Ohio, USA.
⁶ Departments of Pharmacology, Molecular Biology and Microbiology, Biochemistry, and Proteomics and Bioinformatics, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.
⁷ CWRU-Cleveland VAMC Center for Antimicrobial Resistance and Epidemiology (Case VA CARES), Cleveland, Ohio, USA.

PMID: 34962337
DOI: 10.1111/tid.13780

Abstract

A liver transplant recipient developed a urinary tract infection with Citrobacter freundii complex and Klebsiella aerogenes, both producing dual carbapenemases (KPC-3/NDM-1). Whole-genome sequencing suggested plasmid transfer between organisms. Silent plasmid transmission highlights emergent threats to infection prevention, with implications for screening and antimicrobial stewardship.

Keywords: KPC; NDM; avibactam; aztreonam; cefiderocol; dual carbapenemases; infection prevention; transplant.

Publication types

Letter

MeSH terms

Anti-Bacterial Agents / therapeutic use
Bacterial Proteins / genetics
Humans
Klebsiella pneumoniae
Microbial Sensitivity Tests
Organ Transplantation* / adverse effects
Plasmids / genetics
beta-Lactamases* / genetics

Substances

Anti-Bacterial Agents
Bacterial Proteins
beta-Lactamases
carbapenemase