Analysis of Susceptibility to Selected Antibiotics in <i>Klebsiella pneumoniae, Escherichia coli, Enterococcus faecalis</i> and <i>Enterococcus faecium</i> Causing Urinary Tract Infections in Kidney Transplant Recipients over 8 Years: Single-Center Study
<b>Background:</b> Urinary tract infections (UTIs) are the most common bacterial infections among kidney transplant (KTX) recipients. The purpose of this study was to analyze antimicrobial resistance (AMR) in four most common pathogens responsible for UTIs in KTX recipients and determine...
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| Format: | Article |
| Language: | English |
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MDPI AG
2020-05-01
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| Series: | Antibiotics |
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| Online Access: | https://www.mdpi.com/2079-6382/9/6/284 |
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| author | Olga Maria Rostkowska Robert Kuthan Anna Burban Jagoda Salińska Michał Ciebiera Grażyna Młynarczyk Magdalena Durlik |
| author_facet | Olga Maria Rostkowska Robert Kuthan Anna Burban Jagoda Salińska Michał Ciebiera Grażyna Młynarczyk Magdalena Durlik |
| author_sort | Olga Maria Rostkowska |
| collection | DOAJ |
| description | <b>Background:</b> Urinary tract infections (UTIs) are the most common bacterial infections among kidney transplant (KTX) recipients. The purpose of this study was to analyze antimicrobial resistance (AMR) in four most common pathogens responsible for UTIs in KTX recipients and determine risk factors (RF) for resistance in the same group. <b>Methods:</b> Analyzed antibiograms were based on urine samples positive for bacterial growth of 10<sup>5</sup> colony-forming units (CFU)/mL obtained from hospitalized adult KTX recipients presenting with UTI symptoms upon admission to the center in years 2011–2018. <b>Results:</b> In total, 783 antibiograms were analyzed for <i>Klebsiella pneumoniae</i> (258 samples, 33.0%), <i>Escherichia coli</i> (212, 27.0%), <i>Enterococcus faecalis</i> (128, 24.0%), and <i>Enterococcus faecium</i> (125, 16.0%). The decrease in susceptibility of <i>E. coli</i> to amoxicillin/clavulanic acid (62.9% vs. 40.0%) and ciprofloxacin (100% to 40.0%) was observed. Susceptibility to gentamicin increased from 33.3% to 92.9% in <i>E. faecium</i>. Susceptibility to tigecycline remained 100% through all years in case of <i>E. faecalis</i> and <i>E. faecium</i>. Male gender was a RF for resistance to amoxicillin/clavulanic acid (<i>p</i> = 0.008), ciprofloxacin (<i>p</i> = 0.0003), trimethoprim/sulfamethoxazole (<i>p</i> = 0.00009), ceftriaxone (<i>p</i> = 0.0001), and cefuroxime axetil (<i>p</i> = 0.00038) in <i>K. pneumoniae</i> and against gentamicin in <i>E. faecalis</i> (<i>p</i> = 0.015). Higher resistance to ampicillin in <i>E. faecalis</i> (<i>p</i> = 0.012) and to ciprofloxacin (<i>p</i> = 0.0003), trimethoprim/sulfamethoxazole (<i>p</i> = 0.007), piperacillin/tazobactam (<i>p</i> = 0.003), ceftriaxone (<i>p</i> = 0.001), and cefuroxime axetil (<i>p</i> = 0.013) in <i>K. pneumoniae</i> was observed in higher age groups of patients. Diabetes as a cause of kidney insufficiency (<i>p</i> = 0.026) and kidney-pancreas transplantation (<i>p</i> = 0.014) was RF for resistance to ceftriaxone in <i>K. pneumoniae</i>. <b>Conclusions:</b> AMR in uropathogens from KTX recipients fluctuated. There were identifiable RFs for resistance in the examined bacteria–antibiotic combinations. We recommend continuous mapping of site-specific microorganisms as etiology and susceptibility may vary between institutions and over time. |
| first_indexed | 2024-03-10T19:34:30Z |
| format | Article |
| id | doaj.art-375dc07c1763498ba5bd97da72e2c554 |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-10T19:34:30Z |
| publishDate | 2020-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-375dc07c1763498ba5bd97da72e2c5542023-11-20T01:46:41ZengMDPI AGAntibiotics2079-63822020-05-019628410.3390/antibiotics9060284Analysis of Susceptibility to Selected Antibiotics in <i>Klebsiella pneumoniae, Escherichia coli, Enterococcus faecalis</i> and <i>Enterococcus faecium</i> Causing Urinary Tract Infections in Kidney Transplant Recipients over 8 Years: Single-Center StudyOlga Maria Rostkowska0Robert Kuthan1Anna Burban2Jagoda Salińska3Michał Ciebiera4Grażyna Młynarczyk5Magdalena Durlik6Department of Transplantation Medicine, Nephrology, Internal Diseases, T. Orłowski Institute of Transplantation, Medical University of Warsaw, 59 Nowogrodzka Street, 02-006 Warsaw, PolandChair and Department of Medical Microbiology, Medical University of Warsaw, 5 Chałubińskiego Street, 02-004 Warsaw, PolandDepartment of Transplantation Medicine, Nephrology, Internal Diseases, T. Orłowski Institute of Transplantation, Medical University of Warsaw, 59 Nowogrodzka Street, 02-006 Warsaw, PolandDepartment of Transplantation Medicine, Nephrology, Internal Diseases, T. Orłowski Institute of Transplantation, Medical University of Warsaw, 59 Nowogrodzka Street, 02-006 Warsaw, PolandSecond Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, 80 Cegłowska Street, 01–809 Warsaw, PolandChair and Department of Medical Microbiology, Medical University of Warsaw, 5 Chałubińskiego Street, 02-004 Warsaw, PolandDepartment of Transplantation Medicine, Nephrology, Internal Diseases, T. Orłowski Institute of Transplantation, Medical University of Warsaw, 59 Nowogrodzka Street, 02-006 Warsaw, Poland<b>Background:</b> Urinary tract infections (UTIs) are the most common bacterial infections among kidney transplant (KTX) recipients. The purpose of this study was to analyze antimicrobial resistance (AMR) in four most common pathogens responsible for UTIs in KTX recipients and determine risk factors (RF) for resistance in the same group. <b>Methods:</b> Analyzed antibiograms were based on urine samples positive for bacterial growth of 10<sup>5</sup> colony-forming units (CFU)/mL obtained from hospitalized adult KTX recipients presenting with UTI symptoms upon admission to the center in years 2011–2018. <b>Results:</b> In total, 783 antibiograms were analyzed for <i>Klebsiella pneumoniae</i> (258 samples, 33.0%), <i>Escherichia coli</i> (212, 27.0%), <i>Enterococcus faecalis</i> (128, 24.0%), and <i>Enterococcus faecium</i> (125, 16.0%). The decrease in susceptibility of <i>E. coli</i> to amoxicillin/clavulanic acid (62.9% vs. 40.0%) and ciprofloxacin (100% to 40.0%) was observed. Susceptibility to gentamicin increased from 33.3% to 92.9% in <i>E. faecium</i>. Susceptibility to tigecycline remained 100% through all years in case of <i>E. faecalis</i> and <i>E. faecium</i>. Male gender was a RF for resistance to amoxicillin/clavulanic acid (<i>p</i> = 0.008), ciprofloxacin (<i>p</i> = 0.0003), trimethoprim/sulfamethoxazole (<i>p</i> = 0.00009), ceftriaxone (<i>p</i> = 0.0001), and cefuroxime axetil (<i>p</i> = 0.00038) in <i>K. pneumoniae</i> and against gentamicin in <i>E. faecalis</i> (<i>p</i> = 0.015). Higher resistance to ampicillin in <i>E. faecalis</i> (<i>p</i> = 0.012) and to ciprofloxacin (<i>p</i> = 0.0003), trimethoprim/sulfamethoxazole (<i>p</i> = 0.007), piperacillin/tazobactam (<i>p</i> = 0.003), ceftriaxone (<i>p</i> = 0.001), and cefuroxime axetil (<i>p</i> = 0.013) in <i>K. pneumoniae</i> was observed in higher age groups of patients. Diabetes as a cause of kidney insufficiency (<i>p</i> = 0.026) and kidney-pancreas transplantation (<i>p</i> = 0.014) was RF for resistance to ceftriaxone in <i>K. pneumoniae</i>. <b>Conclusions:</b> AMR in uropathogens from KTX recipients fluctuated. There were identifiable RFs for resistance in the examined bacteria–antibiotic combinations. We recommend continuous mapping of site-specific microorganisms as etiology and susceptibility may vary between institutions and over time.https://www.mdpi.com/2079-6382/9/6/284urinary tract infectionskidney transplant recipientantimicrobial resistancedrug resistanceinfectionskidney |
| spellingShingle | Olga Maria Rostkowska Robert Kuthan Anna Burban Jagoda Salińska Michał Ciebiera Grażyna Młynarczyk Magdalena Durlik Analysis of Susceptibility to Selected Antibiotics in <i>Klebsiella pneumoniae, Escherichia coli, Enterococcus faecalis</i> and <i>Enterococcus faecium</i> Causing Urinary Tract Infections in Kidney Transplant Recipients over 8 Years: Single-Center Study Antibiotics urinary tract infections kidney transplant recipient antimicrobial resistance drug resistance infections kidney |
| title | Analysis of Susceptibility to Selected Antibiotics in <i>Klebsiella pneumoniae, Escherichia coli, Enterococcus faecalis</i> and <i>Enterococcus faecium</i> Causing Urinary Tract Infections in Kidney Transplant Recipients over 8 Years: Single-Center Study |
| title_full | Analysis of Susceptibility to Selected Antibiotics in <i>Klebsiella pneumoniae, Escherichia coli, Enterococcus faecalis</i> and <i>Enterococcus faecium</i> Causing Urinary Tract Infections in Kidney Transplant Recipients over 8 Years: Single-Center Study |
| title_fullStr | Analysis of Susceptibility to Selected Antibiotics in <i>Klebsiella pneumoniae, Escherichia coli, Enterococcus faecalis</i> and <i>Enterococcus faecium</i> Causing Urinary Tract Infections in Kidney Transplant Recipients over 8 Years: Single-Center Study |
| title_full_unstemmed | Analysis of Susceptibility to Selected Antibiotics in <i>Klebsiella pneumoniae, Escherichia coli, Enterococcus faecalis</i> and <i>Enterococcus faecium</i> Causing Urinary Tract Infections in Kidney Transplant Recipients over 8 Years: Single-Center Study |
| title_short | Analysis of Susceptibility to Selected Antibiotics in <i>Klebsiella pneumoniae, Escherichia coli, Enterococcus faecalis</i> and <i>Enterococcus faecium</i> Causing Urinary Tract Infections in Kidney Transplant Recipients over 8 Years: Single-Center Study |
| title_sort | analysis of susceptibility to selected antibiotics in i klebsiella pneumoniae escherichia coli enterococcus faecalis i and i enterococcus faecium i causing urinary tract infections in kidney transplant recipients over 8 years single center study |
| topic | urinary tract infections kidney transplant recipient antimicrobial resistance drug resistance infections kidney |
| url | https://www.mdpi.com/2079-6382/9/6/284 |
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