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Colonization with extended‐spectrum beta‐lactamase‐producing E nterobacteriaceae in solid organ transplantation: A meta‐analysis and review
Author(s) -
Alevizakos Michail,
Kallias Athanasios,
Flokas Myrto Eleni,
Mylonakis Eleftherios
Publication year - 2017
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/tid.12718
Subject(s) - medicine , colonization , organ transplantation , transplantation , broad spectrum , microbiology and biotechnology , beta lactam , antibiotics , biology , combinatorial chemistry , chemistry
Background Extended‐spectrum beta‐lactamase‐producing Enterobacteriaceae ( ESBL ‐E) may cause severe infections, often preceded by ESBL ‐E gastrointestinal ( GI ) colonization. Methods We conducted a review of the literature, investigating the prevalence of ESBL ‐E GI colonization in solid organ transplant ( SOT ) patients and the risk for subsequent ESBL ‐E infection. We searched the PubMed and EMBASE databases (to April 1, 2016) looking for studies that contained data on ESBL ‐E colonization among transplant patients. Results Of 341 non‐duplicate citations, four studies reporting data on 1089 patients fulfilled our inclusion criteria. Among them, the pooled prevalence for ESBL ‐E colonization was 18% (95% confidence interval [ CI ] 5%‐36%). Stratifying by transplant type, we identified an ESBL ‐E colonization rate of 17% (95% CI 3%‐39%) among liver transplant recipients and 24% (single report) among kidney transplant recipients. Conclusions Among SOT patients, approximately one in five patients is colonized with ESBL ‐E, although this finding may be skewed by reporting bias from centers with high ESBL ‐E prevalence. ESBL ‐E screening in SOT patients should be considered and evaluated in future studies.