Colonization with extended-spectrum beta-lactamase-producing Enterobacteriaceae in solid organ transplantation: A meta-analysis and review

Michail Alevizakos, Athanasios Kallias, Myrto Eleni Flokas, Eleftherios Mylonakis

Research output: Contribution to journalArticlepeer-review

20 Scopus citations

Abstract

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.

Original languageEnglish (US)
Article numbere12718
JournalTransplant Infectious Disease
Volume19
Issue number4
DOIs
StatePublished - Aug 2017

Keywords

  • ESBL
  • colonization
  • infection
  • meta-analysis
  • solid organ transplantation

ASJC Scopus subject areas

  • Transplantation
  • Infectious Diseases

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