Single mutidrug resistant enterobacteriacae donor-derived infection in four solid organ transplant recipients: a case report
Abstract
Solid organ transplantation (SOT) is the only way to treat end-stage organ disease [1]. However, as the number of potential recipients continues to exceed the number of donated organs from different sources, an imbalance between the number of available organs and potential recipients remains.
This increase in demand has led to the extension of donor or organ criteria and a rise in the use of organs from "marginal donors" of older age and those with comorbidities, including infections. Individual risk assessment is therefore essential for ensuring successful outcomes [2].
Even when potential organ donors are not initially infected upon admission to an intensive care unit (ICU), the risk of infection from ensuing invasive procedures can increase significantly. This risk of infection and subsequent organ contamination must be considered before procurement [3].
However, bacteraemia or bacterial sepsis is not considered an absolute contraindication to organ donation provided adequate antibiotic treatment is administered [4, 5]. On the other hand, infection and sepsis are among the most common causes of morbidity and mortality in patients after SOT.
Risk of infection is not only based on immunosuppression, epidemiologic exposure and invasive procedures performed in the recipient [6, 7], but also on possible pathogen transmission from the donor. In this case series, we report donor-derived infection caused by multidrug-resistant (MDR) bacteria Escherichia coli producing extended spectrum β-lactamase (ESBL) and Klebsiella pneumonia ESBL in four SOT recipients transplanted in one transplant centre (TC).