gms | German Medical Science

Introduction: Bacterial infections remain serious complications in solid organ transplant recipients, despite professional medical care, the introduction of new immunosuppressive drugs and management which decreases the risk of infections. Therefore it was justified to analyse the frequency at which microbe strains occur, their biochemical profile and susceptibility to antimicrobial agents in patients after solid organ transplantation in the early posttransplant period in Poland.

Objectives: The study sample was composed of 511 consecutive solid organ transplant recipients (295 – kidney transplant, 190 – liver transplant, 26 – simultaneous pancreas-kidney transplant) who underwent transplantation at the Department of General Surgery and Transplantation at the Medical University of Warsaw between September 2001 and December 2007.

This six-year-period of observation of transplant patients had been subdivided into two subperiods: from 2001 to 2004 and from 2005 to 2007.

Clinical samples were taken from these recipients before transplantation, intraoperatively and during the first month after the operation. Cultured bacterial and fungal strains were identified and characterised at the Chair and Department of Medical Microbiology at the Medical University of Warsaw using standard microbiological methods.

Methods: The differences between isolated strains in these four periods have been evaluated by statistical analysis using SAS 9.1 program: chi-square test, Fisher test.

Differences between the incidence rate in two periods (2001 - 2004 vs 2005 - 2007) was performed using bootstrap method. The significance level was considered to be alfa = 0.05.

In the analysed clinical materials a high prevalence of multidrug resistant strains was demonstrated: Staphylococcus aureus (MRSA) – 59.7%, methicillinresistant coagulase-negative staphylococci (MRCNS) – 82.2%, Enterococcus spp. (HLAR) – 84.4%, Enterococcus spp. (VRE) – 12.4% and ESBL(+) Gram-negative rods of the Enterobacteriaceae family – 31.1%.

Results:

Table 1 [Tab. 1], Figure 1 [Fig. 1], Figure 2 [Fig. 2], Figure 3 [Fig. 3], Figure 4 [Fig. 4], Figure 5 [Fig. 5], Figure 6 [Fig. 6].