Korean J Transplant.  2020 Jun;34(2):114-116. 10.4285/kjt.2020.34.2.114.

Transplantation of a kidney from a donor with vancomycin-resistant Enterococci

• Lim JH
• Kim CJ
• Oh JH
• Cho AY
• Chang MO
• Kim YS
• Lee KY
• Sun IO

• KMID: 2503888
• DOI: http://doi.org/10.4285/kjt.2020.34.2.114

Abstract

The colonization of vancomycin-resistant Enterococci before and after solid organ transplantation is associated with an increased risk of its infection. The prevalence of these bacterial colonies in renal transplant recipients are as high as that in intensive care unit patients. However, it is unclear whether donors with vancomycin-resistant Enterococci colonization can be considered in renal transplantation. Herein, we report a case wherein a kidney was transplanted from a deceased donor with vancomycin-resistant Enterococci colonies in urine and rectal swab. After transplant, the recipient had no vancomycin-resistant Enterococci infection and maintained relatively good renal function.

Keyword

Kidney transplantation; Vancomycin; Enterococci

Reference

1. Wisplinghoff H, Bischoff T, Tallent SM, Seifert H, Wenzel RP, Edmond MB. 2004; Nosocomial bloodstream infections in US hospitals: analysis of 24,179 cases from a prospective nationwide surveillance study. Clin Infect Dis. 39:309–17. DOI: 10.1086/421946. PMID: 15306996.

2. Kim YJ, Kim SI, Choi JY, Yoon SK, You YK, Kim DG. 2015; Clinical significance of methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci colonization in liver transplant recipients. Korean J Intern Med. 30:694–704. DOI: 10.3904/kjim.2015.30.5.694. PMID: 26354064. PMCID: PMC4578039.

3. Kim YJ, Jun YH, Choi HJ, You YK, Kim DG, Choi JY, et al. 2019; Impact of enterococcal bacteremia in liver transplant recipients. Transplant Proc. 51:2766–70. DOI: 10.1016/j.transproceed.2019.02.064. PMID: 31493916.

4. Linden PK, Pasculle AW, Manez R, Kramer DJ, Fung JJ, Pinna AD, et al. 1996; Differences in outcomes for patients with bacteremia due to vancomycin-resistant Enterococcus faecium or vancomycin-susceptible E. Clin Infect Dis. 22:663–70. DOI: 10.1093/clinids/22.4.663. PMID: 8729206.

5. Bonten MJ, Willems R, Weinstein RA. 2001; Vancomycin-resistant enterococci: why are they here, and where do they come from? Lancet Infect Dis. 1:314–25. DOI: 10.1016/S1473-3099(01)00145-1. PMID: 11871804.

6. Freitas MC, Pacheco-Silva A, Barbosa D, Silbert S, Sader H, Sesso R, et al. 2006; Prevalence of vancomycin-resistant Enterococcus fecal colonization among kidney transplant patients. BMC Infect Dis. 6:133. DOI: 10.1186/1471-2334-6-133. PMID: 16923193. PMCID: PMC1559694.

7. Zirakzadeh A, Gastineau DA, Mandrekar JN, Burke JP, Johnston PB, Patel R. 2008; Vancomycin-resistant enterococcal colonization appears associated with increased mortality among allogeneic hematopoietic stem cell transplant recipients. Bone Marrow Transplant. 41:385–92. DOI: 10.1038/sj.bmt.1705912. PMID: 18084341.

8. Kang Y, Vicente M, Parsad S, Brielmeier B, Pisano J, Landon E, et al. 2013; Evaluation of risk factors for vancomycin-resistant Enterococcus bacteremia among previously colonized hematopoietic stem cell transplant patients. Transpl Infect Dis. 15:466–73. DOI: 10.1111/tid.12120. PMID: 23911080.

9. Ruck JM, Segev DL. 2018; Expanding deceased donor kidney transplantation: medical risk, infectious risk, hepatitis C virus, and HIV. Curr Opin Nephrol Hypertens. 27:445–53. DOI: 10.1097/MNH.0000000000000456. PMID: 30169460. PMCID: PMC6352990.

10. Arias CA, Murray BE. Bennett JE, Dolin R, Blaser MJ, editors. 2015. Enterococcus species, Streptococcus gallolyticus group, and Leucomonstoc species. Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Saunders;Philadelphia, PA: p. 2328–39.

11. Gupta K, Bhadelia N. 2014; Management of urinary tract infections from multidrug-resistant organisms. Infect Dis Clin North Am. 28:49–59. DOI: 10.1016/j.idc.2013.10.002. PMID: 24484574.

12. Bashir A, Attie O, Sullivan M, Sebra R, Singh KV, Altman D, et al. 2017; Genomic confirmation of vancomycin-resistant Enterococcus transmission from deceased donor to liver transplant recipient. PLoS One. 12:e0170449. DOI: 10.1371/journal.pone.0170449. PMID: 28301471. PMCID: PMC5354240.

13. Nellore A, Huprikar S. AST ID Community of Practice. 2019; Vancomycin-resistant Enterococcus in solid organ transplant recipients: guidelines from the American Society of Transplantation Infectious Diseases Community of Practice. Clin Transplant. 33:e13549. DOI: 10.1111/ctr.13549. PMID: 30913322.