Antibiotic-resistant bacterial colonization increases the number of hospitalizations in patients after solid organ transplantation or with non-communicable diseases.

BACKGROUND: Healthcare-associated infections could affect the rate of morbidity, mortality and post-discharge hospitalization among patients. They are also dangerous to healthcare professionals and generate significant cost to the healthcare system. OBJECTIVES: The aim of this study was to evaluate the occurrence rate of colonization with various antibiotic-resistant (AR) bacteria among patients admitted to the Department of Immunology, Transplantology and Internal Diseases. MATERIAL AND METHODS: The study used retrospective analysis of patients (n = 280) with no clinical signs of infection admitted into the department between November 2015 and May 2017. The observational period lasted until January 2019. Collected data included sex, age at admission, location directly prior to current hospitalization, and medical history. Nasal and rectal swabs were collected, and stool and urine samples were obtained on the day of admission. Specimens were cultured according to standard microbiological procedures. In all cases, the appropriate bioMerieux (Marcy-l'Étoile, France) media were used. Isolates were identified using mass spectrometer (Vitek MS; bioMerieux). RESULTS: One-hundred ninety-one (68.2%) of patients were colonized with AR bacteria. The incidence of colonization was not influenced by age or sex. The risk of colonization was associated with admission from another hospital and history of kidney transplantation (p = 0.0136 and p < 0.001, respectively). The number of hospitalizations during the whole observational period was higher in the group of colonized patients compared to non-colonized (2.76 ±2.4 vs 2.07 ±1.68, p = 0.0099). The number of hospitalizations correlated positively with the number of positive cultures obtained from the same patients (rho = 0.18, p = 0.0274). CONCLUSIONS: The rate of colonization at admission to the ward could be high, depending on previous hospitalization and medical history. Colonization significantly increased post-discharge hospitalization rate.

Nonsteroidal Anti-Inflammatory Drugs and Analgesics Use by Kidney Transplant Recipients.

BACKGROUND Nonsteroidal anti-inflammatory drugs (NSAIDs) and analgesics are the most commonly used drugs and are increasingly available over-the-counter (OTC). In certain groups of patients, including kidney transplant recipients, their use may be complicated by adverse effects or drug interactions. The aim of our study was to assess the causes and frequency of OTC NSAIDs or analgesics use, as well as the awareness of related side effects. MATERIAL AND METHODS We enrolled 94 randomly selected kidney transplant recipients, who represented 5% of all kidney transplant recipients at our center. An anonymous survey consisting of 23 multiple-choice questions was administered voluntarily and anonymously. RESULTS In all, 63% of study patients confirmed taking the OTC painkillers; 22% of these patients took these drugs at least several times a week, and 4% took these drugs daily. For 38% of the study kidney transplant recipients, NSAIDs or analgesics were reported to be the only way to manage their pain. In addition, 30% of study patients were unaware of the risks associated with these drugs, despite the fact that 89% of the study patients consider physicians the best source of information. CONCLUSIONS Our study found that 63% of kidney transplant recipients regularly took OTC painkillers and 30% were unaware of the potential adverse effects. This necessitates continuous, ongoing education of kidney transplant recipients about the risks of OTC NSAIDs or analgesics use.