Wild rodents and insectivores as carriers of pathogenic Leptospira and Toxoplasma gondii in The Netherlands.

Small mammals such as rodents can to carry zoonotic pathogens. Currently, there is impaired knowledge on zoonotic pathogens in rodents and insectivores in the Netherlands. This limits opportunities for preventive measures and complicates risk-assessments for zoonotic transmission to humans. Leptospira spp. and Toxoplasma gondii are present on a list of prioritized emerging pathogens in the Netherlands and were therefore the focus of this study. Both pathogens have the ability to survive under moist environmental conditions. In total, a group of 379 small mammals (rodents & insectivores) were tested on pathogenic Leptospira spp., and 312 on T. gondii. Rodents and insectivores were trapped at various sites, but mostly on pig and dairy farms throughout the country. Over five percent of the animals (5.3%, n = 379) tested positive for Leptospira DNA, and five of the animals (1.6%, n = 312) tested were positive for T. gondii DNA. The animals positive for T.gondii were all brown rats and the ones for Leptospira spp. were various species. Our results show that insectivores and rodents might be used as an indicator for the environmental contamination and/or the contamination in wildlife for Leptospira spp.

Successful transplantation of single kidneys from pediatric donors weighing less than or equal to 10 kg into standard weight adult recipients.

BACKGROUND: The outcomes of single kidneys transplanted from pediatric donors into standard adult recipients (>60 kg) are unknown. Furthermore, the outcomes of single kidneys transplanted from pediatric donors less than or equal to 10 kg are also unknown. METHODS: We retrospectively compared 27 recipients of single kidneys from pediatric donors younger than or equal to 5 years with 69 recipients of adult cadaveric kidneys. RESULTS: The mean pediatric kidney recipient weight was 69 kg. Two-year patient and graft survival in pediatric kidney recipients was 100% and 92.5% respectively, compared with 98.5% and 89.8% in adult kidney recipients (P=NS). Mean time (days) to achieve creatinine less than 3 mg/dL was 14+/-9 compared with 14+/-20 in adult kidney recipients (P=NS). Estimated glomerular filtration rate at discharge, 6, 12, 18, and 24 months was equivalent in both cohorts. Stratifying pediatric kidney recipients by donor weight, there were no differences in acute rejection or graft loss in recipients of kidney from donors less than or equal to 10 kg (n=11; mean weight=8.85 kg), but there was a higher incidence of delayed graft function (7 of 11 vs. 1 of 16; P=0.002). Estimated glomerular filtration rate at discharge, 6, 12, 18, and 24 months was equivalent in both cohorts. CONCLUSIONS: Single pediatric kidneys from donors younger than or equal to 5 years can be transplanted into standard adult recipients without compromising outcomes. Transplanting single kidneys from pediatric donors less than or equal to 10 kg into standard adult recipients is associated with an increased risk of delayed graft function; however, this does not compromise 2-year graft survival or function.