Surgical site infections in the early posttransplant period after simultaneous pancreas-kidney transplantation.

OBJECTIVE: This study evaluated the frequency of microbial isolates and their susceptibility profiles among cultures from the "surgical site" of 26 simultaneous pancreas-kidney (SPKT) recipients in the early posttransplant period. PATIENTS AND METHODS: Data on microbiologic cultures of 26 adult patients undergoing SPKT were collected prospectively from 2001 to the end of 2006. The isolation and identification of cultured micro-organisms was performed according to standard microbiological procedures and commercially available tests. Susceptibility of the strains to antibacterial agents was made by the Clinical and Laboratory Standards Institute (CLSI) guidelines. RESULTS: All patients were followed prospectively for the first 4 weeks after surgery yielding 168 microbial isolates from the surgical site. The most commonly isolated organisms were Gram-positive bacteria (65.5%) with domination of staphylococci (52.7%) as methicillin-resistant S aureus and methicillin-resistant coagulase-negative staphylococci. The second most common were enterococci (33.6%) with the presence of an high level aminoglycoside-resistant strains (64.9%) and vancomycin-resistant strains (2.7%). Gram-negative bacteria comprised 19% of positive cultures; among them were isolated extended spectrum beta-lactamase producers and carbapenem-resistant strains. Yeast-like fungi comprised 15.5% of positive cultures. In conclusion, we observed predominantly Gram-positive bacteria, comprising 65.5% of isolates. The increased proportion of multi-drug-resistant bacterial isolates may be due to the frequent prophylaxis of bacterial infections in patients.

Urinary tract infections in the early posttransplant period after simultaneous pancreas-kidney transplantation.

OBJECTIVE: Urinary tract infection (UTI) is among the common infection in simultaneous pancreas-kidney transplantation (SPKT). PATIENTS AND METHODS: The study included 26 adult patients undergoing SPKT between September 2001 and December 2006. All the patients were followed prospectively for UTI during the first 4 weeks after surgery. Urine samples were investigated for bacteriologic cultures. The micro-organisms were identified in accordance with standard bacteriologic procedures. Susceptibility testing was carried out using Clinical and Laboratory Standards Institute (CLSI) procedures. RESULTS: Among 77 urine specimens obtained from all recipients during the first month, there were 30 isolated bacterial strains. The most common were Gram-positive bacteria (53.3%) with predominance of enterococci (75%) associated with high levels of aminoglycoside resistant strains (HLAR; 58.3%) and vancomycin-resistant strains (VRE; 25%). Gram-negative bacteria were detected in 46.7% of positive cultures. CONCLUSIONS: In our study, enterococci predominated as 75% of Gram-positive isolates. The increased proportion of multi-drug-resistant bacteria, which can caused severe UTI in patients after SPKT, may be due to the frequent use of prophylaxis of bacterial infections in patients.

Etiologic agents of bacteremia in the early period after simultaneous pancreas-kidney transplantation.

BACKGROUND: Bacteremia is among the known complications in simultaneous pancreas-kidney transplantation (SPKT). This study evaluated the frequency of microbial isolates and their susceptibility profiles among cultures of clinical samples obtained from blood and from the tips of blood vessel catheters of 26 SPKT recipients suspected of bacteremia in the early posttransplant period. PATIENTS AND METHODS: Data on microbiologic blood cultures of 26 adult patients undergoing SPKT were collected prospectively from 2001 to the end of 2006. The isolation and identification of cultured microorganisms were performed according to standard microbiological procedures and commercially available tests. The susceptibility of the strains to antibacterial agents was established by the Clinical and Laboratory Standards Institute guidelines. RESULTS: All patients were followed prospectively for the first 4 weeks after surgery. Among 66 clinical samples, there were 23 microbial isolates from blood samples of 17 recipients and catheter tips of 12 recipients. The most common isolates were Gram-positive bacteria (73.9%) with domination of staphylococci (64.7%) and MRCNS strains (81.8%). Gram-negative bacteria comprised 17.4% of positive cultures, whereas yeast-like fungi, 8.7% with a predominance of Candida glabrata. CONCLUSION: Our study showed predominately Gram-positive bacteria in 73.9% of isolates. The increased proportion of multi-drug-resistant bacteria and fungi to antimicrobial agents may be due to the frequent use of these agents for prophylaxis of bacterial infections in patients.

Comparison of Delmée and Polish serogroup-specific Clostridium difficile strains.

In this study we compared Delmée and Polish serogroup-specific Clostridium difficile strains by slide agglutination, observation of flagella and SDS-PAGE protein patterns. Among Delmée serogroup specific strains we observed flagella in groups A, D and K. Among Polish serogroup-specific Clostridium difficile strains we did not observe flagella. The Polish serogroup-specific strains gave different protein patterns compared to Delmée strains. SDS-PAGE protein pattern analyses of Polish serogroup-specific strains divide these strains into 3 groups: 71, 88 and third embracing 18, 27, 70, 72, and 89.

[Occurrence of Clostridium difficile in the digestive system of dogs]. / Wystepowanie Clostridium difficile w przewodzie pokarmowym psów.

This study was aimed at seeking strains of Clostridium difficile in feces and investigation of influence of antibiotics application on frequency of isolation and detection of toxing in vivo produced by this microorganism. Samples of feces were obtained from experimental dogs consisting of two groups. To groups I belonged 150 healthy dogs. Group II consisted of samples of feces received from four dogs before and after application of various antibiotics. Clostridium difficile was not isolated from group I dogs. From dogs belonging to group II, 28 strains were isolated. Production of toxing and classification to serological groups of the isolated strains were performed. Presence of this microorganism in feces of dogs is evident only after multiple application of antibiotics. Results of these studies suggest that dogs may constitute a reservoir of Clostridium difficile.

Preparation of antibacterial and antitoxic Clostridium difficile sera.

Preparation of Clostridium difficile antibacterial and antitoxic sera is presented. Fifty one strains (72%) were typeable within Delmee scheme. Twenty strains (28%) belonged to new Polish serogroups designated 18, 27, 70, 71, 72, 88, 89 and NICH. Supernatants of all toxigenic Clostridium difficile strains were neutralized by gamma-globulin fraction of goat Clostridium difficile antitoxin in neutralization assay when it was performed on McCoy cell line. Only 8 toxigenic strains (21%) were positive in counterimmunoelectrophoresis.