COMPLICATIONS - INFECTIONS

L.A. Hernandez¹, A. Arminio², E. Bellorin^2
1Servicio De Nefrología Y Transplante, Hospital Universiatrio de Caracas, Caracas/VENEZUELA, ²Servicio De Nefrologia Y Transplante, Hospital Universitario de Caracas, Caracas/VENEZUELA

Body: Introduction: Kidney transplantation has become a well-established, highly successful therapy for end-stage renal disease and is more widely accessible now than in previous decades. The risk of any infection is much greater in the immunosuppressed transplant population than in general population. Although the current infection-related one-year morbility has been reduced, infectious complications remain serious threats to successful outcomes following transplantation. In this report we describe our clinical experience regarding with five specific kidney-recipients-transplant-patients cases that were infected with vancomicin resistant Staphylococcus aureus and their successful treatment with daptomycin (CUBICIN®). Patients and Method: Patients with kidney tranplantation with Immunosuppressive regimens consisting of cyclosporine or tacrolimus, prednisona, mycophenolate mofetil or enteric-coated mycophenolate sodium; due to occasionally and particular toxicity associated to tacrolimus or cyclosporine, everolimus were incorporated as immunosupressive complement therapy. In five characteristic cases different located abscesses were observed and identified to be associated with a S. aureus infection. Results: Once the associated bacterium was identified different antibacterial treatment were applied, including vancomycin, imipenem, ciprofloxacin and clindamycin, with no apparent results or recurrent recidivism. It was only after the introduction of daptomycin (CUBICIN®) for a period of 7 to 21 days that a free recovery and no recidivism after 8 months were obtained. Conclusions: Infectious complications are important cause of morbidity and mortality in the post-transplant period. Strategies to reduce the infectious complications and adequate antibiotic therapy in solid organs transplant recipients are necessary for the successful kidney transplantation outcome. The successful treatment with daptomycin (CUBICIN®) of gram positive bacteria associated infections, raises as an alternative for antibiotic therapy in solid organ transplant recipients.

Disclosure: All authors have declared no conflicts of interest.