Supplementary Material for: Carbapenem-resistant Enterobacteriaceae colonization or infection were not associated with post liver transplant graft failure: an observational cohort

Introduction
Carbapenem-resistant Enterobacteriaceae (CRE) epidemiology among liver transplant (LT) recipients is variable. We studied CRE colonization and infection impact on LT recipients’ outcomes.

Methods
Observational cohort study including consecutive adult LT recipients between January 2019 and December 2020 at Curry Cabral Hospital, Lisbon, Portugal. Primary exposures were CRE colonization (rectal swabs under screening program) and infection within one year of index LT. Primary endpoint was graft failure within one year of the index LT.

Results
Among 209 patients, median (IQR) age was 57 (47-64) years and 155 (74.2%) were males. CRE colonization was identified in 28 (13.4%) patients during the first year post transplant (median (IQR) number of rectal swabs per patient of 4 (2-7)). CRE resistance genes identified were: OXA48 in 8 (3.6%), KPC in 19 (67.9%), and VIM in 1 (3.6%) patients. Any and CRE infections were diagnosed in 88 (42.1%) and 6 (2.9%) patients, respectively, during the first year post transplant. After adjusting for confounders, neither CRE colonization (aOR (95%CI)=1.83 (0.71-4.70);P=0.21) nor infection (aOR (95%CI)=1.35 (0.17-11.06);P=0.78) were associated with graft failure within one year of index LT.

Discussion/Conclusion
Under a screening program, CRE colonization and infection prevalence was low and neither was associated with graft failure.