Bacteremia During the First Year After Solid Organ Transplantation: An Epidemiological Update.
Details
State: Public
Version: Final published version
License: CC BY-NC-ND 4.0
Serval ID
serval:BIB_93C3850C4E55
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Bacteremia During the First Year After Solid Organ Transplantation: An Epidemiological Update.
Journal
Open forum infectious diseases
Working group(s)
Swiss Transplant Cohort Study
Contributor(s)
Amico P., Aubert J.D., Banz V., Beckmann S., Beldi G., Berger C., Berishvili E., Berzigotti A., Binet I., Bochud P.Y., Branca S., Bucher H., Carrel T., Catana E., Cairoli A., Chalandon Y., De Geest S., De Seigneux S., Dickenmann M., Dreifuss J.L., Duchosal M., Fehr T., Ferrari-Lacraz S., Frossard J., Garzoni C., Golshayan D., Goossens N., Haidar F., Halter J., Heim D., Hess C., Hillinger S., Hirsch H., Hirt P., Hofbauer G., Hoessly L., Huynh-Do U., Immer F., Koller M., Laesser B., Lamoth F., Lehmann R., Leichtle A., Manuel O., Marti H.P., Martinelli M., McLin V., Mellac K., Merçay A., Mettler K., Müller N., Müller-Arndt U., Müllhaupt B., Nägeli M., Oldani G., Pascual M., Passweg J., Pazeller R., Posfay-Barbe K., Rick J., Rosselet A., Rossi S., Rothlin S., Ruschitzka F., Schachtner T., Schaub S., Scherrer A., Schneidawind D., Schnyder A., Schuurmans M., Schwab S., Sengstag T., Simonetta F., Steiger J., Stirnimann G., Stürzinger U., Van Delden C., Venetz J.P., Villard J., Vionnet J., Wick M., Wilhelm M., Yerly P.
ISSN
2328-8957 (Print)
ISSN-L
2328-8957
Publication state
Published
Issued date
06/2023
Peer-reviewed
Oui
Volume
10
Number
6
Pages
ofad247
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Publication Status: epublish
Abstract
There are limited contemporary data on the epidemiology and outcomes of bacteremia in solid organ transplant recipients (SOTr).
Using the Swiss Transplant Cohort Study registry from 2008 to 2019, we performed a retrospective nested multicenter cohort study to describe the epidemiology of bacteremia in SOTr during the first year post-transplant.
Of 4383 patients, 415 (9.5%) with 557 cases of bacteremia due to 627 pathogens were identified. One-year incidence was 9.5%, 12.8%, 11.4%, 9.8%, 8.3%, and 5.9% for all, heart, liver, lung, kidney, and kidney-pancreas SOTr, respectively (P = .003). Incidence decreased during the study period (hazard ratio, 0.66; P < .001). One-year incidence due to gram-negative bacilli (GNB), gram-positive cocci (GPC), and gram-positive bacilli (GPB) was 5.62%, 2.81%, and 0.23%, respectively. Seven (of 28, 25%) Staphylococcus aureus isolates were methicillin-resistant, 2/67 (3%) enterococci were vancomycin-resistant, and 32/250 (12.8%) GNB produced extended-spectrum beta-lactamases. Risk factors for bacteremia within 1 year post-transplant included age, diabetes, cardiopulmonary diseases, surgical/medical post-transplant complications, rejection, and fungal infections. Predictors for bacteremia during the first 30 days post-transplant included surgical post-transplant complications, rejection, deceased donor, and liver and lung transplantation. Transplantation in 2014-2019, CMV donor-negative/recipient-negative serology, and cotrimoxazole Pneumocystis prophylaxis were protective against bacteremia. Thirty-day mortality in SOTr with bacteremia was 3% and did not differ by SOT type.
Almost 1/10 SOTr may develop bacteremia during the first year post-transplant associated with low mortality. Lower bacteremia rates have been observed since 2014 and in patients receiving cotrimoxazole prophylaxis. Variabilities in incidence, timing, and pathogen of bacteremia across different SOT types may be used to tailor prophylactic and clinical approaches.
Using the Swiss Transplant Cohort Study registry from 2008 to 2019, we performed a retrospective nested multicenter cohort study to describe the epidemiology of bacteremia in SOTr during the first year post-transplant.
Of 4383 patients, 415 (9.5%) with 557 cases of bacteremia due to 627 pathogens were identified. One-year incidence was 9.5%, 12.8%, 11.4%, 9.8%, 8.3%, and 5.9% for all, heart, liver, lung, kidney, and kidney-pancreas SOTr, respectively (P = .003). Incidence decreased during the study period (hazard ratio, 0.66; P < .001). One-year incidence due to gram-negative bacilli (GNB), gram-positive cocci (GPC), and gram-positive bacilli (GPB) was 5.62%, 2.81%, and 0.23%, respectively. Seven (of 28, 25%) Staphylococcus aureus isolates were methicillin-resistant, 2/67 (3%) enterococci were vancomycin-resistant, and 32/250 (12.8%) GNB produced extended-spectrum beta-lactamases. Risk factors for bacteremia within 1 year post-transplant included age, diabetes, cardiopulmonary diseases, surgical/medical post-transplant complications, rejection, and fungal infections. Predictors for bacteremia during the first 30 days post-transplant included surgical post-transplant complications, rejection, deceased donor, and liver and lung transplantation. Transplantation in 2014-2019, CMV donor-negative/recipient-negative serology, and cotrimoxazole Pneumocystis prophylaxis were protective against bacteremia. Thirty-day mortality in SOTr with bacteremia was 3% and did not differ by SOT type.
Almost 1/10 SOTr may develop bacteremia during the first year post-transplant associated with low mortality. Lower bacteremia rates have been observed since 2014 and in patients receiving cotrimoxazole prophylaxis. Variabilities in incidence, timing, and pathogen of bacteremia across different SOT types may be used to tailor prophylactic and clinical approaches.
Keywords
bacteremia, bloodstream infection, clinical outcomes, epidemiology, risk factors, solid organ transplant, timing
Pubmed
Web of science
Open Access
Yes
Create date
23/06/2023 9:45
Last modification date
01/03/2024 9:06
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