One in 10 solid organ transplant recipients develops bacteremia 1 year after transplant
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Key takeaways:
- Nearly 10% of solid organ transplant recipients may develop bacteremia during the first year after transplant.
- Risk factors include age, diabetes, surgical complications, rejection and fungal infections.
Nearly 10% of solid organ transplant recipients may develop bacteremia in the first year after transplant, according to a study published in Open Forum Infectious Diseases.
“There are limited contemporary robust data on the epidemiology of bacteremia during the first fragile year after a solid organ transplantation,” Dionysios Neofytos, MD, specialist in the division of infectious diseases at the University Hospital of Geneva, told Healio.
“Those data are important to inform clinicians caring for those patients, including primary care physicians and internists who may care for transplant recipients after the first couple of months post-transplant. In addition, those data are important to inform diagnostic and prophylactic strategies at transplant centers,” Neofytos said.
Using the Swiss Transplant Cohort Study registry, Neofytos and colleagues conducted a retrospective nested multicenter cohort study to determine the incidence and timing of bacteremia during the first year after transplant overall and by type of transplant among solid organ transplant recipients.
According to the study, all adult solid organ transplant recipients who received a heart, liver, lung, kidney or kidney-pancreas transplant between Jan. 5, 2008, and Dec. 31, 2019, with at least 12 months of follow-up were included.
Of 4,383 recipients included in the analysis, 415 (9.5%) with 557 bacteremia due to 627 pathogens were identified, although the researchers found that bacteremia incidence decreased during the study period (HR = 0.66; P < .001).
The 1-year incidence for all health, liver, lung, kidney and kidney-pancreas solid organ transplant recipients was 9.5%, 12.8%, 11.4%, 9.8%, 8.3% and 5.9%, respectively (P = .003). They also found that the 1-year incidence due to gram-negative bacilli was 5.62%, gram-positive cocci was 2.81% and gram-positive bacilli was 0.23%.
Additionally, they recorded seven S. aureus isolates that were methicillin resistant, two enterococci that were vancomycin resistant and 32 gram-negative bacilli that produced extended-spectrum beta-lactamases.
The researchers determined that risk factors for bacteremia within 1 year of solid organ transplant also included age (HR = 1.19; P < .001); diabetes (HR = 1.82; P = .02); cardiopulmonary diseases (HR = 1.38; P = .005); surgical (HR = 3.13; P < .001) and medical (HR = 2.32; P = .001) post-transplant complications; rejection (HR = 2.24; P < .001); and fungal infections (HR = 3.55; P < .002).
Predictors for bacteremia during the first 30-days after transplant included surgical post-transplant complications (HR = 2.45; P < .001) and rejection, (HR = 2.76; P < .001), as well as having a deceased donor or liver or lung transplantation.
“Bacteremias are becoming less frequent complications post-transplant with excellent survival rates, underscoring the progress made in this field of medicine,” Neofytos said. “Of course, continuous efforts and vigilance are required to further decrease the incidence of bacteremia and maintain and further optimize clinical outcomes.
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