Incisional surgical site infection in kidney transplantation

Incisional surgical site infections are common bacterial infections in kidney transplantation. The purpose of this study was to determine the incidence, timing, etiology, and risk factors for incisional surgical site infections.

We performed a prospective study that included a population of 1400 consecutive patients (58.4% males) who underwent kidney transplantation in Spanish hospitals pertaining to the RESITRA research network.

A total of 55 patients developed 63 episodes of incisional surgical site infections. Median time from transplant to incisional surgical site infections was 20 days (range, 2 to 76 days). All infected patients recovered from incisional surgical site infections. The most frequently isolated pathogens were Escherichia coli (31.7%), Pseudomonas aeruginosa (13.3%), Enterococcus faecalis (11.6%), Enterobacter spp. (10%), and coagulase-negative staphylococci (8.3%). Diabetic patients had an increased risk of incisional surgical site infections (7.5%, P = 0.013). We used several different regimens of antimicrobial prophylaxis. None were found to be associated with an increased risk of incisional surgical site infections. The use of sirolimus was associated with an increased risk of incisional surgical site infections (7.4%, P = 0.018).

Diabetic patients, and those who received sirolimus-based immunosuppressive regimens, showed an increased risk of developing incisional surgical site infections after kidney transplantation.