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Early bacteremia after solid organ transplantation.

L Linares¹, J F García-Goez, C Cervera

¹Service of Infectious Diseases, Hospital Clínic, Barcelona-IDIBAPS-University of Barcelona, Barcelona, Spain.

Transplantation Proceedings

|September 1, 2009

Summary

This summary is machine-generated.

Early bloodstream infections (BSI) are common after solid organ transplantation, particularly in liver recipients. While gram-negative bacteria are frequent, mortality remains low, with urinary tract and catheter sources being most common.

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Area of Science:

Transplantation Medicine
Infectious Diseases
Critical Care

Background:

Bloodstream infections (BSI) represent a significant cause of morbidity and mortality in solid organ transplant recipients.
Understanding the epidemiology of early BSI is crucial for optimizing patient management and outcomes post-transplantation.

Purpose of the Study:

To analyze the incidence, causative agents, and sources of early bloodstream infections (BSI) following solid organ transplantation.
To identify specific transplant types with higher risks for early BSI and characterize the antimicrobial resistance patterns observed.

Main Methods:

A prospective cohort study was conducted from 2003-2007, including patients undergoing kidney, simultaneous kidney-pancreas (SPK), or orthotopic liver transplantation (OLT).
Data collected included demographics, comorbidities, transplant procedures, and post-transplant complications. Early BSI were defined as infections within 30 days post-transplantation and confirmed by CDC criteria.

Main Results:

A total of 902 transplantations were performed, with 70 episodes of early BSI diagnosed in 67 patients (7.4%).
Incidence varied by transplant type: 4.8% for renal, 4.5% for SPK, and 12% for OLT (P < .001).
Gram-negative bacteria, notably multidrug-resistant Pseudomonas aeruginosa and extended-spectrum beta-lactamase-producing Escherichia coli, were prevalent. Urinary tract and catheter were the most common infection sources. Mortality was low (3%) and unrelated to BSI.

Conclusions:

Early BSI incidence is high in solid organ transplant recipients, especially OLT patients, but associated mortality is low.
Urinary tract and catheter-associated infections are frequent sources of early BSI.
A significant proportion of gram-negative BSIs exhibit multidrug resistance, highlighting the need for vigilant antimicrobial stewardship.