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Bacteremia after renal transplantation.

H E Nielsen, B Korsager

    Scandinavian Journal of Infectious Diseases
    |January 1, 1977
    PubMed
    Summary

    Bacteremia after kidney transplants is common, especially from urinary tract infections in the first 6 months, leading to a high death rate. Gram-negative bacteria were the most frequent cause.

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    Area of Science:

    • Nephrology
    • Infectious Diseases
    • Transplantation Immunology

    Background:

    • Renal allotransplantation is a critical treatment for end-stage renal disease.
    • Post-transplant infections, particularly bacteremia, pose a significant threat to patient survival.
    • Understanding bacteremia patterns is crucial for improving outcomes in kidney transplant recipients.

    Purpose of the Study:

    • To investigate the incidence, timing, and causes of bacteremia in renal allotransplant recipients.
    • To identify predisposing factors and common pathogens associated with post-transplant bacteremia.
    • To determine the mortality rate associated with bacteremic episodes in this patient population.

    Main Methods:

    • Retrospective analysis of 291 patients who underwent renal allotransplantation between 1964 and 1974.
    • Detailed review of medical records to identify bacteremic episodes within the first six months post-transplant.
    • Analysis of causative pathogens, sources of infection, and associated predisposing factors.

    Main Results:

    • 121 bacteremic episodes occurred in 94 patients within six months post-transplantation.
    • The overall mortality rate for bacteremic episodes was 38%.
    • Urinary tract infections accounted for 65% of bacteremia, with gram-negative rods (e.g., Escherichia coli, Klebsiella, Proteus) being the most common pathogens. Ureteral complications, leucopenia, and immunosuppression were significant predisposing factors.

    Conclusions:

    • Bacteremia is a serious complication following renal allotransplantation, predominantly occurring within the first 2-3 months.
    • Urinary tract infections are the primary source of bacteremia, driven by gram-negative bacteria.
    • Identifying and managing predisposing factors is essential to reduce the high mortality associated with post-transplant bacteremia.

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