Risk of Staphylococcus aureus Bacteremia Before and After Solid Organ Transplantation

Area of Science:

• Infectious Diseases
• Transplant Medicine
• Public Health

Background:

• Solid organ transplant recipients (SOTR) have elevated risks for Staphylococcus aureus bacteremia (SAB).
• Understanding SAB risk dynamics before and after transplantation is crucial for patient management.
• Limited research exists on SAB incidence across different phases of the transplant journey.

Purpose of the Study:

• To investigate the temporal trends and risk factors associated with Staphylococcus aureus bacteremia in solid organ transplant recipients.
• To compare SAB hospitalization rates in the pre-transplant and post-transplant periods.
• To identify variations in SAB risk based on transplanted organ type.

Main Methods:

• A population-based, retrospective, self-controlled study design.
• Utilized the State Inpatient Database from 10 US states (2004-2018).
• Longitudinal tracking of adult and pediatric SOTR for one year pre- and post-transplant, excluding immediate peritransplant periods.

Main Results:

• SAB hospitalization occurred in 0.77% pre-transplant and 0.32% post-transplant (P < 0.001).
• SAB odds increased closer to transplantation (7-12 months to 1-6 months pre-transplant) and decreased significantly post-transplant (7-12 months post-transplant).
• Post-transplant risk reduction was linked to central line-associated bloodstream infections and endocarditis in kidney and heart recipients; liver transplant showed no change, while lung transplant showed increased risk.

Conclusions:

• Immunosuppression and post-transplant organ support reversal may influence SAB risk in SOTR.
• Findings suggest distinct SAB risk profiles pre- and post-transplant, influenced by organ type.
• Results inform targeted infection prevention strategies and future research for S. aureus in transplant populations.