Novel intervention based on an individualized bundle of care to decrease infection in kidney transplant recipients.

Area of Science:

• Nephrology
• Transplantation Immunology
• Infectious Diseases

Background:

• Infection is a significant complication following kidney transplantation (KT).
• Evidence-based practice bundles are a recognized strategy to improve clinical outcomes.
• This study investigated a personalized bundle to decrease infection incidence in the first year after KT.

Purpose of the Study:

• To evaluate the effectiveness of a personalized infection prevention bundle in kidney transplant recipients.
• To assess the impact of the bundle on compliance with preventive measures.
• To determine the effect on infection rates, hospitalizations, and severe infections within 12 months post-KT.

Main Methods:

• A prospective, single-center cohort study compared 148 patients receiving an individualized infection prevention strategy with a preintervention cohort of 159 patients.
• The intervention bundle included immunization review, infection risk assessment, latent tuberculosis infection (LTBI) screening, antimicrobial prophylaxis, and immunological assessment.
• Individualized recommendations were provided at a 30-day post-transplant visit.

Main Results:

• The intervention group demonstrated higher compliance with vaccinations, LTBI screening, and supplementation (p <.001).
• A lower 1-year incidence of infection (42.6% vs. 57.9%, p=.037) and infection-related hospitalization (17.6% vs. 32.1%, p=.003) was observed in the intervention cohort.
• The incidence of severe bacterial infection was also reduced; no differences in graft rejection or mortality were noted.

Conclusions:

• A multifaceted intervention, incorporating a bundle of evidence-based practices, improved adherence to preventive measures.
• This personalized approach was associated with a reduced incidence of infection within 12 months after kidney transplantation.