Impact of Pretransplant Antimicrobial Sulfonamide Allergy Label in Kidney Transplant Recipients.

IF 2.6 4区医学 Q3 IMMUNOLOGY

Transplant Infectious Disease Pub Date : 2025-06-04 DOI:10.1111/tid.70063

Harry Ross Powers, Hani M Wadei, Cesar Campos Cuellar, Amogharvasha Venugopal, Vasili Pleqi, Alex Hochwald, Yaohua Ma, Alexei Gonzales

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引用次数: 0

Abstract

Background: Sulfa antibiotic allergy labels (SALs) are encountered frequently in kidney transplant recipients (KTs). This often results in patients receiving second-line prophylaxis for both Pneumocystis jiroveci and urinary tract infections (UTIs). The effect of SAL on outcomes including UTIs after KT is unclear.

Methods: In our single-center retrospective cohort study, we investigated the effect of SALs on bacteriuria after KT. We identified patients with pre-KT SALs from 2011 to 2022. A matched cohort was then created using KT with no pretransplant SALs. The groups were compared using proportional analysis and univariable and multivariable Cox proportional regression models. The primary outcome of interest was the proportion of individuals experiencing one or more episodes of bacteriuria within 1 year posttransplant. Secondary outcomes included bacteremic UTIs, acute kidney injury, and opportunistic infections.

Results: We found that the proportion of individuals experiencing bacteriuria within the first-year posttransplant was significantly greater in the SAL group versus the control group (n = 21, 28% vs. n = 22, 14.7%, p = 0.012). This result was also seen in univariable and multivariable survival analysis. In addition, episodes of UTI with associated bacteremia (n = 11, 14.7% vs. n = 5, 3.3%, p = 0.002) were statistically significantly higher in the SAL group.

Conclusion: There was a significantly greater number of episodes of bacteriuria in the first-year posttransplant in subjects with pretransplant SAL. Based on our findings, we suggest that all KTs with pretransplant SALs undergo evaluation and intervention prior to transplantation.

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移植前抗菌磺胺过敏标签对肾移植受者的影响。

背景：磺胺类抗生素过敏标签（SALs）在肾移植受者（KTs）中经常遇到。这通常导致患者接受二线预防的肺囊虫和尿路感染（uti）。SAL对包括KT后尿路感染在内的预后的影响尚不清楚。方法：在我们的单中心回顾性队列研究中，我们调查了SALs对KT后细菌的影响。我们从2011年到2022年确定了kt前SALs患者。然后使用没有移植前SALs的KT创建匹配的队列。采用比例分析、单变量和多变量Cox比例回归模型对各组进行比较。研究的主要结局是移植后1年内出现一次或多次细菌尿的个体比例。次要结局包括细菌性尿路感染、急性肾损伤和机会性感染。结果：我们发现，移植后一年内出现细菌尿的个体比例在SAL组显著高于对照组（n = 21,28% vs. n = 22,14.7%, p = 0.012）。在单变量和多变量生存分析中也可以看到这一结果。此外，尿路感染合并菌血症的发生率（n = 11, 14.7% vs. n = 5, 3.3%, p = 0.002）在SAL组中有统计学意义。结论：移植前SAL患者在移植后一年内发生细菌尿的次数显著增加。根据我们的研究结果，我们建议所有移植前SALs的患者在移植前接受评估和干预。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Transplant Infectious Disease 医学-传染病学

CiteScore

5.30

自引率

7.70%

发文量

210

审稿时长

4-8 weeks

期刊介绍： Transplant Infectious Disease has been established as a forum for presenting the most current information on the prevention and treatment of infection complicating organ and bone marrow transplantation. The point of view of the journal is that infection and allograft rejection (or graft-versus-host disease) are closely intertwined, and that advances in one area will have immediate consequences on the other. The interaction of the transplant recipient with potential microbial invaders, the impact of immunosuppressive strategies on this interaction, and the effects of cytokines, growth factors, and chemokines liberated during the course of infections, rejection, or graft-versus-host disease are central to the interests and mission of this journal. Transplant Infectious Disease is aimed at disseminating the latest information relevant to the infectious disease complications of transplantation to clinicians and scientists involved in bone marrow, kidney, liver, heart, lung, intestinal, and pancreatic transplantation. The infectious disease consequences and concerns regarding innovative transplant strategies, from novel immunosuppressive agents to xenotransplantation, are very much a concern of this journal. In addition, this journal feels a particular responsibility to inform primary care practitioners in the community, who increasingly are sharing the responsibility for the care of these patients, of the special considerations regarding the prevention and treatment of infection in transplant recipients. As exemplified by the international editorial board, articles are sought throughout the world that address both general issues and those of a more restricted geographic import.