Early Onset Bacteremia in Kidney Transplant Recipients in the Current Era.

IF 2.5 4区医学 Q3 IMMUNOLOGY

Transplant Infectious Disease Pub Date : 2026-09-01 Epub Date: 2026-07-16 DOI:10.1111/tid.70278

Lana Hasan, Nabin K Shrestha, Mathew Duck, Joshua Augustine, Richard Fatica, Alvin Wee, Christine E Koval

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引用次数: 0

Abstract

Background: Bloodstream infection (BSI) after kidney transplantation increases the risk of graft loss and mortality. We aimed to identify contemporary risk factors and outcomes of early BSI (eBSI) at our transplant center.

Methods: We conducted a retrospective chart review of adult kidney transplant recipients (KTRs) from 2019 to 2023. Those with the eBSI (within 90 days of KTR) were matched by age and gender to controls. Risk factors were identified using multivariable logistic regression. All KTRs surviving to 90 days, were included in graft and patient survival analysis.

Results: Among 1408 KTRs, 75 (5.3%) developed eBSI, at a median of 21 days (IQR: 12-42.5). On multivariable analysis, each doubling of hospital duration was independently associated with a 49% increase in the risk of eBSI (OR: 1.49, 95% CI: 1.19-1.91; p < 0.001), and each doubling of postsurgical drain retention duration was independently associated with a 68% increase in the risk of eBSI (OR: 1.68, 95% CI: 1.17-2.48; p 0.006). eBSI was associated with 1-year mortality (aHR: 3.32, 95% CI: 1.51-7.28; p 0.003) and 3-year graft failure (aHR: 2.78, 95% CI: 1.31-5.93; p 0.008).

Conclusion: eBSI was associated with graft failure and mortality. The donor and recipient factors identified highlight the need for further studies to better characterize their impact on eBSI.

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当代肾移植受者的早发菌血症。

背景：肾移植后血流感染（BSI）增加移植物丢失和死亡的风险。我们的目的是确定移植中心早期BSI （eBSI）的当代危险因素和结果。方法：我们对2019年至2023年成人肾移植受者（KTRs）进行回顾性图表回顾。eBSI患者（KTR后90天内）按年龄和性别与对照组相匹配。使用多变量逻辑回归确定危险因素。所有存活至90天的KTRs均纳入移植物和患者生存分析。结果：在1408例ktr中，75例（5.3%）发生eBSI，中位时间为21天（IQR: 12-42.5）。在多变量分析中，住院时间每延长一倍与eBSI风险增加49%独立相关（OR: 1.49, 95% CI: 1.19-1.91; p < 0.001），术后引流液潴留时间每延长一倍与eBSI风险增加68%独立相关（OR: 1.68, 95% CI: 1.17-2.48; p 0.006）。eBSI与1年死亡率（aHR: 3.32, 95% CI: 1.51-7.28; p 0.003）和3年移植物衰竭（aHR: 2.78, 95% CI: 1.31-5.93; p 0.008）相关。结论：eBSI与移植物衰竭和死亡率相关。已确定的供体和受体因素强调需要进一步研究，以更好地描述其对eBSI的影响。

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.