Bacteremia During the First Year After Solid Organ Transplantation : An Epidemiological Update

Article Article scientifique Article Bacteremia During the First Year After Solid Organ Transplantation : An Epidemiological Update eng 2023-05-05 2023-06 author Neofytos Dionysios 0000-0001-6970-2869 Transplant Infectious Diseases Unit, Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland. 911674 Département de médecine (DEMED) author Stampf Susanne Clinic for Transplantation Immunology and Nephrology (Swiss Transplant Cohort Study), University Hospital of Basel, Basel, Switzerland. author Hoessly Linard D Clinic for Transplantation Immunology and Nephrology (Swiss Transplant Cohort Study), University Hospital of Basel, Basel, Switzerland. author D'Asaro Matilde Transplant Infectious Diseases Unit, Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland. 730740 author Nguyen Tang Gaël Cao-Tam Transplant Infectious Diseases Unit, Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland. 801363 author Boggian Katia Division of Infectious Diseases, Cantonal Hospital St Gallen, St Gallen, Switzerland. author Hirzel Cedric Department of Infectious Diseases, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. author Khanna Nina 0000-0002-2642-419X Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Basel, Basel, Switzerland. author Manuel Oriol Division of Infectious Diseases, University Hospital of Vaud, Lausanne, Switzerland. author Mueller Nicolas J Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Zurich, Switzerland. author Van Delden Christian Transplant Infectious Diseases Unit, Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland. 24088 Département de médecine (DEMED) Swiss Transplant Cohort Study collaborator Berishvili Berney Ekaterine 0000-0002-7969-1937 826237 Département de chirurgie (CHIRU) collaborator Chalandon Yves 0000-0001-9341-8104 644957 Département de médecine (DEMED) collaborator De Seigneux Matthey Sophie 105798 Département de médecine (DEMED) collaborator Mclin Valérie Anne 799651 Département de Pédiatrie, Gynécologie et Obstétrique (PETRI) collaborator Posfay Barbe Klara 39230 Département de Pédiatrie, Gynécologie et Obstétrique (PETRI) collaborator Villard Jean 29595 Département de médecine (DEMED) ofad247 10.1093/ofid/ofad247 37323422 2328-8957 PMC10267299 Background: There are limited contemporary data on the epidemiology and outcomes of bacteremia in solid organ transplant recipients (SOTr). Methods: Using the Swiss Transplant Cohort Study registry from 2008 to 2019, we performed a retrospective nested multicenter cohort study to describe the epidemiology of bacteremia in SOTr during the first year post-transplant. Results: Of 4383 patients, 415 (9.5%) with 557 cases of bacteremia due to 627 pathogens were identified. One-year incidence was 9.5%, 12.8%, 11.4%, 9.8%, 8.3%, and 5.9% for all, heart, liver, lung, kidney, and kidney-pancreas SOTr, respectively (P= .003). Incidence decreased during the study period (hazard ratio, 0.66;P< .001). One-year incidence due to gram-negative bacilli (GNB), gram-positive cocci (GPC), and gram-positive bacilli (GPB) was 5.62%, 2.81%, and 0.23%, respectively. Seven (of 28, 25%)Staphylococcus aureusisolates were methicillin-resistant, 2/67 (3%) enterococci were vancomycin-resistant, and 32/250 (12.8%) GNB produced extended-spectrum beta-lactamases. Risk factors for bacteremia within 1 year post-transplant included age, diabetes, cardiopulmonary diseases, surgical/medical post-transplant complications, rejection, and fungal infections. Predictors for bacteremia during the first 30 days post-transplant included surgical post-transplant complications, rejection, deceased donor, and liver and lung transplantation. Transplantation in 2014-2019, CMV donor-negative/recipient-negative serology, and cotrimoxazolePneumocystisprophylaxis were protective against bacteremia. Thirty-day mortality in SOTr with bacteremia was 3% and did not differ by SOT type. Conclusions: Almost 1/10 SOTr may develop bacteremia during the first year post-transplant associated with low mortality. Lower bacteremia rates have been observed since 2014 and in patients receiving cotrimoxazole prophylaxis. Variabilities in incidence, timing, and pathogen of bacteremia across different SOT types may be used to tailor prophylactic and clinical approaches. Bacteremia Bloodstream infection Clinical outcomes Epidemiology Risk factors Solid organ transplant Timing Dewey 616 Dewey 617 Dewey 618 56 Département de médecine 221 57 Département de chirurgie 222 58 Département de pédiatrie, gynécologie et obstétrique 223 false 235 Perception du Quorum et gènes de virulence 301 1323 Création de tissus par bio-ingénieurie et régénération d'organes 1021 897 Insuffisance rénale chronique 941 559 Pathologies hépatiques congénitales et acquises de l'enfant 900 515 Recherche en infectiologie pédiatrique et en pédiatrie générale 853 298 Transplantation immunologie et osteoimmunologie 561 1216 Leucémie et transplantation allogénique de cellules souches hématopoïétiques 982 Open forum infectious diseases 10 6 aa3ef829-7b1a-4540-9f87-ba88aabdd697 Article (Published version) Public Article-scientifique-from-europePmc.pdf 1074583 application/pdf CC BY-NC-ND-4.0 d75d0829abbff2487a910943d5d8ceb750a089d23047c35cb7e19ae69f765a6e openAccess Faculté de médecine / Section de médecine clinique / Département de médecine Faculté de médecine / Section de médecine clinique / Département de chirurgie Faculté de médecine / Section de médecine clinique / Département de pédiatrie, gynécologie et obstétrique

Title	Published in	Year	Views	Downloads

Bacteremia During the First Year After Solid Organ Transplantation : An Epidemiological Update	Open forum infectious diseases	2023	130	135
Le sixième sens clinique	Revue médicale suisse	2018	76	74

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Nguyen Tang, Gaël Cao-Tam