ONE in ten recipients of a solid organ transplant develop bacteraemia in the first year following their transplant, according to a retrospective, multicentre cohort study. Dionysios Neofytos, University Hospital of Geneva, Switzerland, and colleagues, analysed the incidence and timing of bacteraemia in solid organ transplant recipients, and by type of transplant during the first year post-transplant.
In total, 4,838 patients having received a liver, heart, lung, kidney, or kidney-pancreas transplant between 5th January 2008–31st December 2019 were included in the analysis. The team identified 557 bacteraemias due to 627 pathogens, and noted that the incidence decreased over the period of the study.
Gram-negative bacilli had an incidence of 5.62%, while Gram-positive cocci had an incidence of 2.81%, and Gram-positive bacilli 0.23%. Researchers further noted that two recorded enterococci were vancomycin resistant, seven Staphylococcus aureus isolates were methicillin resistant, and 32 gram-negative bacilli produced extended-spectrum β-lactamases.
The following risk factors for bacteraemia within 1 year of transplant were identified: diabetes (hazard ratio [HR]: 1.82; p=0.020), age (HR: 1.19; p<0.010), surgical (HR: 3.13; p<0.010) and medical (HR: 2.32; p=0.010) post-transplant complications, cardiopulmonary diseases (HR: 1.38; p=0.005), fungal infections (HR: 2.45; p<0.001), and rejection (HR: 2.24; p=0.010). Furthermore, surgical post-transplant complication (HR: 2.45; p<0.001), rejection (HR: 2.76; p<0.001), and having a deceased donor, liver, or lung transplantation were identified as predictors for bacteraemia during the first 30 days post-transplant.
“Bacteraemias are becoming less frequent complications post-transplant with excellent survival rates, underscoring the progress made in this field of medicine,” Neofytos stated. “Of course, continuous efforts and vigilance are required to further decrease the incidence of bacteraemia, and maintain and further optimise clinical outcomes.”
The team hopes this data will aid to inform the clinicians who care for these patients after the first few months post-transplant, and allow for better diagnostic as well as prophylactic strategies at transplant centres.