Changing trends in the aetiology, treatment and outcomes of bloodstream infection occurring in the first year after solid organ transplantation: a single-centre prospective cohort study

Transplant International : Official Journal of the European Society for Organ Transplantation
Isabel OriolJ Carratalà

Abstract

To analyse trends in the aetiology, treatment and outcomes of bloodstream infection (BSI) within the first year post-transplant over the last 10-year period, we prospectively recorded all episodes of BSI occurring in solid organ transplant (SOT) recipients during the first year post-transplant from 2007 to 2016. Trends of factors were analysed by 2-year periods. Of 475 consecutive episodes of BSI, 218 occurred within a year of SOT in 178 SOT recipients. Gram-positive BSI decreased over time (40.5-2.2%). In contrast, there was a steady increase in Gram-negative bacilli (GNB) BSI (54.1-93.3%; P < 0.001), mainly due to Pseudomonas aeruginosa (2.4-20.4%) and Klebsiella pneumoniae (7.1-26.5%). Multidrug-resistant (MDR) GNB (4.8-38.8%; P < 0.001) rose dramatically, especially due to extended-spectrum β-lactamase (ESBL) production (7.1-34.7%). There was a sharp rise in the use of carbapenems, both as empirical (11.9-55.3%; P < 0.001) and as targeted antibiotic treatment (11.9-46.9%; P < 0.001). In conclusion, today, GNB are the leading causative agents of BSI in SOT recipients within the first year after SOT. In addition, MDR GNB have emerged mainly due to ESBL-producing strains. In spite of these changes, length of hospital stay, day...Continue Reading

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Citations

Oct 10, 2018·Current Opinion in Infectious Diseases·Jose Tiago SilvaJose Maria Aguado
Feb 16, 2020·International Journal of Molecular Sciences·Manuela CarugatiIfalt Working Group
May 16, 2020·Transplantation·Ashrit MultaniJeffrey J Teuteberg
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Mar 17, 2021·Transplant Infectious Disease : an Official Journal of the Transplantation Society·Rebecca WangJudith A Anesi
Jul 30, 2021·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·Dina Leth MøllerSusanne Dam Nielsen
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Sep 10, 2021·Transplant Infectious Disease : an Official Journal of the Transplantation Society·Emily M EichenbergerVance G Fowler

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