Factors influencing mortality in solid organ transplant recipients with bloodstream infection

• Published in: Clinical microbiology and infection Vol. 21; no. 12; pp. 1104.e9 - 1104.e14
• Main Authors: Oriol, I., Sabé, N., Melilli, E., Lladó, L., González-Costello, J., Soldevila, L., Carratalà, J.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.12.2015
• Subjects: Acute graft rejection; Aged; antibiotic resistance; Bacteremia - mortality; bloodstream infection; Female; Humans; Kidney Transplantation - adverse effects; Logistic Models; Male; Middle Aged; mortality; Organ Transplantation - adverse effects; Organ Transplantation - mortality; Prognosis; Prospective Studies; Risk Factors; septic shock; solid organ transplantation; Tertiary Care Centers - statistics & numerical data; Transplant Recipients; mortality; solid organ transplantation; septic shock; bloodstream infection; Acute graft rejection; antibiotic resistance
• ISSN: 1198-743X; 1469-0691
• DOI: 10.1016/j.cmi.2015.07.021

Although bloodstream infection (BSI) is a major cause of mortality after solid organ transplantation, information regarding its prognostic factors is scarce. To identify risk factors for 30-day mortality in solid organ transplant (SOT) recipients with BSI, we prospectively recorded all episodes of BSI occurring in adult SOT recipients from January 2007 to October 2014 at a university hospital. We identified 361 consecutive episodes of BSI involving 246 patients. The 30-day case-fatality rate from the onset of BSI was 11.4%. Factors independently associated with 30-day mortality in a logistic regression analysis were shock at presentation (OR 13.658; 95% CI 5.985–31.168), acute graft rejection in the previous 6 months (OR 3.681; 95% CI 1.059–12.795), and a platelet count of <50 000 × 109/L (OR 3.070; 95% CI 1.173–8.038). Kidney recipients were the patients with the best prognosis (OR 0.375; 95% CI 0.156–0.900). Our findings may help to identify SOT recipients with BSI who are at the highest risk of death.