Factors influencing mortality in solid organ transplant recipients with bloodstream infection

Clin Microbiol Infect. 2015 Dec;21(12):1104.e9-14. doi: 10.1016/j.cmi.2015.07.021. Epub 2015 Aug 4.

Abstract

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 × 10(9)/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.

Keywords: Acute graft rejection; antibiotic resistance; bloodstream infection; mortality; septic shock; solid organ transplantation.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Bacteremia / mortality*
  • Female
  • Humans
  • Kidney Transplantation / adverse effects
  • Logistic Models
  • Male
  • Middle Aged
  • Organ Transplantation / adverse effects*
  • Organ Transplantation / mortality
  • Prognosis
  • Prospective Studies
  • Risk Factors
  • Tertiary Care Centers / statistics & numerical data
  • Transplant Recipients