Bacterial and fungal bloodstream infections in solid organ transplant recipients: results from a Danish cohort with nationwide follow-up
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Bacterial and fungal bloodstream infections in solid organ transplant recipients : results from a Danish cohort with nationwide follow-up. / Møller, Dina Leth; Sørensen, Søren Schwartz; Perch, Michael; Gustafsson, Finn; Rezahosseini, Omid; Knudsen, Andreas Dehlbæk; Scheike, Thomas; Knudsen, Jenny Dahl; Lundgren, Jens; Rasmussen, Allan; Nielsen, Susanne Dam.
In: Clinical Microbiology and Infection, Vol. 28, No. 3, 2022, p. 391-397.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Bacterial and fungal bloodstream infections in solid organ transplant recipients
T2 - results from a Danish cohort with nationwide follow-up
AU - Møller, Dina Leth
AU - Sørensen, Søren Schwartz
AU - Perch, Michael
AU - Gustafsson, Finn
AU - Rezahosseini, Omid
AU - Knudsen, Andreas Dehlbæk
AU - Scheike, Thomas
AU - Knudsen, Jenny Dahl
AU - Lundgren, Jens
AU - Rasmussen, Allan
AU - Nielsen, Susanne Dam
N1 - Publisher Copyright: © 2021 European Society of Clinical Microbiology and Infectious Diseases
PY - 2022
Y1 - 2022
N2 - Objectives: Bloodstream infections (BSI) are prevalent after solid organ transplantation (SOT). In this study, we aimed to investigate the incidence and risk factors for BSI in the first 5 years post-transplantation. Methods: The study included 1322 SOT (kidney, liver, lung and heart) recipients transplanted from 2010 to 2017 with a total of 5616 years of follow-up. Clinical characteristics and microbiology were obtained from the Centre of Excellence for Personalized Medicine of Infectious Complications in Immune Deficiency (PERSIMUNE) data repository with nationwide follow-up. Incidence was investigated in the different SOT groups. Risk factors associated with BSI were assed in the combined group in time-updated multivariable Cox regressions. Results: The cumulative incidence of first BSI in the first 5 years post-transplantation differed in the SOT groups with a lower incidence in heart transplant recipients than in the other SOT groups (heart: 4.4%, CI 0.0–9.7%, vs. kidney: 24.6%, CI 20.9–28.2%, liver: 24.7%, CI 19.4–29.9%, and lung: 19.6%, CI 14.5–24.8%, p <0.001). Age above 55 years (HR 1.71, CI 1.2–2.4, p=0.002) and higher Charlson comorbidity index score (HR per unit increase: 1.25, CI 1.1–1.4, p<0.001) at transplantation, current cytomegalovirus (CMV) infection (HR 4.5, CI 2.6–7.9, p<0.001) and current leucopenia (HR 13.3, CI 3.7–47.9, p<0.001) were all associated with an increased risk of BSI. Conclusion: In SOT recipients, the incidence of BSI differed with the type of transplanted organ. Risk of BSI was higher in older recipients and in recipients with comorbidity, current CMV infection or leucopenia. Thus, increased attention towards BSI in recipients with these characteristics is warranted.
AB - Objectives: Bloodstream infections (BSI) are prevalent after solid organ transplantation (SOT). In this study, we aimed to investigate the incidence and risk factors for BSI in the first 5 years post-transplantation. Methods: The study included 1322 SOT (kidney, liver, lung and heart) recipients transplanted from 2010 to 2017 with a total of 5616 years of follow-up. Clinical characteristics and microbiology were obtained from the Centre of Excellence for Personalized Medicine of Infectious Complications in Immune Deficiency (PERSIMUNE) data repository with nationwide follow-up. Incidence was investigated in the different SOT groups. Risk factors associated with BSI were assed in the combined group in time-updated multivariable Cox regressions. Results: The cumulative incidence of first BSI in the first 5 years post-transplantation differed in the SOT groups with a lower incidence in heart transplant recipients than in the other SOT groups (heart: 4.4%, CI 0.0–9.7%, vs. kidney: 24.6%, CI 20.9–28.2%, liver: 24.7%, CI 19.4–29.9%, and lung: 19.6%, CI 14.5–24.8%, p <0.001). Age above 55 years (HR 1.71, CI 1.2–2.4, p=0.002) and higher Charlson comorbidity index score (HR per unit increase: 1.25, CI 1.1–1.4, p<0.001) at transplantation, current cytomegalovirus (CMV) infection (HR 4.5, CI 2.6–7.9, p<0.001) and current leucopenia (HR 13.3, CI 3.7–47.9, p<0.001) were all associated with an increased risk of BSI. Conclusion: In SOT recipients, the incidence of BSI differed with the type of transplanted organ. Risk of BSI was higher in older recipients and in recipients with comorbidity, current CMV infection or leucopenia. Thus, increased attention towards BSI in recipients with these characteristics is warranted.
KW - Bacteraemia
KW - Fungaemia
KW - Incidence
KW - Risk factors
KW - Transplantation
U2 - 10.1016/j.cmi.2021.07.021
DO - 10.1016/j.cmi.2021.07.021
M3 - Journal article
C2 - 34325067
AN - SCOPUS:85113281696
VL - 28
SP - 391
EP - 397
JO - Clinical Microbiology and Infection
JF - Clinical Microbiology and Infection
SN - 1198-743X
IS - 3
ER -
ID: 278039159