Bacterial and fungal bloodstream infections in solid organ transplant recipients: results from a Danish cohort with nationwide follow-up

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

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.

OriginalsprogEngelsk
TidsskriftClinical Microbiology and Infection
ISSN1198-743X
DOI
StatusAccepteret/In press - 2021

Bibliografisk note

Funding Information:
M.P. received a grant from Roche and lecture honoraria from Astra Zeneca and GSK not related to this work; O.R. received a grant from The Research Foundation of Rigshospitalet related to this work and a grant from A.P. M?ller Fonden not related to this work; A.D.K. received a grant from the Danish Heart Foundation not related to this work; S.D.N. received unrestricted research grants from Novo Nordisk Foundation and Independent Research Fund (FSS) not related to this work; D.L.M., S.S.S., F.G., T.S., J.D.K., J.L., A.R. reported no conflict of interest. This work was supported by the Novo Nordic Foundation, the Independent Research Fund (FSS), the Danish National Research Foundation (DNRF) grant no. 126, and the Research Foundation of Rigshospitalet. The funding sources were not involved in any part of the study design, data collection, data analysis, and interpretation of the data or the writing of this manuscript.

Funding Information:
M.P. received a grant from Roche and lecture honoraria from Astra Zeneca and GSK not related to this work; O.R. received a grant from The Research Foundation of Rigshospitalet related to this work and a grant from A.P. Møller Fonden not related to this work; A.D.K. received a grant from the Danish Heart Foundation not related to this work; S.D.N. received unrestricted research grants from Novo Nordisk Foundation and Independent Research Fund (FSS) not related to this work; D.L.M., S.S.S., F.G., T.S., J.D.K., J.L., A.R. reported no conflict of interest. This work was supported by the Novo Nordic Foundation, the Independent Research Fund (FSS), the Danish National Research Foundation ( DNRF ) grant no. 126, and the Research Foundation of Rigshospitalet. The funding sources were not involved in any part of the study design, data collection, data analysis, and interpretation of the data or the writing of this manuscript.

Publisher Copyright:
© 2021 European Society of Clinical Microbiology and Infectious Diseases

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