دورية أكاديمية
Risk factors and outcomes of bloodstream infection from a urinary source in kidney transplant recipients.
العنوان: | Risk factors and outcomes of bloodstream infection from a urinary source in kidney transplant recipients. |
---|---|
المؤلفون: | Eichenberger EM; Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA., Donzo MW; Emory University School of Medicine, Atlanta, Georgia, USA., Anderson R; Emory University School of Medicine, Atlanta, Georgia, USA., Karadkhele G; Emory Transplant Center, Emory University Hospital, Atlanta, Georgia, USA., Pouch SM; Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA., Larsen CP; Emory Transplant Center, Emory University Hospital, Atlanta, Georgia, USA.; Department of Surgery, Emory University Hospital, Atlanta, Georgia, USA. |
المصدر: | Clinical transplantation [Clin Transplant] 2024 Mar; Vol. 38 (3), pp. e15279. |
نوع المنشور: | Journal Article |
اللغة: | English |
بيانات الدورية: | Publisher: Munksgaard Country of Publication: Denmark NLM ID: 8710240 Publication Model: Print Cited Medium: Internet ISSN: 1399-0012 (Electronic) Linking ISSN: 09020063 NLM ISO Abbreviation: Clin Transplant Subsets: MEDLINE |
أسماء مطبوعة: | Original Publication: Copenhagen : Munksgaard, |
مواضيع طبية MeSH: | Kidney Transplantation*/adverse effects , Bacteriuria*/etiology , Urethral Stricture*/etiology , Sepsis*/etiology , Diabetes Mellitus*/etiology , Renal Insufficiency*/etiology, Humans ; Male ; Case-Control Studies ; Escherichia coli ; Risk Factors ; Transplant Recipients |
مستخلص: | Background: Bacteriuria is common among kidney transplant recipients (KTR). Risk factors and outcomes associated with bloodstream infection due to a urinary source (BSIU) in KTR are poorly understood. Methods: This single center case-control study from 2010 to 2022 compared KTR with BSIU to those with bacteria without bloodstream infection (BU). Multivariable logistic regression identified BSIU risk factors, and Cox models assessed its impact on graft failure. Results: Among 3435 patients, who underwent kidney transplantation at Emory Hospital, 757 (22%) developed bacteriuria, among whom 142 (18.8%) were BSIU. Male sex, presence of Escherichia coli, Klebsiella pneumoniae, or Pseudomonas species in urine culture, urethral stricture, neuromuscular bladder disorder, and history of diabetes-induced renal failure were independently associated with increased odds of BSIU (Male sex: aOR 2.29, 95% CI 1.52, 3.47, E. coli: aOR 5.14, 95% CI 3.02, 9.13; K. pneumoniae aOR 3.19, 95% CI 1.65, 6.27, Pseudomonas spp aOR 3.06, 95% CI 1.25, 7.18; urethral stricture: 4.10, 95% CI 1.63, 10.3, neuromuscular bladder disorder aOR 1.98, 95% CI 1.09, 3.53, diabetes: aOR 1.64, 95% CI 1.08, 2.49). BSIU was associated with increased hazard of graft failure (HR 1.52, 95% CI 1.05, 2.20). Conclusion: Close monitoring is warranted for male KTR with bacteriuria, those with urine cultures positive for Pseudomonas spp, K. pneumoniae, or E. coli, as well as KTR with a history of diabetes-induced renal failure, urethral stricture, or neuromuscular bladder disorder due to their risk for developing BSIU. Future research should explore strategies to mitigate BSIU risk in these high-risk KTR and reduce the associated risk of long-term graft failure. (© 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.) |
References: | Agrawal A, Ison MG, Danziger-Isakov L. Long-term infectious complications of kidney transplantation. Clin J Am Soc Nephrol. 2022;17(2):286-295. doi:10.2215/CJN.15971020. Tong SYC, Davis JS, Eichenberger E, Holland TL, Fowler VG. Staphylococcus aureus infections: epidemiology, pathophysiology, clinical manifestations, and management. Clin Microbiol Rev. 2015;28(3):603-661. doi:10.1128/CMR.00134-14. Roufosse C, Simmonds N, Clahsen-van Groningen M, et al. A 2018 reference guide to the Banff classification of renal allograft pathology. Transplantation. 2018;102(11):1795-1814. doi:10.1097/TP.0000000000002366. Bhatt PJ, Ali M, Rana M, et al. Infections due to multidrug-resistant organisms following heart transplantation: epidemiology, microbiology, and outcomes. Transpl Infect Dis. 2020;22(1):e13215. doi:10.1111/tid.13215. Eichenberger EM, Troy J, Ruffin F, et al. Gram-negative bacteremia in solid organ transplant recipients: clinical characteristics and outcomes as compared to immunocompetent non-transplant recipients. Transpl Infect Dis. 2022;24(6):e13969. doi:10.1111/tid.13969. Goldman JD, Julian K. Urinary tract infections in solid organ transplant recipients: guidelines from the American Society of Transplantation Infectious Diseases Community of Practice. Clin Transplant. 2019;33(9):e13507. doi:10.1111/ctr.13507. Levey AS, Stevens LA, Schmid CH, et al. A new equation to estimate glomerular filtration rate. Ann Intern Med. 2009;150(9):604. doi:10.7326/0003-4819-150-9-200905050-00006. Fox J, Weisberg S. An {R} Companion to Applied Regression. 3rd ed. Sage; 2019. https://socialsciences.mcmaster.ca/jfox/Books/Companion/. Wickham H. Ggplot2: Elegant Graphics for Data Analysis. 2nd ed. Springer International Publishing : Imprint: Springer; 2016. doi:10.1007/978-3-319-24277-4. Foxman B, Brown P. Epidemiology of urinary tract infections: transmission and risk factors, incidence, and costs. Infect Dis Clin North Am. 2003;17(2):227-241. doi:10.1016/s0891-5520(03)00005-9. Hooton TM. Clinical practice. Uncomplicated urinary tract infection. N Engl J Med. 2012;366(11):1028-1037. doi:10.1056/NEJMcp1104429. Ariza-Heredia EJ, Beam EN, Lesnick TG, Kremers WK, Cosio FG, Razonable RR. Urinary tract infections in kidney transplant recipients: role of gender, urologic abnormalities, and antimicrobial prophylaxis. Ann Transplant. 2013;18:195-204. doi:10.12659/AOT.883901. Sabé N, Maristany M, Tuells M, et al. Risk factors and outcomes of acute graft pyelonephritis with bacteremia due to multidrug-resistant gram-negative bacilli among kidney transplant recipients. J Clin Med. 2022;11(11):3165. doi:10.3390/jcm11113165. McVary KT, Roehrborn CG, Avins AL, et al. Update on AUA guideline on the management of benign prostatic hyperplasia. J Urol. 2011;185(5):1793-1803. doi:10.1016/j.juro.2011.01.074. Muller LMAJ, Gorter KJ, Hak E, et al. Increased risk of common infections in patients with type 1 and type 2 diabetes mellitus. Clin Infect Dis. 2005;41(3):281-288. doi:10.1086/431587. Shah BR, Hux JE. Quantifying the risk of infectious diseases for people with diabetes. Diabetes Care. 2003;26(2):510-513. doi:10.2337/diacare.26.2.510. Kamei J, Yamamoto S. Complicated urinary tract infections with diabetes mellitus. J Infect Chemother. 2021;27(8):1131-1136. doi:10.1016/j.jiac.2021.05.012. Delamaire M, Maugendre D, Moreno M, Le Goff MC, Allannic H, Genetet B. Impaired leucocyte functions in diabetic patients. Diabet Med. 1997;14(1):29-34. doi:10.1002/(SICI)1096-9136(199701)14:1<29::AID-DIA300>3.0.CO;2-V. Alexiewicz JM, Kumar D, Smogorzewski M, Klin M, Massry SG. Polymorphonuclear leukocytes in non-insulin-dependent diabetes mellitus: abnormalities in metabolism and function. Ann Intern Med. 1995;123(12):919-924. doi:10.7326/0003-4819-123-12-199512150-00004. Martin RM, Bachman MA. Colonization, infection, and the accessory genome of Klebsiella pneumoniae. Front Cell Infect Microbiol. 2018;8:4. doi:10.3389/fcimb.2018.00004. Coussement J, Argudín MA, Heinrichs A, et al. Host and microbial factors in kidney transplant recipients with Escherichia coli acute pyelonephritis or asymptomatic bacteriuria: a prospective study using whole-genome sequencing. Nephrol Dial Transplant. 2019;34(5):878-885. doi:10.1093/ndt/gfy292. Mathews T, Pushkar D, Kaul A, et al. Early versus Late acute graft pyelonephritis: a retrospective analysis of graft and patient outcomes. Transpl Immunol. 2022;75:101657. doi:10.1016/j.trim.2022.101657. Powers HR, Hellinger WC, Cortese C, et al. Histologic acute graft pyelonephritis after kidney transplantation: incidence, clinical characteristics, risk factors, and association with graft loss. Transpl Infect Dis. 2022;24(2):e13801. doi:10.1111/tid.13801. Origüen J, López-Medrano F, Fernández-Ruiz M, et al. Should asymptomatic bacteriuria be systematically treated in kidney transplant recipients? Results from a randomized controlled trial. Am J Transplant. 2016;16(10):2943-2953. doi:10.1111/ajt.13829. Arencibia N, Agüera ML, Rodelo C, et al. Short-term outcome of untreated versus treated asymptomatic bacteriuria in renal transplant patients. Transplant Proc. 2016;48(9):2941-2943. doi:10.1016/j.transproceed.2016.07.041. Green H, Rahamimov R, Goldberg E, et al. Consequences of treated versus untreated asymptomatic bacteriuria in the first year following kidney transplantation: retrospective observational study. Eur J Clin Microbiol Infect Dis. 2013;32(1):127-131. doi:10.1007/s10096-012-1727-2. |
فهرسة مساهمة: | Keywords: bacteriuria; bloodstream infection; kidney transplant; urinary source |
تواريخ الأحداث: | Date Created: 20240314 Date Completed: 20240318 Latest Revision: 20240418 |
رمز التحديث: | 20240419 |
DOI: | 10.1111/ctr.15279 |
PMID: | 38485657 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1399-0012 |
---|---|
DOI: | 10.1111/ctr.15279 |