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. |
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| 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.) |
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| 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 |
Full Text Finder | تدمد: | 1399-0012 |
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| DOI: | 10.1111/ctr.15279 |