Table 1.
Risk factors for the development of BSI in SOT recipients in selected publications.
| Organ | Reference | Type of study | Number of patients | Risk factors | Summary of main results |
|---|---|---|---|---|---|
| Liver | 52 | Retrospective | 242 | - Diabetes mellitus - Albumine level <2.4g/dl | Hypoalbuminemia (p = 0.006), catheterization for more than 3 weeks (p = 0.009) and post-transplant hemodialysis (p = 0.001) independently predicted BSI. Hyperglycemia (p = 0.03 to p = 0.002 according to the studies) and previous antibiotic therapy (OR 11.15, p = 0.005 if exposure to more than 3 antibiotics) were additionally associated with the development of candidemia. Reoperation or biliary complications (p < 0.001) as well as retransplantation (p = 0.014) were the most important risk factors not only for BSI but also for BSI due to MDR Gram-negative pathogens. Preoperative S. aureus nasal carriage also increased the risk for post transplant BSI (p = 0.007). |
| 9 | Retrospective | 144 | - Catheterization for more than 22 days- Post transplant hemodialysis - Recipient age >55 years | ||
| 53 | Retrospective matched case-control study | 26 with candidemia and 52 controls | - Hyperglycemia treated with insulin up to 2 weeks before candidemia - Exposure to > 3 different intravenous antibiotics | ||
| 54 | Prospective | 704 | - Preoperative S. aureus nasal carriage - Kidney transplantation- Intraoperative transfusions - Return to surgery - Retransplantation- Biliary complications | ||
| 55 | Prospective | 475 | - Post transplant abdominal infection - Reoperation - One or more episodes of acute rejection- Prolonged endotracheal intubation - Tracheostomy - Length of ICU stay after transplantation | ||
| Kidney | 40 | Retrospective | 33′479 | - Female recipient - Older recipient age >65 years - Diabetes- Urologic disease - Dialysis in the first week after transplant - Duration of pre-transplant dialysis - Rejection | Female gender (OR 1.49), older age (OR 1.44) and diabetes (OR 2.05) were independent risk factors associated with bacteremia after kidney transplantation. Both studies emphasized the role of renal insufficiency (adjusted OR 2.55, p = 0.045) and dialysis before (OR 1.17) as well as after transplantation (OR 1.28 if dialysis in the first week post transplant) |
| 41 | Retrospective | 99 | - Immunosuppression with tacrolimus - Baseline serum creatinine level >1.3 mg/dL | ||
| Heart | 5 | Prospective | 309 | - Hemodialysis - Prolonged ICU stay - Viral infection (mainly cytomegalovirus) | Independent risk factors for BSI after heart transplantation were hemodialysis (OR 6.5; 95% CI 3.2–13, p < 0.001), prolonged ICU stay (OR 3.6; 95% CI 1.6–8.1, p = 0.002), and viral infection (OR 2.1; 95% CI 1.1–4, p = 0.01). |
| Lung | 62 | Prospective | 176 | - Cystic fibrosis - Pretransplant mechanical ventilation - Younger age | BSIs were significantly more common in patients with cystic fibrosis (p = 0.001), and with the use of pre transplant mechanical ventilation (p = 0.007) |
Notes: BSI: Bloodstream infection
ICU: intensive care unit
MDR: multidrug resistant
OR: odds ratio