Six-month incidence of bloodstream infections in intestinal transplant patients

• Published in: Transplant infectious disease 2012-06, Vol.14 (3), p.242-247
• Main Authors: Akhter, K., Timpone, J., Matsumoto, C., Fishbein, T., Kaufman, S., Kumar, P.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Bacteremia - epidemiology; Bacteremia - microbiology; Bacteria - isolation & purification; bloodstream infections; Child; Child, Preschool; Female; Gram-Negative Bacterial Infections - epidemiology; Gram-Negative Bacterial Infections - microbiology; Gram-Positive Bacterial Infections - epidemiology; Gram-Positive Bacterial Infections - microbiology; Humans; Incidence; Infant; intestinal transplant; Intestine, Small - transplantation; Male; Middle Aged; Postoperative Complications; Retrospective Studies; Risk Factors; Time Factors; Young Adult
• ISSN: 1398-2273; 1399-3062
• DOI: 10.1111/j.1399-3062.2011.00683.x

Background Intestinal transplantation has emerged as an established treatment for life‐threatening intestinal failure. The most common complication and cause of death is infection. Risk of infection is highest during the first 6 months, as a consequence of maximal immunosuppression, greater than that required for any other organ allograft. Methods We performed a retrospective chart review of all (56) adult and pediatric (5, surgical complications, and acute rejection. Results A BSI developed in 34 of the 56 patients, with a total of 85 BSI episodes. Of these BSI episodes, 65.9% were due to gram‐positive organisms, 34.1% gram‐negative organisms, and 2.4% due to fungi. The most common isolates were Enterococcus species, Enterobacter species, Klebsiella species, and coagulase‐negative staphylococci. Inclusion of the liver and/or a preoperative bilirubin >5 mg/dL appeared to increase the incidence of BSI (P = 0.0483 and 0.0005, respectively). Acute rejection and colonic inclusion did not appear to affect the incidence of BSI (P = 0.9419 and 0.8248, respectively). The BSI incidence was higher in children (P = 0.0058). Conclusions BSIs are a common complication of intestinal transplantation. Risk factors include age 5. Acute rejection and colon inclusion do not appear to be associated with increased BSI risk.