Surgical site infections after kidney transplantation are independently associated with graft loss.

Autor:	Schreiber PW; Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich and University Zurich, Zurich, Switzerland. Electronic address: peterwerner.schreiber@usz.ch., Hoessly LD; Clinic for Transplantation Immunology and Nephrology, Basel University Hospital, Basel, Switzerland., Boggian K; Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland., Neofytos D; Transplant Infectious Diseases Unit, Service of Infectious Diseases, University Hospitals Geneva, University of Geneva, Geneva, Switzerland., van Delden C; Transplant Infectious Diseases Unit, Service of Infectious Diseases, University Hospitals Geneva, University of Geneva, Geneva, Switzerland., Egli A; Institute of Medical Microbiology, University of Zurich, Zurich, Switzerland., Dickenmann M; Clinic for Transplantation Immunology and Nephrology, Basel University Hospital, Basel, Switzerland., Hirzel C; Department of Infectious Diseases, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland., Manuel O; Infectious Diseases Service, University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland; Transplantation Center, University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland., Koller M; Clinic for Transplantation Immunology and Nephrology, Basel University Hospital, Basel, Switzerland., Rossi S; Clinic for Transplantation Immunology and Nephrology, Basel University Hospital, Basel, Switzerland., Banz V; University Clinic for Visceral Surgery and Medicine, University Hospital Bern and University of Bern, Bern, Switzerland., Schmied B; Department of General, Visceral, Endocrine and Transplantation Surgery, Cantonal Hospital St. Gallen, St. Gallen, Switzerland., Guerke L; Department of Vascular and Transplant Surgery, Basel University Hospital, Basel, Switzerland., Matter M; Visceral Surgery Department, University Hospital of Lausanne (CHUV), Lausanne, Switzerland., de Rougemont O; Department of Surgery and Transplantation, University Hospital Zurich, Zurich, Switzerland., Bonani M; Division of Nephrology, University Hospital Zurich, Zurich, Switzerland., Golshayan D; Transplantation Center, University Hospital of Lausanne (CHUV), Lausanne, Switzerland., Schnyder A; Clinic for Nephrology, Cantonal Hospital St. Gallen, St.Gallen, Switzerland., Sidler D; Division of Nephrology and Hypertension, Inselspital, Bern University Hospital, Bern, Switzerland., Haidar F; Division of Nephrology, Department of Medicine, University Hospital of Geneva, Geneva, Switzerland., Kuster SP; Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich and University Zurich, Zurich, Switzerland., Stampf S; Clinic for Transplantation Immunology and Nephrology, Basel University Hospital, Basel, Switzerland., Mueller NJ; Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich and University Zurich, Zurich, Switzerland.
Jazyk:	angličtina
Zdroj:	American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons [Am J Transplant] 2024 May; Vol. 24 (5), pp. 795-802. Date of Electronic Publication: 2023 Nov 30.
DOI:	10.1016/j.ajt.2023.11.013
Abstrakt:	Surgical site infections (SSIs) are common health care-associated infections. SSIs after kidney transplantation (K-Tx) can endanger patient and allograft survival. Multicenter studies on this early posttransplant complication are scarce. We analyzed consecutive adult K-Tx recipients enrolled in the Swiss Transplant Cohort Study who received a K-Tx between May 2008 and September 2020. All data were prospectively collected with the exception of the categorization of SSI which was performed retrospectively according to the Centers for Disease Control and Prevention criteria. A total of 58 out of 3059 (1.9%) K-Tx recipients were affected by SSIs. Deep incisional (15, 25.9%) and organ/space infections (34, 58.6%) predominated. In the majority of SSIs (52, 89.6%), bacteria were detected, most frequently Escherichia coli (15, 28.9%), Enterococcus spp. (14, 26.9%), and coagulase-negative staphylococci (13, 25.0%). A BMI ≥25 kg/m 2 (multivariable OR 2.16, 95% CI 1.07-4.34, P = .023) and delayed graft function (multivariable OR 2.88, 95% CI 1.56-5.34, P = .001) were independent risk factors for SSI. In Cox proportional hazard models, SSI was independently associated with graft loss (multivariable HR 3.75, 95% CI 1.35-10.38, P = .011). In conclusion, SSI was a rare complication after K-Tx. BMI ≥25 kg/m 2 and delayed graft function were independent risk factors. SSIs were independently associated with graft loss. (Copyright © 2023 American Society of Transplantation & American Society of Transplant Surgeons. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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