Bacteremia in solid organ transplant recipients as compared to immunocompetent patients: Acute phase cytokines and outcomes in a prospective, matched cohort study
| Autor: | Barbara D. Alexander, Andrew N. Macintyre, Batu K. Sharma-Kuinkel, Scott M. Palmer, Stacey A. Maskarinec, Michael Dagher, Vance G. Fowler, Sin-Ho Jung, Lauren Hale, Felicia Ruffin, Emily M. Eichenberger, Reginald Lerebours, Celia Kohler, Matthew R. Sinclair, Joshua T. Thaden |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Bacteremia Gastroenterology Article Cohort Studies Matched cohort Internal medicine Humans Immunology and Allergy Medicine Pharmacology (medical) Prospective Studies Transplantation business.industry Septic shock Staphylococcus aureus bacteremia Organ Transplantation medicine.disease Transplant Recipients Cytokine response Lower incidence Cytokine Cytokines business Solid organ transplantation |
| Zdroj: | Am J Transplant |
| ISSN: | 1600-6135 |
| DOI: | 10.1111/ajt.16388 |
| Popis: | We undertook a prospective, matched cohort study of patients with Staphylococcus aureus bacteremia (SAB) and gram-negative bacteremia (GNB) to compare the characteristics, outcomes, and chemokine and cytokine response in transplant recipients to immunocompetent, nontransplant recipients. Fifty-five transplant recipients (GNB n = 29; SAB n = 26) and 225 nontransplant recipients (GNB n = 114; SAB n = 111) were included for clinical analysis. Transplant GNB had a significantly lower incidence of septic shock than nontransplant GNB (10.3% vs 30.7%, p = .03). Thirty-day mortality did not differ significantly between transplant and nontransplant recipients with GNB (10.3% vs 15.8%, p = .57) or SAB (0.0% vs 11.7%, p = .13). Next, transplant patients were matched 1:1 with nontransplant patients for the chemokine and cytokine analysis. Five cytokines and chemokines were significantly lower in transplant GNB vs nontransplant GNB: IL-2 (median [IQR]: 7.1 pg/ml [7.1, 7.1] vs 32.6 pg/ml [7.1, 88.0]; p = .001), MIP-1β (30.7 pg/ml [30.7, 30.7] vs 243.3 pg/ml [30.7, 344.4]; p = .001), IL-8 (32.0 pg/ml [5.6, 53.1] vs 59.1 pg/ml [39.2, 119.4]; p = .003), IL-15 (12.0 pg/ml [12.0, 12.0] vs 12.0 pg/ml [12.0, 126.7]; p = .03), and IFN-α (5.1 pg/mL [5.1, 5.1] vs 5.1 pg/ml [5.1, 26.3]; p = .04). Regulated upon Activation, Normal T Cell Expressed and Secreted (RANTES) was higher in transplant SAB vs nontransplant SAB (mean [SD]: 750.2 pg/ml [194.6] vs 656.5 pg/ml [147.6]; p = .046). |
| Databáze: | OpenAIRE |
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