Preponderance of microbial isolates among heart transplantation recipients requiring renal replacement therapy: a propensity score-adjusted analysis
Autor: | Filip Lončarić, Hrvoje Gasparovic, Maja Čikeš, Lucija Svetina, Bojan Biocina, Davor Miličić, Jana Ljubas |
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Rok vydání: | 2018 |
Předmět: |
Adult
Male medicine.medical_specialty Adolescent medicine.medical_treatment Renal function Bacteremia 01 natural sciences 03 medical and health sciences Postoperative Complications 0302 clinical medicine Risk Factors blood-stream infections international society epidemiology bacteremia outcome registry failure Internal medicine Odds Ratio Humans Transplantation Homologous Medicine Renal replacement therapy Child Propensity Score Aged Retrospective Studies Bacteria business.industry Incidence Incidence (epidemiology) Retrospective cohort study General Medicine Odds ratio Acute Kidney Injury Middle Aged Clinical Science medicine.disease 0104 chemical sciences Renal Replacement Therapy Survival Rate 010404 medicinal & biomolecular chemistry Child Preschool 030220 oncology & carcinogenesis Propensity score matching Heart Transplantation Female business Body mass index |
Zdroj: | Croatian Medical Journal Volume 59 Issue 5 |
ISSN: | 1332-8166 0353-9504 |
Popis: | Aim: To assess the association between renal replacement therapy (RRT) and post-transplant infection incidence. Methods: This single-center retrospective cohort study included 158 patients who underwent heart transplantation (HTx) in our center from 2008 to 2016, survived beyond the first post-procedural day, and had available microbial data. The patients were dichotomized according to the need for periprocedural RRT. Twenty-seven patients in RRT group had lower preoperative creatinine clearance, greater body mass index, and higher likelihood of having diabetes. Propensity score adjustment was used to account for multiple covariates. The primary outcome measure was the presence of bacteremia in patients with and without the need for RRT. The secondary outcome measures were the presence of microbial isolates from any culture and clinical outcome data. Results: Unadjusted analysis showed that the RRT group had higher incidence of any positive microbial isolate (93% vs 73% ; odds ratio [OR] 4.77, 95% confidence interval [CI] 1.01-30.53 ; P=0.026) and an increased susceptibility to bacteremia (50% vs 22% ; OR 3.50, 95% CI 1.28-9.67 ; P=0.012). Propensity score-adjusted analysis corroborated the between- group difference in positive blood cultures (OR 3.97, 95% CI 1.28- 12.32 ; P=0.017). There was no difference in the incidence of total microbial isolates between the groups (OR 4.55, 95% CI 0.90- 23.05 ; P=0.067). Conclusions: Patients requiring RRT after HTx had an increased susceptibility to infections via various portals of entry, predominantly due to an increase in blood-borne infections. Understanding the underlying conditions leading to infection- related morbidity is important for infection control and prevention. |
Databáze: | OpenAIRE |
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