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
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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