Matched retrospective study of infective endocarditis among solid organ transplant recipients compared to non‐transplant: Seven‐year experience in a US Referral Center
| Autor: | Nabin K. Shrestha, Kyle D. Brizendine, Sally Chuang |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment 030230 surgery Infections Organ transplantation 03 medical and health sciences 0302 clinical medicine Internal medicine Epidemiology medicine Humans Endocarditis Risk factor Referral and Consultation Retrospective Studies Transplantation business.industry Retrospective cohort study Organ Transplantation medicine.disease Transplant Recipients Infectious Diseases Infective endocarditis 030211 gastroenterology & hepatology Hemodialysis Complication business |
| Zdroj: | Transplant Infectious Disease. 22 |
| ISSN: | 1399-3062 1398-2273 |
| DOI: | 10.1111/tid.13368 |
| Popis: | Background Infective endocarditis (IE) is a rare complication following solid organ transplant (SOT); data on the clinical features and outcomes of IE in SOT recipients in the modern era are limited. Methods We conducted a single-center retrospective cohort study of IE diagnosed from 1/2008-12/2014 in SOT recipients, who were matched by age and microorganism to cases of IE in non-SOT, to describe the clinical features and outcomes. Results There were 14 cases of IE identified in SOT recipients matched to 56 non-SOT controls. Median time from transplant to IE was 1017 days (IQR 379-1830). Compared to non-SOT patients, SOT patients were more likely to be undergoing current hemodialysis (16% vs 36%) and to possess indwelling central venous catheters within the 30 days prior to diagnosis of IE (27% vs 50%). No SOT patients had documented drug use as a risk factor for IE whereas 6 (11%) non-SOT did. Enterococcus was the most common etiologic agent and was isolated in 50% of cases; only one fungal infection was identified, a mixed infection with Candida. Thirty-day mortality was 14% in SOT patients, significantly higher versus no deaths in non-SOT (P = .037). Conclusions The present study illustrates a change in epidemiology of IE in SOT patients characterized by IE that generally occurs more than one-year post-transplant, is due to bacterial infection rather than fungus, and appears to be health care associated. Multicenter studies are merited to explore transplant-specific risk factors for IE in the special population of SOT patients. |
| Databáze: | OpenAIRE |
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