title: Mortality predictors of bloodstream infections in solid-organ transplant recipients.
abstract: OBJECTIVE
  Bloodstream infections are of great concerns and a major cause of mortality in solid-organ transplant recipients. This study investigated the possible predictors influencing survival among solid-organ transplant recipients with bloodstream infections.
  
  
  METHODS
  We performed a retrospective analysis of bloodstream infections in patients who underwent solid-organ transplant between January 2002 and November 2011. During the study, 133 episodes of bloodstream infections occurred in 98 solid-organ transplant recipients. The predictors were identified by univariate and multivariate logistic regression analyses.
  
  
  RESULTS
  The mean age for the 98 enrolled patients was 42.3 years (42.3 ± 12.8 y). The majority of infections were nosocomial (79.6%), and the bloodstream infection-related mortality rate was 39.8% (39 of 98 patients). The univariate analysis identified the following variables as predictors of bloodstream infection-related mortality: intra-abdominal/biliary focus (P = .011), polymicrobial infection (P < .001), liver transplant (P = .002), platelet count <50 000 × 109/L (P < .001), lymphocyte count <300 × 109/L (P = .027), and septic shock (P < .001). The multivariate logistic regression analysis identified platelet count < 50 000 × 109/L and septic shock as independent predictors of mortality.
  
  
  CONCLUSIONS
  The predictors significantly associated with increased mortality in solid-organ transplant recipients with bloodstream infections included decreased platelet count and septic shock. Even with appropriate antimicrobial therapy, bloodstream infections, accompanied by septic shock or decreased platelet count, are associated with high mortality rates. Therefore, steps must be taken to reduce the incidence of bloodstream infections in solid-organ transplant patients.
authors.affiliation: Department of Transplant Surgery, the Third Affiliated Hospital, Central South University, Changsha 410013, Hunan, China.
authors.forename: Qiquan
authors.initials: Q
authors.lastname: Wan
authors.forename: Qifa
authors.initials: Q
authors.lastname: Ye
authors.forename: Jiandang
authors.initials: J
authors.lastname: Zhou
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D002648:Child; D003141:Communicable Diseases / Q000097:blood / Q000209:etiology / Q000401:mortality*; D003428:Cross Infection / Q000097:blood / Q000209:etiology / Q000401:mortality*; D005260:Female; D006801:Humans; D016015:Logistic Models; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D016377:Organ Transplantation / Q000009:adverse effects / Q000401:mortality*; D010976:Platelet Count; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012772:Shock, Septic / Q000097:blood / Q000209:etiology / Q000401:mortality; D013997:Time Factors; D055815:Young Adult