title: Frequency and clinical outcomes of ESKAPE bacteremia in solid organ transplantation and the risk factors for mortality.
abstract: BACKGROUND
  Although bacteremias caused by the 6 ESKAPE pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species) have recently been highlighted as a serious complication in solid organ transplant (SOT), more information is urgently needed. We sought to investigate the frequency and clinical outcomes of ESKAPE bacteremia in SOT and determine the risk factors for mortality.
  
  
  METHODS
  A retrospective analysis of bacteremia after SOT was reviewed. Risk factors for mortality caused by ESKAPE bacteremia were identified.
  
  
  RESULTS
  Eighty-four episodes of bacteremia were caused by ESKAPE strains. Of these strains, 41 were caused by resistant ESKAPE (rESKAPE) organisms. The only factor for bacteremia-related mortality independently associated with ESKAPE was septic shock (odds ratio [OR] = 21.017, 95% confidence interval [CI] = 5.038-87.682, P < 0.001). The factors for bacteremia-related mortality independently associated with rESKAPE bacteremia were septic shock (OR = 16.558, 95% CI = 6.620-104.668, P = 0.003) and age ≥40 years (OR = 7.521, 95% CI = 1.196-47.292, P = 0.031).
  
  
  CONCLUSIONS
  To improve the outcomes of transplantation, more effective therapeutic treatments are of paramount importance when older SOT recipients with bacteremia due to ESKAPE/rESKAPE organisms present with septic shock.
authors.affiliation: Department of Transplant Surgery, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China; Department of Transplant Surgery, Zhongnan Hospital, Wuhan University, Wuhan, Hubei, China.
authors.forename: Q F
authors.initials: QF
authors.lastname: Ye
authors.forename: J
authors.initials: J
authors.lastname: Zhao
authors.forename: Q Q
authors.initials: QQ
authors.lastname: Wan
authors.forename: B B
authors.initials: BB
authors.lastname: Qiao
authors.forename: J D
authors.initials: JD
authors.lastname: Zhou
mesh_terms: D000151:Acinetobacter Infections / Q000453:epidemiology / Q000382:microbiology / Q000401:mortality*; D040981:Acinetobacter baumannii; D000328:Adult; D000367:Age Factors; D016470:Bacteremia / Q000453:epidemiology* / Q000382:microbiology* / Q000401:mortality; D002681:China / Q000453:epidemiology; D024881:Drug Resistance, Bacterial; D004754:Enterobacter; D004756:Enterobacteriaceae Infections / Q000382:microbiology / Q000401:mortality; D016984:Enterococcus faecium; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000382:microbiology / Q000401:mortality; D006801:Humans; D007710:Klebsiella Infections / Q000453:epidemiology / Q000382:microbiology / Q000401:mortality*; D007711:Klebsiella pneumoniae; D008297:Male; D008875:Middle Aged; D016377:Organ Transplantation / Q000009:adverse effects*; D011552:Pseudomonas Infections / Q000453:epidemiology / Q000382:microbiology / Q000401:mortality*; D011550:Pseudomonas aeruginosa; D012189:Retrospective Studies; D012306:Risk; D012772:Shock, Septic / Q000401:mortality*; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000382:microbiology / Q000401:mortality*; D013211:Staphylococcus aureus
keywords: ESKAPE; bacteremia; mortality; risk factors; solid organ transplantation