title: Factors influencing mortality in solid organ transplant recipients with bloodstream infection.
abstract: Although bloodstream infection (BSI) is a major cause of mortality after solid organ transplantation, information regarding its prognostic factors is scarce. To identify risk factors for 30-day mortality in solid organ transplant (SOT) recipients with BSI, we prospectively recorded all episodes of BSI occurring in adult SOT recipients from January 2007 to October 2014 at a university hospital. We identified 361 consecutive episodes of BSI involving 246 patients. The 30-day case-fatality rate from the onset of BSI was 11.4%. Factors independently associated with 30-day mortality in a logistic regression analysis were shock at presentation (OR 13.658; 95% CI 5.985-31.168), acute graft rejection in the previous 6 months (OR 3.681; 95% CI 1.059-12.795), and a platelet count of <50,000 × 10(9)/L (OR 3.070; 95% CI 1.173-8.038). Kidney recipients were the patients with the best prognosis (OR 0.375; 95% CI 0.156-0.900). Our findings may help to identify SOT recipients with BSI who are at the highest risk of death.
authors.affiliation: Department of Infectious Diseases, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Oriol
authors.affiliation: Department of Infectious Diseases, Spain.
authors.forename: N
authors.initials: N
authors.lastname: Sabé
authors.affiliation: Department of Nephrology, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Melilli
authors.affiliation: Department of General Surgery, Spain.
authors.forename: L
authors.initials: L
authors.lastname: Lladó
authors.affiliation: Department of Cardiology, Hospital de Bellvitge, Institut d'Investigació Biomèdica de Bellvitge, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: J
authors.initials: J
authors.lastname: González-Costello
authors.affiliation: Department of Infectious Diseases, Spain.
authors.forename: L
authors.initials: L
authors.lastname: Soldevila
authors.affiliation: Department of Infectious Diseases, Spain. Electronic address: jcarratala@ub.edu.
authors.forename: J
authors.initials: J
authors.lastname: Carratalà
mesh_terms: D000368:Aged; D016470:Bacteremia / Q000401:mortality*; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016377:Organ Transplantation / Q000009:adverse effects* / Q000401:mortality; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D062606:Tertiary Care Centers / Q000706:statistics & numerical data; D066027:Transplant Recipients
keywords: Acute graft rejection; antibiotic resistance; bloodstream infection; mortality; septic shock; solid organ transplantation