Surgical site infections after kidney transplantation are

被引：6

作者：

Schreiber, Peter W. ^{[1
,2
]}

Hoessly, Linard D. ^{[3
]}

Boggian, Katia ^{[4
]}

Neofytos, Dionysios ^{[5
]}

van Delden, Christian ^{[5
]}

Egli, Adrian ^{[6
]}

Dickenmann, Michael ^{[3
]}

Hirzel, Cedric ^{[7
]}

Manuel, Oriol ^{[8
,9
,10
]}

Koller, Michael ^{[3
]}

Rossi, Simona ^{[3
]}

Banz, Vanessa ^{[11
,12
]}

Schmied, Bruno ^{[13
]}

Guerke, Lorenz ^{[14
]}

Matter, Maurice ^{[15
]}

de Rougemont, Olivier ^{[16
]}

Bonani, Marco ^{[17
]}

Golshayan, Dela ^{[18
]}

Schnyder, Aurelia ^{[19
]}

Sidler, Daniel ^{[20
]}

Haidar, Fadi ^{[21
]}

Kuster, Stefan P. ^{[1
,2
]}

Stampf, Susanne ^{[3
]}

Mueller, Nicolas J. ^{[1
,2
]}

机构：

[1] Univ Hosp Zurich, Hosp Epidemiol, Dept Infect Dis, Raemistr 100, CH-8091 Zurich, Switzerland

[2] Univ Zurich, Raemistr 100, CH-8091 Zurich, Switzerland

[3] Univ Hosp Basel, Clin Transplantat Immunol & Nephrol, Basel, Switzerland

[4] Cantonal Hosp St Gallen, Div Infect Dis & Hosp Epidemiol, St Gallen, Switzerland

[5] Univ Geneva, Univ Hosp Geneva, Serv Infect Dis, Transplant Infect Dis Unit, Geneva, Switzerland

[6] Univ Zurich, Inst Med Microbiol, Zurich, Switzerland

[7] Univ Bern, Dept Infect Dis, Inselspital, Bern Univ Hosp, Bern, Switzerland

[8] Univ Hosp CHUV, Infect Dis Serv, Lausanne, Switzerland

[9] Univ Lausanne, Lausanne, Switzerland

[10] Univ Hosp CHUV, Transplantat Ctr, Lausanne, Switzerland

[11] Univ Hosp Bern, Univ Clin Visceral Surg & Med, Bern, Switzerland

[12] Univ Bern, Bern, Switzerland

[13] Cantonal Hosp St Gallen, Dept Gen Visceral Endocrine & Transplantat Surg, St Gallen, Switzerland

[14] Basel Univ Hosp, Dept Vasc & Transplant Surg, Basel, Switzerland

[15] Univ Hosp Lausanne CHUV, Visceral Surg Dept, Lausanne, Switzerland

[16] Univ Hosp Zurich, Dept Surg & Transplantat, Zurich, Switzerland

[17] Univ Hosp Zurich, Div Nephrol, Zurich, Switzerland

[18] Univ Hosp Lausanne CHUV, Transplantat Ctr, Lausanne, Switzerland

[19] Cantonal Hosp St Gallen, Clin Nephrol, St Gallen, Switzerland

[20] Bern Univ Hosp, Div Nephrol & Hypertens, Inselspital, Bern, Switzerland

[21] Univ Hosp Geneva, Dept Med, Div Nephrol, Geneva, Switzerland

来源：

AMERICAN JOURNAL OF TRANSPLANTATION | 2024年 / 24卷 / 05期

基金：

瑞士国家科学基金会;

关键词：

kidney transplantation; surgical site infection; health care-associated infection; graft loss; RISK-FACTORS; GRAFT FUNCTION; DONOR AGE; COMPLICATIONS; OUTCOMES; NETWORK; IMPACT;

D O I：

10.1016/j.ajt.2023.11.013

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Surgical site infections (SSIs) are common health care -associated infections. SSIs after kidney transplantation (K -Tx) can endanger patient and allograft survival. Multicenter studies on this early posttransplant complication are scarce. We analyzed consecutive adult K -Tx recipients enrolled in the Swiss Transplant Cohort Study who received a K -Tx be- tween May 2008 and September 2020. All data were prospectively collected with the exception of the categorization of SSI which was performed retrospectively according to the Centers for Disease Control and Prevention criteria. A total of 58 out of 3059 (1.9%) K -Tx recipients were affected by SSIs. Deep incisional (15, 25.9%) and organ/space infections (34, 58.6%) predominated. In the majority of SSIs (52, 89.6%), bacteria were detected, most frequently Escherichia coli (15, 28.9%), Enterococcus spp. (14, 26.9%), and coagulase-negative staphylococci (13, 25.0%). A BMI >25 kg/m(2) (multivariable OR 2.16, 95% CI 1.07-4.34, P = .023) and delayed graft function (multivariable OR 2.88, 95% CI 1.56-5.34, P = .001) were independent risk factors for SSI. In Cox proportional hazard models, SSI was independently associated with graft loss (multivariable HR 3.75, 95% CI 1.35-10.38, P = .011). In conclusion, SSI was a rare complication after K -Tx. BMI >25 kg/ m(2) and delayed graft function were independent risk factors. SSIs were independently associated with graft loss.

引用

页码：795 / 802

页数：8

共 33 条

[1] EFFECT OF DONOR AGE ON OUTCOME OF KIDNEY-TRANSPLANTATION - A 2-YEAR ANALYSIS OF TRANSPLANTS REPORTED TO THE UNITED-NETWORK-FOR-ORGAN-SHARING-REGISTRY [J].

ALEXANDER, JW ;

BENNETT, LE ;

BREEN, TJ .

TRANSPLANTATION, 1994, 57 (06) :871-876

[2]

[Anonymous], R: A language and environment for statistical computing

[3] Morbidity and mortality associated with surgical site infections:: results from the 1997-1999 INCISO surveillance [J].

Astagneau, P ;

Rioux, C ;

Golliot, F ;

Brücker, G .

JOURNAL OF HOSPITAL INFECTION, 2001, 48 (04) :267-274

[4] Trends in the Causes of Death among Kidney Transplant Recipients in the United States (1996-2014) [J].

Awan, Ahmed A. ;

Niu, Jingbo ;

Pan, Jenny S. ;

Erickson, Kevin F. ;

Mandayam, Sreedhar ;

Winkelmayer, Wolfgang C. ;

Navaneethan, Sankar D. ;

Ramanathan, Venkat .

AMERICAN JOURNAL OF NEPHROLOGY, 2018, 48 (06) :472-481

[5] Centers for Disease Control and Prevention Guideline for the Prevention of Surgical Site Infection, 2017 [J].

Berrios, Sandra I. ;

Umscheid, Craig A. ;

Bratzler, Dale W. ;

Leas, Brian ;

Stone, Erin C. ;

Kelz, Rachel R. ;

Reinke, Caroline E. ;

Morgan, Sherry ;

Solomkin, Joseph S. ;

Mazuski, John E. ;

Dellinger, E. Patchen ;

Itani, Kamal M. F. ;

Berbari, Elie F. ;

Segreti, John ;

Parvizi, Javad ;

Blanchard, Joan ;

Allen, George ;

Kluytmans, Jan A. J. W. ;

Donlan, Rodney ;

Schecter, William P. .

JAMA SURGERY, 2017, 152 (08) :784-791

[6]

Centers for Disease Control and Prevention, 2020, Surgical site infection (SSI) Event

[7] Patient and graft outcomes from deceased kidney donors age 70 years and older: An analysis of the Organ Procurement Transplant Network/United Network of Organ Sharing database [J].

Chavalitdhamrong, Disaya ;

Gill, Jagbir ;

Takemoto, Steve ;

Madhira, Bhaskara R. ;

Cho, Yong W. ;

Shah, Tariq ;

Bunnapradist, Suphamai .

TRANSPLANTATION, 2008, 85 (11) :1573-1579

[8] Adverse impact of surgical site infections in English hospitals [J].

Coello, R ;

Charlett, A ;

Wilson, J ;

Ward, V ;

Pearson, A ;

Borriello, P .

JOURNAL OF HOSPITAL INFECTION, 2005, 60 (02) :93-103

[9] Nosocomial infections in renal transplant patients: risk factors and treatment implications associated with urinary tract and surgical site infections [J].

Dantas, S. R. P. E. ;

Kuboyama, R. H. ;

Mazzali, M. ;

Moretti, M. L. .

JOURNAL OF HOSPITAL INFECTION, 2006, 63 (02) :117-123

[10]

Federal Office for Public Health, Figures on organ donation and transplantation

← 1 2 3 4 →