Nosocomial bloodstream infections in a nationwide study: comparison between solid organ transplant patients and the general population

Background The incidence of bloodstream infection (BSI) varies according to the transplanted organ. Mortality can be as high as 24%, with a significant impact on graft survival. Transplantation is a risk factor for multidrug‐resistant (MDR) organisms, but comparison with a non‐transplanted populatio...

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Published in:	Transplant infectious disease Vol. 17; no. 2; pp. 308 - 313
Main Authors:	Camargo, L.F.A., Marra, A.R., Pignatari, A.C.C., Sukiennik, T., Behar, P.P.P., Medeiros, E.A.S., Ribeiro, J., Girão, E., Correa, L., Guerra, C., Brites, C., Pereira, C.A.P., Carneiro, I., Reis, M., Souza, M.A., Barata, C.U., Edmond, M.B.
Format:	Journal Article
Language:	English
Published:	Denmark Blackwell Publishing Ltd 01-04-2015 Wiley Subscription Services, Inc
Subjects:	Acinetobacter Infections - epidemiology Acinetobacter Infections - microbiology Adolescent Adult Aged Aged, 80 and over Bacteremia - epidemiology Bacteremia - microbiology Bacteria bloodstream infection Brazil - epidemiology Candidemia - epidemiology Candidemia - microbiology Child Child, Preschool Cross Infection - epidemiology Cross Infection - microbiology Drug Resistance, Bacterial epidemiology Escherichia coli Infections - epidemiology Escherichia coli Infections - microbiology Female Fungemia - epidemiology Fungemia - microbiology hospital Humans Infant Infant, Newborn Klebsiella Infections - epidemiology Klebsiella Infections - microbiology Male Middle Aged Mortality Nosocomial infection Organisms Population Prospective Studies Pseudomonas Infections - epidemiology Pseudomonas Infections - microbiology Risk factors Staphylococcal Infections - epidemiology Staphylococcal Infections - microbiology surveillance Transplant Recipients - statistics & numerical data transplantation Transplants & implants Young Adult Brazil epidemiology bloodstream infection surveillance hospital transplantation
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Summary:	Background The incidence of bloodstream infection (BSI) varies according to the transplanted organ. Mortality can be as high as 24%, with a significant impact on graft survival. Transplantation is a risk factor for multidrug‐resistant (MDR) organisms, but comparison with a non‐transplanted population in a single large cohort has not been described. Methods This is a prospective nationwide study (16 centers) reporting data on 2364 monomicrobial nosocomial BSIs, comparing 83 episodes in solid organ transplant patients with 2447 BSIs occurring in the general hospital population. Results The prevalence of groups of infecting organisms (gram‐positive, gram‐negative, and fungi) was similar between transplant patients and the general population and a similar crude mortality rate was observed (34.9% in transplant vs. 43.3% in non‐transplant patients). Staphylococcus aureus was the single most frequently isolated organism in both groups, and Acinetobacter species was more frequently isolated in the general population. Regarding MDR organisms, Klebsiella species, and Enterobacter species resistant to cefepime, as well as Acinetobacter species resistant to meropenem, were significantly more frequent in transplant patients. Conclusion Antimicrobial resistance is higher, particularly among gram‐negative bacteria in the transplant population, although the overall mortality rate between transplant and non‐transplant patients with nosocomial BSI is similar.
Bibliography:	FAPESP istex:3B013E347E33D51664A575C0140B14630F28D29A ArticleID:TID12356 ark:/67375/WNG-JJ01H504-1 Pfizer Laboratories ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1398-2273 1399-3062
DOI:	10.1111/tid.12356