Burden and Timeline of Infectious Diseases in the First Year After Solid Organ Transplantation in the Swiss Transplant Cohort Study.

van Delden, Christian; Stampf, Susanne; Hirsch, Hans H; Manuel, Oriol; Meylan, Pascal; Cusini, Alexia; Hirzel, Cédric; Khanna, Nina; Weisser, Maja; Garzoni, Christian; Boggian, Katja; Berger, Christoph; Nadal, David; Koller, Michael; Saccilotto, Ramon; Mueller, Nicolas J (2020). Burden and Timeline of Infectious Diseases in the First Year After Solid Organ Transplantation in the Swiss Transplant Cohort Study. Clinical infectious diseases, 71(7), e159-e169. Oxford University Press 10.1093/cid/ciz1113

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BACKGROUND

The burden and timeline of posttransplant infections are not comprehensively documented in the current era of immunosuppression and prophylaxis.

METHODS

In this prospective study nested within the Swiss Transplant Cohort Study (STCS), all clinically relevant infections were identified by transplant-infectious diseases physicians in persons receiving solid organ transplant (SOT) between May 2008 and December 2014 with ≥12 months of follow-up.

RESULTS

Among 3541 SOT recipients, 2761 (1612 kidney, 577 liver, 286 lung, 213 heart, and 73 kidney-pancreas) had ≥12 months of follow-up; 1520 patients (55%) suffered 3520 infections during the first year posttransplantation. Burden and timelines of clinically relevant infections differed between transplantations. Bacteria were responsible for 2202 infections (63%) prevailing throughout the year, with a predominance of Enterobacteriaceae (54%) as urinary pathogens in heart, lung, and kidney transplant recipients, and as digestive tract pathogens in liver transplant recipients. Enterococcus spp (20%) occurred as urinary tract pathogens in kidney transplant recipients and as digestive tract pathogens in liver transplant recipients, and Pseudomonas aeruginosa (9%) in lung transplant recipients. Among 1039 viral infections, herpesviruses predominated (51%) in kidney, liver, and heart transplant recipients. Among 263 fungal infections, Candida spp (60%) prevailed as digestive tract pathogens in liver transplant recipients. Opportunistic pathogens, including Aspergillus fumigatus (1.4%) and cytomegalovirus (6%), were rare, scattering over 12 months across all SOT recipients.

CONCLUSIONS

In the current era of immunosuppression and prophylaxis, SOT recipients experience a high burden of infections throughout the first year posttransplantation, with rare opportunistic pathogens and a predominance of bacteria.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Infectiology

UniBE Contributor:

Cusini, Alexia and Hirzel, Cédric

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1537-6591

Publisher:

Oxford University Press

Language:

English

Submitter:

Annelies Luginbühl

Date Deposited:

11 Feb 2020 09:43

Last Modified:

25 Oct 2020 01:31

Publisher DOI:

10.1093/cid/ciz1113

PubMed ID:

31915816

Uncontrolled Keywords:

bacterial fungal infection solid organ transplant viral

BORIS DOI:

10.7892/boris.139180

URI:

https://boris.unibe.ch/id/eprint/139180

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