Epidemiology and outcomes of bone and joint infections in solid organ transplant recipients.

Pham, Truong-Thanh; Andrey, Diego O; Stampf, Susanne; Burkhard, Sara H; Hirzel, Cedric; Tschopp, Johnathan; Ullrich, Kathrin; Strahm, Carol; Schreiber, Peter W; Boillat-Blanco, Noémie; Garzoni, Christian; Khanna, Nina; Manuel, Oriol; Mueller, Nicolas J; Suva, Domizio; van Delden, Christian; Uçkay, Ilker; Neofytos, Dionysios (2022). Epidemiology and outcomes of bone and joint infections in solid organ transplant recipients. American journal of transplantation, 22(12), pp. 3031-3046. Wiley 10.1111/ajt.17184

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Bone and joint infection (BJI) epidemiology and outcomes in solid organ transplant recipients (SOTr) remain largely unknown. We aim to describe BJI in a multi-center cohort of SOTr (Swiss Transplant Cohort Study). All consecutive SOTr with BJI (01.05.2008-31.12.2019) were included. A nested case-control study to identify risk factors for BJI was performed. Among 4,482 patients, 61 SOTr with 82 BJI were included, at an incidence of 1.4% (95%CI 1.1-1.7), higher in heart and kidney-pancreas SOTr (Gray's test p<0.01). Although BJI were predominately late events (median of 18.5 months post-SOT), most infections occurred during the first year post-transplant in thoracic SOTr. Diabetic foot osteomyelitis was the most frequent infection (38/82, 46.3%), followed by non-vertebral osteomyelitis (26/82, 31.7%). Pathogens included Gram-positive cocci (70/131, 53.4%), Gram-negative bacilli (34/131, 26.0%), and fungi (9/131, 6.9%). BJI predictors included male gender (OR 2.94, 95% CI 1.26-6.89) and diabetes (OR 2.97, 95% CI 1.34-6.56). Treatment failure was observed in 25.9% (21/81) patients and 1-year mortality post-BJI diagnosis was 14.8% (9/61). BJI remain a rare event in SOTr, associated with subtle clinical presentations, high morbidity and relapses, requiring additional studies in the future.

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:	Hirzel, Cédric
Subjects:	600 Technology > 610 Medicine & health
ISSN:	1600-6143
Publisher:	Wiley
Language:	English
Submitter:	Pubmed Import
Date Deposited:	31 Aug 2022 10:26
Last Modified:	05 Dec 2022 16:23
Publisher DOI:	10.1111/ajt.17184
PubMed ID:	36031963
Uncontrolled Keywords:	BJI Solid organ transplant recipients bone and joint infection epidemiology
URI:	https://boris.unibe.ch/id/eprint/172491