Bacteremia During the First Year After Solid Organ Transplantation: An Epidemiological Update.

Neofytos, Dionysios; Stampf, Susanne; Hoessly, Linard D; D'Asaro, Matilde; Tang, Gael Nguyen; Boggian, Katia; Hirzel, Cedric; Khanna, Nina; Manuel, Oriol; Mueller, Nicolas J; Van Delden, Christian (2023). Bacteremia During the First Year After Solid Organ Transplantation: An Epidemiological Update. Open Forum Infectious Diseases, 10(6), ofad247. Oxford University Press 10.1093/ofid/ofad247

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There are limited contemporary data on the epidemiology and outcomes of bacteremia in solid organ transplant recipients (SOTr).


Using the Swiss Transplant Cohort Study registry from 2008 to 2019, we performed a retrospective nested multicenter cohort study to describe the epidemiology of bacteremia in SOTr during the first year post-transplant.


Of 4383 patients, 415 (9.5%) with 557 cases of bacteremia due to 627 pathogens were identified. One-year incidence was 9.5%, 12.8%, 11.4%, 9.8%, 8.3%, and 5.9% for all, heart, liver, lung, kidney, and kidney-pancreas SOTr, respectively (P = .003). Incidence decreased during the study period (hazard ratio, 0.66; P < .001). One-year incidence due to gram-negative bacilli (GNB), gram-positive cocci (GPC), and gram-positive bacilli (GPB) was 5.62%, 2.81%, and 0.23%, respectively. Seven (of 28, 25%) Staphylococcus aureus isolates were methicillin-resistant, 2/67 (3%) enterococci were vancomycin-resistant, and 32/250 (12.8%) GNB produced extended-spectrum beta-lactamases. Risk factors for bacteremia within 1 year post-transplant included age, diabetes, cardiopulmonary diseases, surgical/medical post-transplant complications, rejection, and fungal infections. Predictors for bacteremia during the first 30 days post-transplant included surgical post-transplant complications, rejection, deceased donor, and liver and lung transplantation. Transplantation in 2014-2019, CMV donor-negative/recipient-negative serology, and cotrimoxazole Pneumocystis prophylaxis were protective against bacteremia. Thirty-day mortality in SOTr with bacteremia was 3% and did not differ by SOT type.


Almost 1/10 SOTr may develop bacteremia during the first year post-transplant associated with low mortality. Lower bacteremia rates have been observed since 2014 and in patients receiving cotrimoxazole prophylaxis. Variabilities in incidence, timing, and pathogen of bacteremia across different SOT types may be used to tailor prophylactic and clinical approaches.

Item Type:

Journal Article (Original Article)


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

UniBE Contributor:

Hirzel, Cédric


600 Technology > 610 Medicine & health




Oxford University Press




Pubmed Import

Date Deposited:

19 Jun 2023 11:31

Last Modified:

08 Jan 2024 12:52

Publisher DOI:


PubMed ID:


Additional Information:

Annalisa Berzigotti, Guido Stirnimann, Guido Beldi und Vanessa Banz are members of the Swiss Transplant Cohort Study

Uncontrolled Keywords:

bacteremia bloodstream infection clinical outcomes epidemiology risk factors solid organ transplant timing




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