Bloodstream infection caused by enteric organisms during the first 6 months after intestinal transplant

Research output: Contribution to journalArticle

Abstract

Background: Data on bloodstream infection (BSI) due to enteric organisms are scarce. Methods: This retrospective study (1/2009-5/2017) was aimed to evaluate the incidence of BSI episodes due to enteric organisms during the first 6 months after intestinal transplant (ITx). Differences between the first (2009-2012) and second period (2013-2017) were evaluated as they differed from each other in the perioperative fungal prophylaxis and immunosuppressive regimen. Results: Fifty-five adult patients were analyzed. Twenty-eight (51%) patients developed a total of 51 episodes of BSI. Mean time from transplant to BSI was 85.5 ± 58.8 days. The most common organisms were Klebsiella pneumoniae (33%), Enterococcus spp (31%), and Candida spp (18%). Twenty-three (45%) were multidrug resistant. The most common sources were gut translocation (35%), central line infection (20%), and intra-abdominal abscess (14%). Biopsy-proven rejection was associated with 16 (31%) of the BSI episodes. Patients during the first period were more likely to develop BSI (79% vs 41%, P = 0.03). There were more episodes of rejection associated with BSI in the first period (45% vs 14%, P = 0.03). The rate of reoperation into the abdominal cavity within 2 weeks after ITx was higher and the transplant hospital stay was longer among those who developed BSI (P = 0.04 for both). Conclusions: Half of our patients developed BSI (typically during the first 3 months). Gut translocation was the most common source of BSI. Patients with rejection and/or enteritis should be monitored closely for BSI.

Original languageEnglish (US)
Article numbere13064
JournalTransplant Infectious Disease
DOIs
StatePublished - Jan 1 2019

Keywords

  • bloodstream infection
  • enteric organisms
  • gut translocation
  • multidrug-resistant organisms
  • rejection

ASJC Scopus subject areas

  • Transplantation
  • Infectious Diseases

Fingerprint Dive into the research topics of 'Bloodstream infection caused by enteric organisms during the first 6 months after intestinal transplant'. Together they form a unique fingerprint.

  • Cite this