Characteristics of infection pathogens and risk of death after kidney transplantation
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1.Department of General Intensive Care Unit, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510700, China;2.Department of General Ward, West District Hospital, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510000, China;3.Department of Kidney Transplantation, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510700, China

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    Abstract:

    Objective To explore the distribution pattern of infection pathogens and risk factors for death within one year after kidney transplantation. Methods Post-surgery infection in kidney transplant recipients who underwent allogeneic kidney transplantation in a hospital and were followed up from January 2018 to December 2020 were analyzed retrospectively. The occurrence of infection and distribution of pathogens of patients who developed infection in different periods within one year after surgery were analyzed. According to the prognosis within one year, patients were divided into the survival group and the death group. Clinical data and risk factors for death between two groups of patients were compared. Results Among the 326 kidney transplant patients, 119 had at least once infection within one year after surgery, a total of 145 episodes of infection occurred. A total of 71 bacterial strains, 31 fungal strains, and 26 viral strains were isolated. The main infection type was pulmonary infection (53.1%). Bacterial infection was the main cause (86.1%) at the early stage, while fungal and viral infection increased in the middle and late stages. There were 104 cases in the survival group and 15 cases in the death group. Pulmonary infection and opportunistic infection were the main causes of death caused by infection after kidney transplantation. Compared with the survival group, patients in the death group had higher proportion of delayed recovery of kidney function and acute rejection, lower level of serum albumin level 28 days after surgery, and higher blood drug concentration of FK506, with statistically significant differences(all P < 0.05). Binary logistic regression analysis showed that delayed recovery of the function of transplanted kidney was an independent risk factor for infection-related death (OR=4.479, P < 0.05), while high serum albumin level was a protective factor (OR=0.266, P < 0.05). Conclusion Pulmonary infection and opportunistic infection are the main causes for death after kidney transplantation. Health care workers should pay attention to patients with delayed recovery of kidney function and monitor changes in serum albumin levels after surgery.

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冼盈,段智勤,李衡,等.肾移植术后感染病原菌特点及死亡风险[J].中国感染控制杂志英文版,2023,(5):539-546. DOI:10.12138/j. issn.1671-9638.20233265.
Ying XIAN, Zhi-qin DUAN, Heng LI, et al. Characteristics of infection pathogens and risk of death after kidney transplantation[J]. Chin J Infect Control, 2023,(5):539-546. DOI:10.12138/j. issn.1671-9638.20233265.

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History
  • Received:August 18,2022
  • Revised:
  • Adopted:
  • Online: April 28,2024
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