Izvorni znanstveni članak
https://doi.org/10.3325/cmj.2018.59.224
Preponderance of microbial isolates among heart transplantation recipients requiring renal replacement therapy: a propensity scoreadjusted analysis
Hrvoje Gašparović
; Department of Cardiac Surgery University Hospital Center Zagreb, Zagreb, Croatia
Lucija Svetina
; Department of Cardiac Surgery University Hospital Center Zagreb, Zagreb, Croatia
Filip Lončarić
; Department of Cardiac Surgery University Hospital Center Zagreb, Zagreb, Croatia
Jana Ljubas
; Department of Cardiology University Hospital Center Zagreb,Zagreb, Croatia
Maja Čikeš
; Department of Cardiology University Hospital Center Zagreb, Zagreb, Croatia
Bojan Biočina
; Department of Cardiac Surgery University Hospital Center Zagreb, Zagreb, Croatia
Davor Miličić
; Department of Cardiology University Hospital Center Zagreb, Zagreb, Croatia
Sažetak
Aim To assess the association between renal replacement
therapy (RRT) and post-transplant infection incidence.
Methods This single-center retrospective cohort study included
158 patients who underwent heart transplantation
(HTx) in our center from 2008 to 2016, survived beyond the
first post-procedural day, and had available microbial data.
The patients were dichotomized according to the need for
periprocedural RRT. Twenty-seven patients in RRT group
had lower preoperative creatinine clearance, greater body
mass index, and higher likelihood of having diabetes. Propensity
score adjustment was used to account for multiple
covariates. The primary outcome measure was the presence
of bacteremia in patients with and without the need
for RRT. The secondary outcome measures were the presence
of microbial isolates from any culture and clinical outcome
data. Results Unadjusted analysis showed that the RRT group
had higher incidence of any positive microbial isolate
(93% vs 73%; odds ratio [OR] 4.77, 95% confidence interval
[CI] 1.01-30.53; P = 0.026) and an increased susceptibility
to bacteremia (50% vs 22%; OR 3.50, 95% CI 1.28-9.67;
P = 0.012). Propensity score-adjusted analysis corroborated
the between-group difference in positive blood cultures
(OR 3.97, 95% CI 1.28-12.32; P = 0.017). There was no difference
in the incidence of total microbial isolates between
the groups (OR 4.55, 95% CI 0.90-23.05; P = 0.067).
Conclusions Patients requiring RRT after HTx had an increased
susceptibility to infections via various portals of
entry, predominantly due to an increase in blood-borne
infections. Understanding the underlying conditions leading
to infection-related morbidity is important for infection
control and prevention.
Ključne riječi
Hrčak ID:
239182
URI
Datum izdavanja:
16.10.2018.
Posjeta: 573 *