Hospitalizations for Bacterial Septicemia after Renal Transplantation in the United States

Abstract

Background: It is common belief in the transplant community that rates of septicemia in transplant recipients have declined, but this has not been studied in a national population. Methods: Therefore, 33,479 renal transplant recipients in the United States Renal Data System from July 1, 1994 to June 30, 1997 were analyzed in a retrospective registry study of the incidence, associated factors, and mortality of hospitalizations with a primary discharge diagnosis of septicemia (ICD9 Code 038.x). Results: Renal transplant recipients had an adjusted incidence ratio of hospitalizations for septicemia of 41.52 (95% CI 35.45–48.96) compared to the general population. Hospitalizations for septicemia were most commonly associated with urinary tract infection as a secondary diagnosis (30.6%). In multivariate analysis, diabetes and urologic disease, female gender, delayed graft function, rejection, and pre-transplant dialysis, but not induction antibody therapy, were associated with hospitalizations for septicemia. Recipients hospitalized for septicemia had a mean patient survival of 9.03 years (95% CI 7.42–10.63) compared to 15.73 years (95% CI 14.77–16.69) for all other recipients. Conclusions: Even in the modern era, renal transplant recipients remain at high risk for hospitalizations for septicemia, which are associated with substantially decreased patient survival. Newly identified risks in this population were female recipients and pre-transplant dialysis.

Hospitalized Nephrolithiasis after Renal Transplantation in the United States

“…It may also possibly be related to the higher rate of urinary tract infections and subsequent serious infections after renal transplantation (19), but this remains to be demonstrated.…”

“…The demographics of the renal transplant population have been previously described (2001 USRDS report). SAF.TXUNOS was used as the primary dataset, and merged with variables from SAF.HOSP for hospitalization data, and SAF.PATIENTS for dates and causes of death as well as causes of renal disease, as previously reported (12)(13)(14). Patient characteristics and treatment factors were those at the date of transplant.…”

The Role of Host Factors and Bacterial Virulence Genes in the Development of Pyelonephritis Caused by Escherichia coli in Renal Transplant Recipients

“…Especially in the setting of renal transplantation, asymptomatic bacteriuria or symptomatic forms such as cystitis (Cys) and pyelonephritis (PN) account for approximately 47% of infectious complications (1) and up to 60% of bacteremias (2). The development of UTIs depends on anatomical factors, the integrity of host defense mechanisms, and the virulence of the infecting organisms (3).…”

Shigellemia in a post renal transplant patient: a case report and literature review

“…A retrospective study of 33,479 renal transplants conducted in the US showed an adjusted incidence ratio of 41.52% of hospitalization due to septicemia [5]. With only a handful of reported cases of septicemia due to Shigella spp.…”