Bacteremia in renal transplant recipients: retrospective analysis of 60 episodes in a teaching hospital.

BACKGROUND

Bacteremia is a major cause of death in renal transplant recipients. However, an understanding of the clinical spectrum of bacteremia post kidney transplantation in Taiwan is lacking. This study was undertaken in an attempt to analyze the causative organisms, the sites of primary infection, and the possible significant determinants of mortality.

METHODS

Eighty-six positive blood cultures from renal transplant recipients were seen at the Taichung Veterans General Hospital from August 1993 to April 1999. Sixty blood cultures obtained from episodes that occurred in 43 kidney recipients were regarded as significant and included. All the data were obtained by reviewing medical records.

RESULTS

Forty-six episodes (76.7%) of bacteremia happened 6 months after transplantation. Gram-negative bacilli accounted for 73.3% (44/60) of the cases of bacteremia. Escherichia coli, constituting 26.7% (16/60) of the etiologic agents, was the most common pathogen. In 50.0% of all episodes, urinary tract infection was the main cause of bacteremia. The overall mortality rate in this series was 16.7%. Risk of death seemed higher if bacteremia occurred with a primary site of infection other than the urinary tract (26.7% vs 6.7%) and after methylprednisolone pulse therapy (33.3% vs 12.5%), though both correlations were not statistically significant.

CONCLUSIONS

This study may shed light on the empirical therapy and better management needed for treating bacteremia in renal transplant recipients in Taiwan and provide a nidus for further prospective surveys.