Risk factors for Klebsiella spp. infection after solid organ transplantation: a multi-centre, case-control study.

BACKGROUND

Klebsiella spp. are a major cause of antimicrobial-resistant hospital-acquired infections. This study aimed to identify possible risk factors for Klebsiella spp. infection during the first180 days post-transplantation.

METHODS

A multi-centre, retrospective, case-control study was conducted in three hospitals in Greece and Italy between 2016 and 2021, including patients aged >50 years who had undergone solid organ transplantation.

RESULTS

In total, 202 transplant patients (115 liver, 79 kidney, seven heart and four pancreas) were included in this study, of which 120 (59.4%) suffered from at least one infection due to Klebsiella spp. (141 infections). The most common site of infection was the urinary tract (48/141, 34%), and the most common species was Klebsiella pneumoniae (132/141, 93.6%). Among all Klebsiella spp. isolates, 40.3% were carbapenem-resistant. History of cardiovascular disease [odds ratio (OR) 2.06, 95% confidence interval (CI) 1.14-3.8; P=0.019] and post-transplant intensive care unit (ICU) hospitalization for ≥3 days (OR 2.08, 95% CI 1.18-3.72; P=0.012) were independently associated with Klebsiella spp. infection among all organ recipients. In liver transplant patients, post-transplant ICU hospitalization for ≥3 days (OR 2.87, 95% CI 1.25-6.78; P=0.014) was associated with Klebsiella spp. infection, and in kidney transplant patients, history of cardiovascular disease was associated with Klebsiella spp. infection (OR 2.84, 95% CI 1.12-7.48; P=0.03).

CONCLUSION

Post-transplant ICU stay for ≥3 days and history of cardiovascular disease are associated with increased risk of Klebsiella spp. infection in solid organ transplant recipients aged >50 years.