Surgical site infections after simultaneous pancreas kidney and pancreas transplantation in the Swiss Transplant Cohort Study.
Hospital-acquired infection
Pancreas transplantation
Simultaneous kidney–pancreas transplantation
Surgical site infection
Journal
The Journal of hospital infection
ISSN: 1532-2939
Titre abrégé: J Hosp Infect
Pays: England
ID NLM: 8007166
Informations de publication
Date de publication:
Oct 2022
Oct 2022
Historique:
received:
21
03
2022
revised:
01
07
2022
accepted:
04
07
2022
pubmed:
16
7
2022
medline:
6
10
2022
entrez:
15
7
2022
Statut:
ppublish
Résumé
Among hospital-acquired infections, surgical site infections (SSIs) are frequent. SSI in the early post-transplant course poses a relevant threat to transplant recipients. To determine incidence, risk factors for SSI and its association with post-transplant outcomes and pancreas transplant (P-Tx) recipients. Adult simultaneous kidney-pancreas transplantation (SPK-T) and P-Tx recipients with a follow-up of at least 90 days were identified in the Swiss Transplant Cohort Study (STCS) dataset. Except for the categorization of SSIs according to Centers for Disease Control and Prevention (CDC) criteria, all other data were prospectively collected. Risk factors for SSI were investigated with logistic regression. A Weibull accelerated failure-time model was applied to address the impact of SSI on length of stay, correcting for transplant-related complications and delayed graft function. Of 130 transplant recipients, 108 SPK-Tx and 22 P-Tx, 18 (14%) individuals developed SSI within the first 90 days after transplantation. Deep incisional (seven, 38.9%) and organ/space infections (eight, 44.4%) predominated. In the majority of SSIs (11, 61.1%; two SSIs with simultaneous identification of fungal pathogens) bacteria were detected with Enterococcus spp. being most frequent. The median duration of hospitalization after transplantation was significantly longer in recipients with SSI (median: 26 days; interquartile range (IQR): 19-44) than in patients without SSI (median: 17 days; IQR: 12-25; P = 0.002). In multivariate analysis, SSI was significantly associated with increased length of stay and prolonged the duration of hospitalization by 36% (95% confidence interval: 4-79). SSI after SPK-Tx and P-Tx occurred at a frequency of 14%. Among pathogens, Enterococcus spp. predominated. SSI was independently associated with a longer hospitalization after transplantation.
Sections du résumé
BACKGROUND
BACKGROUND
Among hospital-acquired infections, surgical site infections (SSIs) are frequent. SSI in the early post-transplant course poses a relevant threat to transplant recipients.
AIM
OBJECTIVE
To determine incidence, risk factors for SSI and its association with post-transplant outcomes and pancreas transplant (P-Tx) recipients.
METHODS
METHODS
Adult simultaneous kidney-pancreas transplantation (SPK-T) and P-Tx recipients with a follow-up of at least 90 days were identified in the Swiss Transplant Cohort Study (STCS) dataset. Except for the categorization of SSIs according to Centers for Disease Control and Prevention (CDC) criteria, all other data were prospectively collected. Risk factors for SSI were investigated with logistic regression. A Weibull accelerated failure-time model was applied to address the impact of SSI on length of stay, correcting for transplant-related complications and delayed graft function.
FINDINGS
RESULTS
Of 130 transplant recipients, 108 SPK-Tx and 22 P-Tx, 18 (14%) individuals developed SSI within the first 90 days after transplantation. Deep incisional (seven, 38.9%) and organ/space infections (eight, 44.4%) predominated. In the majority of SSIs (11, 61.1%; two SSIs with simultaneous identification of fungal pathogens) bacteria were detected with Enterococcus spp. being most frequent. The median duration of hospitalization after transplantation was significantly longer in recipients with SSI (median: 26 days; interquartile range (IQR): 19-44) than in patients without SSI (median: 17 days; IQR: 12-25; P = 0.002). In multivariate analysis, SSI was significantly associated with increased length of stay and prolonged the duration of hospitalization by 36% (95% confidence interval: 4-79).
CONCLUSION
CONCLUSIONS
SSI after SPK-Tx and P-Tx occurred at a frequency of 14%. Among pathogens, Enterococcus spp. predominated. SSI was independently associated with a longer hospitalization after transplantation.
Identifiants
pubmed: 35840001
pii: S0195-6701(22)00224-9
doi: 10.1016/j.jhin.2022.07.009
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
47-53Investigateurs
P Amico
(P)
J-D Aubert
(JD)
V Banz
(V)
S Beckmann
(S)
G Beldi
(G)
C Berger
(C)
E Berishvili
(E)
A Berzigotti
(A)
I Binet
(I)
P-Y Bochud
(PY)
S Branca
(S)
H Bucher
(H)
E Catana
(E)
A Cairoli
(A)
Y Chalandon
(Y)
S De Geest
(S)
O De Rougemont
(O)
S De Seigneux
(S)
M Dickenmann
(M)
J L Dreifuss
(JL)
M Duchosal
(M)
T Fehr
(T)
S Ferrari-Lacraz
(S)
C Garzoni
(C)
D Golshayan
(D)
N Goossens
(N)
F H J Halter
(FHJ)
D Heim
(D)
C Hess
(C)
S Hillinger
(S)
H H Hirsch
(HH)
P Hirt
(P)
G Hofbauer
(G)
U Huynh-Do
(U)
F Immer
(F)
M Koller
(M)
M Laager
(M)
B Laesser
(B)
F Lamoth
(F)
R Lehmann
(R)
A Leichtle
(A)
O Manuel
(O)
H P Marti
(HP)
M Martinelli
(M)
V McLin
(V)
K Mellac
(K)
A Merçay
(A)
K Mettler
(K)
A Müller
(A)
N J Mueller
(NJ)
U Müller-Arndt
(U)
B Müllhaupt
(B)
M Nägeli
(M)
G Oldani
(G)
M Pascual
(M)
J Passweg
(J)
R Pazeller
(R)
K Posfay-Barbe
(K)
J Rick
(J)
A Rosselet
(A)
S Rossi
(S)
S Rothlin
(S)
F Ruschitzka
(F)
T Schachtner
(T)
U Schanz
(U)
S Schaub
(S)
A Scherrer
(A)
A Schnyder
(A)
M Schuurmans
(M)
S Schwab
(S)
T Sengstag
(T)
F Simonetta
(F)
S Stampf
(S)
J Steiger
(J)
G Stirnimann
(G)
U Stürzinger
(U)
C Van Delden
(C)
J-P Venetz
(JP)
J Villard
(J)
J Vionnet
(J)
M Wick
(M)
M Wilhelm
(M)
P Yerly
(P)
Informations de copyright
Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.