Epidemiology, risk factors and impact on long-term pancreatic function of infection following pancreas-kidney transplantation. [artículo]
Por: Aguado García, José María [Enfermedades Infecciosas]
| Andrés Belmonte, Amado [Nefrología] | De Dios, B [Instituto de Investigación i+12] | García Reyne, Ana [Medicina Interna] | Gutiérrez Martínez, Eduardo [Nefrología] | Herrero Martínez, Juan María [Medicina Interna] | Jiménez Romero, Carlos [Cirugía General y del Aparato Digestivo] | Lizasoaín Hernández, Manuel [Medicina Interna] | López Medrano, Francisco [Enfermedades Infecciosas] | Lumbreras Bermejo, Carlos [Medicina Interna] | Manrique Municio, Alejandro [Cirugía General y del Aparato Digestivo] | Moreno González, Enrique [Cirugía General y del Aparato Digestivo] | San Juan Garrido, Rafael [Medicina Interna].
Colaborador(es): Servicio de Medicina Interna | Servicio de Nefrología | Servicio de Cirugía General y del Aparato Digestivo | Instituto de Investigación imas12.
Editor: Clinical microbiology and infection: the official publication of the European Society of Clinical Microbiology and Infectious Diseases, 2013Descripción: 19(12):1132-9.Recursos en línea: Solicitar documento Resumen: Limited information exists about epidemiology and risk factors of infection following pancreas-kidney transplantation and its impact on long-term pancreatic graft function. A retrospective chart review of episodes of severe infection in consecutive pancreas-kidney transplantations in a single institution was performed to assess the epidemiology, risk factors for infection and their impact on the development of pancreatic graft dysfunction. Ninety-four (81%) of 116 recipients (median follow-up of 1492 days; mean 1594) developed 248 episodes of severe infection. Bacterial infections were present in 208 episodes, with 12% of the isolates resistant to antibiotics used in prophylaxis. There were 40 episodes of fungal infection in 32 patients (28%) (mostly Candida spp), and CMV disease appeared in 20 patients (17%), of which 50% appeared after the third month following surgery. The multivariate analysis identified that surgical re-intervention and the use of steroid pulses were independently associated with the development of any infection. Additionally, pre-transplant evidence of peripheral artery disease, a longer cold ischaemia time and high transfusional requirements were associated with fungal infections. Cytomegalovirus (CMV) mismatch was independently related to CMV disease and female sex, and bladder drainage of the exocrine pancreas was associated with urinary tract infection. At the end of follow-up, 29 patients (25%) had developed severe pancreatic graft dysfunction, and fungal infection was independently associated with it. Our study identifies a subset of pancreas-kidney transplant recipients at a higher risk of developing severe infection. Fungal infection is an independent risk factor for the development of severe pancreatic graft dysfunction.
| Tipo de ítem | Ubicación actual | Signatura | Estado | Fecha de vencimiento |
|---|---|---|---|---|
Artículo
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PC10059 (Navegar estantería) | Disponible |
Navegando Hospital Universitario 12 de Octubre Estantes Cerrar el navegador de estanterías
Formato Vancouver:
Herrero-Martínez JM, Lumbreras C, Manrique A, San-Juan R, García-Reyne A, López-Medrano F et al. Epidemiology, risk factors and impact on long-term pancreatic function of infection following pancreas-kidney transplantation. Clin Microbiol Infect. 2013 Dec;19(12):1132-9.
PMID: 23480521
Contiene 25 referencias
Limited information exists about epidemiology and risk factors of infection following pancreas-kidney transplantation and its impact on long-term pancreatic graft function. A retrospective chart review of episodes of severe infection in consecutive pancreas-kidney transplantations in a single institution was performed to assess the epidemiology, risk factors for infection and their impact on the development of pancreatic graft dysfunction. Ninety-four (81%) of 116 recipients (median follow-up of 1492 days; mean 1594) developed 248 episodes of severe infection. Bacterial infections were present in 208 episodes, with 12% of the isolates resistant to antibiotics used in prophylaxis. There were 40 episodes of fungal infection in 32 patients (28%) (mostly Candida spp), and CMV disease appeared in 20 patients (17%), of which 50% appeared after the third month following surgery. The multivariate analysis identified that surgical re-intervention and the use of steroid pulses were independently associated with the development of any infection. Additionally, pre-transplant evidence of peripheral artery disease, a longer cold ischaemia time and high transfusional requirements were associated with fungal infections. Cytomegalovirus (CMV) mismatch was independently related to CMV disease and female sex, and bladder drainage of the exocrine pancreas was associated with urinary tract infection. At the end of follow-up, 29 patients (25%) had developed severe pancreatic graft dysfunction, and fungal infection was independently associated with it. Our study identifies a subset of pancreas-kidney transplant recipients at a higher risk of developing severe infection. Fungal infection is an independent risk factor for the development of severe pancreatic graft dysfunction.
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