Risk Factors for S. aureus Infections Post-Tx
Diana Florescu, MD
VANCOUVER, British Columbia—Younger age and steroid treatment are independently associated with an increased risk of Staphylococcus aureus (SA) infections following kidney transplantation, according to new data presented at the 48th Annual Meeting of the Infectious Diseases Society of America.
Over the past decade, SA infections have had an increasingly significant impact on patient outcomes and health care costs, but data on risk factors and outcomes of SA infections in renal transplant recipients have been lacking.
Researchers at the University of Nebraska in Omaha compared SA-infected kidney recipients with non-SA-infected controls who were matched for age, gender, and transplant type. The cases included 20 patients with SA infections; 15 patients had received kidneys, three kidney/pancreas transplants, and two patients received a kidney/liver transplant. The control group included 40 patients; 34 patients received a kidney, two kidney/pancreas transplants, two liver/small bowel/kidney transplant, one a bowel/kidney transplant, and one received a liver/kidney transplant.
Methicillin-resistant SA caused 32.1% of SA infections. The majority of the infections were surgical site infections (skin 42.9% and intra-abdominal 35.7%), followed by bloodstream (10.7%), and pulmonary infections (10.7%). Multivariate analysis revealed that steroid treatment in the previous four weeks increased the risk of developing an SA infection six fold compared with the control group. Conversely, the risk of infection decreased by 35% for every one-year increment in age.
“This is the first study to show that young age is a risk factor for Staph aureus infections in kidney recipients,” said investigator Diana Florescu, MD, Assistant Professor of Medicine. “Most of these infections will likely be diagnosed in the first month after a transplant and these infections can be prevented by following infection control policies and can be easily treated if diagnosed early.” SA infections did not influence graft and patient survival, but Dr. Florescu cautioned that the study was not powered to evaluate graft and patient survival outcomes.