Moreno A, Cervera C, Gavaldá J, Rovira M, de la Cámara R, Jarque I, Montejo M, de la Torre-Cisneros J, Miguel Cisneros J, Fortún J, López-Medrano F, Gurguí M, Muñoz P, Ramos A, Carratalá J
Hospital Clínic-IDIBAPS-University of Barcelona, Barcelona, Spain.
Am J Transplant. 2007 Nov;7(11):2579-86. doi: 10.1111/j.1600-6143.2007.01964.x. Epub 2007 Sep 14.
Bloodstream infections (BSIs) are a major cause of morbidity and mortality in transplant recipients. The aim of this study is to describe the incidence, microbiology and outcomes of BSIs in transplant recipients in Spain. The Spanish Network for Research on Infection in Transplantation (RESITRA) is formed by 16 centers with transplant program in Spain. The incidence and characteristics of BSIs in transplant patients were obtained prospectively from the cohort. We included 3926 transplant recipients (2935 solid organ and 991 hematopoietic stem cell transplants). Overall, 730 episodes of BSIs were recorded with an incidence rate ranging from 3 episodes per 10 000 transplant days in kidney recipients to 44 episodes per 10 000 transplant days in allogeneic hematopoietic stem cell transplantation (HSCT). The most frequent sources were intravascular catheters and the most frequent microorganisms isolated were coagulase-negative staphylococci. Crude mortality of BSIs was 7.8%, being highest in liver recipients (16%). Multidrug resistant nonfermentative gram-negative BSIs had significantly worse prognosis than those caused by their susceptible counterparts (p = 0.015), but no differences were found between resistant and susceptible gram-negative enteric bacilli, S. aureus or Candida spp. BSIs are still a major concern in transplant recipients. The increasing isolations of multiresistant microorganisms represent a challenge for the next years.
血流感染（BSIs）是移植受者发病和死亡的主要原因。本研究旨在描述西班牙移植受者中血流感染的发病率、微生物学情况及转归。西班牙移植感染研究网络（RESITRA）由西班牙16个设有移植项目的中心组成。前瞻性地从该队列中获取移植患者血流感染的发病率及特征。我们纳入了3926例移植受者（2935例实体器官移植和991例造血干细胞移植）。总体而言，共记录到730例血流感染发作，发病率从肾移植受者每10000个移植日3例到异基因造血干细胞移植（HSCT）每10000个移植日44例不等。最常见的感染源是血管内导管，分离出的最常见微生物是凝固酶阴性葡萄球菌。血流感染的粗死亡率为7.8%，在肝移植受者中最高（16%）。多重耐药非发酵革兰阴性菌血流感染的预后明显比其敏感菌所致者差（p = 0.015），但耐药和敏感的革兰阴性肠杆菌、金黄色葡萄球菌或念珠菌属所致血流感染之间未发现差异。血流感染仍是移植受者的主要担忧问题。多重耐药微生物分离株不断增加对未来几年构成了挑战。
