Feredj Elsa, Audureau Etienne, Boueilh Anna, Fihman Vincent, Fourati Slim, Lelièvre Jean-Daniel, Gallien Sébastien, Grimbert Philippe, Matignon Marie, Melica Giovanna
Infectious Disease Department, Groupe Hospitalier Henri-Mondor/Albert Chenevier, Assistance Publique-Hôpitaux de Paris (AP-HP), 94010 Créteil, France.
IMRB (Institut Mondor de Recherche Biomédicale), Université Paris-Est-Créteil (UPEC), INSERM U955, Equipe 16, 94010 Créteil, France.
Pathogens. 2023 Jan 3;12(1):74. doi: 10.3390/pathogens12010074.
Respiratory tract infections (RTIs) are a leading cause of death after kidney transplant. Preventive strategies may be implemented during a dedicated infectious disease consultation (IDC) before transplantation. Impact of IDC on RTIs after transplant has not been determined.
We conducted a monocentric retrospective cohort analysis including all kidney transplant recipients from January 2015 to December 2019. We evaluated the impact of IDC on RTIs and identified risk and protective factors associated with RTIs.
We included 516 kidney transplant recipients. Among these, 145 had an IDC before transplant. Ninety-five patients presented 123 RTIs, including 75 (61%) with pneumonia. Patient that benefited from IDC presented significantly less RTIs ( = 0.049). RTIs were an independent risk factor of mortality (HR = 3.64 (1.97-6.73)). Independent risk factors for RTIs included HIV (OR = 3.33 (1.43-7.74)) and HCV (OR = 3.76 (1.58-8.96)). IDC was identified as an independent protective factor (OR = 0.48 (0.26-0.88)). IDC prior to transplantation is associated with diminished RTIs and is an independent protective factor. RTIs after kidney transplant are an independent risk factor of death. Implementing systematic IDC may have an important impact on reducing RTIs and related morbidity and mortality.
呼吸道感染（RTIs）是肾移植后死亡的主要原因。预防策略可在移植前专门的传染病咨询（IDC）期间实施。IDC对移植后RTIs的影响尚未确定。
我们进行了一项单中心回顾性队列分析，纳入了2015年1月至2019年12月期间所有的肾移植受者。我们评估了IDC对RTIs的影响，并确定了与RTIs相关的风险和保护因素。
我们纳入了516名肾移植受者。其中，145名在移植前进行了IDC。95名患者出现了123次RTIs，包括75次（61%）肺炎。受益于IDC的患者出现的RTIs明显较少（P = 0.049）。RTIs是死亡的独立危险因素（HR = 3.64（1.97 - 6.73））。RTIs的独立危险因素包括HIV（OR = 3.33（1.43 - 7.74））和HCV（OR = 3.76（1.58 - 8.96））。IDC被确定为独立保护因素（OR = 0.48（0.26 - 0.88））。移植前的IDC与RTIs减少相关，是一个独立保护因素。肾移植后的RTIs是死亡的独立危险因素。实施系统性IDC可能对降低RTIs及相关发病率和死亡率有重要影响。
