Bos Feline, Gueneau Romain, Crepin Thomas, Tinévez Claire, Taton Benjamin, Couzi Lionel, Moreau Karine, Schvartz Betoul, Perrin Peggy, Gatault Philippe, Scemla Anne, Chatelet-Pouliquen Valérie, Levi Charlène, Kamar Nassim, Lanternier Fanny, Lanotte Philippe, Neau Didier, Merville Pierre, Lehours Philippe, Puges Mathilde, Kaminski Hannah
Infectious and Tropical Diseases Department, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France.
Department of Nephrology, Transplantation, Dialysis and Apheresis, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France.
Open Forum Infect Dis. 2024 Sep 4;11(9):ofae498. doi: 10.1093/ofid/ofae498. eCollection 2024 Sep.
Campylobacteriosis in kidney transplant recipients (KTRs) is the most common identified bacterial cause of diarrhea. Risk factors in KTRs are unknown.
A 10-year multicentric, retrospective 1:1 case-control study was performed in France between 2010 and 2020. The main aim was to identify factors associated with -related infection in KTRs. The KTRs with a functional graft and campylobacteriosis (positive stool culture and/or blood culture and/or positive nucleic amplification test) and their controls matched on transplantation date within the same center were included.
We identified 326 patients with campylobacteriosis. The estimated incidence rate of campylobacteriosis was 2.3/1000 patient-years. The infection occurred at a median of 2.4 years posttransplantation. The independent risk factors for campylobacteriosis were use of corticosteroids as maintenance regimen (75.8% vs 66%; < .001), acute rejection (8.9% vs 4%; = .048), low lymphocyte count (0.96 vs 1.4 giga/liter (G/L); < .001), and low basal estimated glomerular filtration rate (eGFR) (44.2 vs 57.5 mL/minute/1.73 m; < .001). A fluoroquinolone was initiated in 64 (21.4%) patients, with 51.1% of antimicrobial resistance, whereas almost all strains were erythromycin sensitive.
Campylobacteriosis has a higher incidence in the 2 first years of transplantation. The factors independently associated with campylobacteriosis are corticosteroids as maintenance immunosuppressive regimen, low lymphocyte counts, low eGFR, and a history of acute rejection. Due to high antimicrobial resistance with fluoroquinolone, the first line of treatment should be azithromycin.
肾移植受者（KTRs）中的弯曲杆菌病是已确定的腹泻最常见细菌病因。KTRs中的危险因素尚不清楚。
2010年至2020年期间在法国进行了一项为期10年的多中心回顾性1:1病例对照研究。主要目的是确定与KTRs中弯曲杆菌相关感染相关的因素。纳入具有功能正常移植物且患有弯曲杆菌病（粪便培养阳性和/或血培养阳性和/或核酸扩增试验阳性）的KTRs及其在同一中心移植日期匹配的对照。
我们确定了326例弯曲杆菌病患者。弯曲杆菌病的估计发病率为2.3/1000患者年。感染发生在移植后的中位数2.4年。弯曲杆菌病的独立危险因素为使用皮质类固醇作为维持方案（75.8%对66%；P<0.001）、急性排斥反应（8.9%对4%；P=0.048）、淋巴细胞计数低（0.96对1.4千兆/升（G/L）；P<0.001）以及基础估计肾小球滤过率（eGFR）低（44.2对57.5毫升/分钟/1.73平方米；P<0.001）。64例（21.4%）患者开始使用氟喹诺酮，其中51.1%有抗菌药物耐药性，而几乎所有菌株对红霉素敏感。
弯曲杆菌病在移植后的头两年发病率较高。与弯曲杆菌病独立相关的因素为作为维持免疫抑制方案的皮质类固醇、淋巴细胞计数低、eGFR低以及急性排斥反应史。由于氟喹诺酮的高抗菌药物耐药性，一线治疗应为阿奇霉素。
