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Incidence Rate of Post-Kidney Transplant Infection: A Retrospective Cohort Study Examining Infection Rates at a Large Canadian Multicenter Tertiary-Care Facility

BACKGROUND: Reducing post-operative infections among kidney transplant patients is critical to improve long-term outcomes. With shifting disease demographics and implementation of new transplantation protocols, frequent evaluation of infection rate and type is necessary. OBJECTIVE: Our objectives we...

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Autores principales: Cowan, Juthaporn, Bennett, Alexandria, Fergusson, Nicholas, McLean, Cheynne, Mallick, Ranjeeta, Cameron, D. William, Knoll, Greg
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6136109/
https://www.ncbi.nlm.nih.gov/pubmed/30224973
http://dx.doi.org/10.1177/2054358118799692
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author Cowan, Juthaporn
Bennett, Alexandria
Fergusson, Nicholas
McLean, Cheynne
Mallick, Ranjeeta
Cameron, D. William
Knoll, Greg
author_facet Cowan, Juthaporn
Bennett, Alexandria
Fergusson, Nicholas
McLean, Cheynne
Mallick, Ranjeeta
Cameron, D. William
Knoll, Greg
author_sort Cowan, Juthaporn
collection PubMed
description BACKGROUND: Reducing post-operative infections among kidney transplant patients is critical to improve long-term outcomes. With shifting disease demographics and implementation of new transplantation protocols, frequent evaluation of infection rate and type is necessary. OBJECTIVE: Our objectives were to assess the incidence and types of post-operative infections in kidney transplant recipients at a large tertiary-care facility and determine sample sizes needed for future intervention trials. DESIGN: Retrospective cohort study. SETTING: The Ottawa Hospital, Ottawa, Ontario. PATIENTS: Adult kidney transplant patients, N = 142. MEASUREMENTS: Demographic data, transplant protocol, infections up to 2 years following transplantation. METHODS: Infections within 2 years following transplantation in all kidney transplant recipients between January 2011 and December 2012 were reviewed. Sample sizes were determined using all-cause infection rates and infection-free survival data. RESULTS: Of 142 patients, 44 (31.0%) had at least one infection. The incidence of infection was 36.2 per 100 patient-years by 2 years post-transplant. A total of 32 (22.5%) patients had 56 infection-related hospitalizations with 73.2% occurring in the first year. In the first 2 years, urinary tract infections had the highest incidence (18.1 per 100 patient-years) followed by skin (3.9 per 100 patient-years), cytomegalovirus (3.9 per 100 patient-years), and bacteremia (3.9 per 100 patient-years). Results indicate that 206 patients per study arm would be needed to show a 30% reduction in the 2-year incidence of infection post-transplantation. LIMITATIONS: Infection rates may be slightly underestimated due to the relatively short 2-year follow-up; however, the highest infection-risk period was captured within this time frame. CONCLUSIONS: Infections post-kidney transplant are still common, particularly urinary tract infections. They are associated with significant morbidity and hospitalization. Given the feasible sample sizes calculated in this study, intervention trials are indicated to further reduce infection rates within the first 2 years post-kidney transplantation.
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spelling pubmed-61361092018-09-17 Incidence Rate of Post-Kidney Transplant Infection: A Retrospective Cohort Study Examining Infection Rates at a Large Canadian Multicenter Tertiary-Care Facility Cowan, Juthaporn Bennett, Alexandria Fergusson, Nicholas McLean, Cheynne Mallick, Ranjeeta Cameron, D. William Knoll, Greg Can J Kidney Health Dis Original Research Article BACKGROUND: Reducing post-operative infections among kidney transplant patients is critical to improve long-term outcomes. With shifting disease demographics and implementation of new transplantation protocols, frequent evaluation of infection rate and type is necessary. OBJECTIVE: Our objectives were to assess the incidence and types of post-operative infections in kidney transplant recipients at a large tertiary-care facility and determine sample sizes needed for future intervention trials. DESIGN: Retrospective cohort study. SETTING: The Ottawa Hospital, Ottawa, Ontario. PATIENTS: Adult kidney transplant patients, N = 142. MEASUREMENTS: Demographic data, transplant protocol, infections up to 2 years following transplantation. METHODS: Infections within 2 years following transplantation in all kidney transplant recipients between January 2011 and December 2012 were reviewed. Sample sizes were determined using all-cause infection rates and infection-free survival data. RESULTS: Of 142 patients, 44 (31.0%) had at least one infection. The incidence of infection was 36.2 per 100 patient-years by 2 years post-transplant. A total of 32 (22.5%) patients had 56 infection-related hospitalizations with 73.2% occurring in the first year. In the first 2 years, urinary tract infections had the highest incidence (18.1 per 100 patient-years) followed by skin (3.9 per 100 patient-years), cytomegalovirus (3.9 per 100 patient-years), and bacteremia (3.9 per 100 patient-years). Results indicate that 206 patients per study arm would be needed to show a 30% reduction in the 2-year incidence of infection post-transplantation. LIMITATIONS: Infection rates may be slightly underestimated due to the relatively short 2-year follow-up; however, the highest infection-risk period was captured within this time frame. CONCLUSIONS: Infections post-kidney transplant are still common, particularly urinary tract infections. They are associated with significant morbidity and hospitalization. Given the feasible sample sizes calculated in this study, intervention trials are indicated to further reduce infection rates within the first 2 years post-kidney transplantation. SAGE Publications 2018-09-12 /pmc/articles/PMC6136109/ /pubmed/30224973 http://dx.doi.org/10.1177/2054358118799692 Text en © The Author(s) 2018 http://www.creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Research Article
Cowan, Juthaporn
Bennett, Alexandria
Fergusson, Nicholas
McLean, Cheynne
Mallick, Ranjeeta
Cameron, D. William
Knoll, Greg
Incidence Rate of Post-Kidney Transplant Infection: A Retrospective Cohort Study Examining Infection Rates at a Large Canadian Multicenter Tertiary-Care Facility
title Incidence Rate of Post-Kidney Transplant Infection: A Retrospective Cohort Study Examining Infection Rates at a Large Canadian Multicenter Tertiary-Care Facility
title_full Incidence Rate of Post-Kidney Transplant Infection: A Retrospective Cohort Study Examining Infection Rates at a Large Canadian Multicenter Tertiary-Care Facility
title_fullStr Incidence Rate of Post-Kidney Transplant Infection: A Retrospective Cohort Study Examining Infection Rates at a Large Canadian Multicenter Tertiary-Care Facility
title_full_unstemmed Incidence Rate of Post-Kidney Transplant Infection: A Retrospective Cohort Study Examining Infection Rates at a Large Canadian Multicenter Tertiary-Care Facility
title_short Incidence Rate of Post-Kidney Transplant Infection: A Retrospective Cohort Study Examining Infection Rates at a Large Canadian Multicenter Tertiary-Care Facility
title_sort incidence rate of post-kidney transplant infection: a retrospective cohort study examining infection rates at a large canadian multicenter tertiary-care facility
topic Original Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6136109/
https://www.ncbi.nlm.nih.gov/pubmed/30224973
http://dx.doi.org/10.1177/2054358118799692
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