168. Epidemiology, Risk Factors and Outcome of Bloodstream Infection Within the First Year After Kidney Transplantation

BACKGROUND: Bloodstream infections (BSIs) are an important cause of morbidity and mortality among kidney transplant (KT) recipients, especially within the first year. We investigated for an epidemiology, risk factors and outcome of this specific infection following KT. METHODS: We conducted a retrospective study of all adult KT recipients who developed BSI within the first year after KT from January to December 2016 at a large referral single transplant center in Bangkok, Thailand. The cumulative incidence of BSI after transplant was estimated with Kaplan–Meier methodology. Clinical characteristics, microbiological data, and outcome were extracted. Risk factors for BSI were assessed with multivariate Cox proportional hazards models. RESULTS: A total of 26 (15.2%) episodes of BSI occurred in 171 KT recipients, 58.5% of them were men and the mean ± SD age was 43 ± 12 years. The majority received deceased-donor allograft (58.5%) and induction therapy (59%). The Kaplan–Meier estimated for BSIs were 12.3% at 3 months, 13.5% at 6 months, and 15.2% at 12 months after KT. Gram-negative bacteria were responsible for 92% of BSI, with Escherichia coli was the most common causative pathogen (65%) and 71% of those produced extended-spectrum β-lactamases enzyme. The genitourinary tracts were the predominant source of BSIs (85%). In a multivariate analysis, the second kidney transplantation [HR, 4.55; 95% CI, 1.24–16.79 (P =0.02)] and receiving induction therapy [HR, 3.05; 95% CI, 1.15–8.10 (P<0.03)] were associated with BSI. One patient (4%) developed acute cellular rejection and one patient (4%) died from septic shock. CONCLUSION: One-sixth of KT recipients could develop gram-negative bloodstream infection within the first year after KT especially those underwent the second transplantation or received induction therapy. [Image: see text] DISCLOSURES: All authors: No reported disclosures.