Kidney damage relates to agonal bacteremia: a single-center retrospective study.

IF 2.2 4区医学 Q2 UROLOGY & NEPHROLOGY Clinical and Experimental Nephrology Pub Date : 2024-08-01 Epub Date: 2024-03-20 DOI:10.1007/s10157-024-02485-8

Yumiko Mikami, Meiko Ogawa, Yuuki Hayasaka, Asuka Yamakami, Kanako Hattori, Chizumi Fukazawa, Takafumi Ito, Naoki Kanomata, Hiroyuki Terawaki

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Abstract

Background: Agonal bacteremia, diagnosed with postmortem positive blood culture results, is considered a possible contributing factor to death. We hypothesized that some premortem organ damage, such as kidney damage, can enhance agonal bacteremia.

Methods: We performed a postmortem blood and alveolar fluid culture study in 30 cadavers and evaluated the relationship between blood culture results and clinical parameters, including organ damage (brain, heart, lung, kidney, liver and gastrointestinal tract).

Results: A total of 23 cases (76.7%) were positive for blood culture; the number of cultured species was one in 12 cases, two in 7 cases, and three in 4 cases. The ratio of agonal bacteremia was significantly higher in patients with heart damage (100%, n = 13) and those with kidney damage (end-stage kidney damage, acute kidney injury, obstructive kidney failure, or metastatic kidney tumours) (100%, n = 13). The mean number of cultured species was 0.67 ± 0.98 in heart or kidney damage, 1.40 ± 0.55 in heart damage only, 1.40 ± 0.55 in kidney damage only, and 2.00 ± 0.93 in heart and kidney damage. As the number of damaged organs increased (0 organs, no heart/kidney damage; 1 organ, heart or kidney damage; and 2 organs, heart and kidney damage), the mean number of cultured species increased significantly (p for trend = 0.001964).

Conclusion: Premortem kidney damage relates to agonal bacteremia.

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与激动性菌血症有关的肾损伤：一项单中心回顾性研究。

背景：死后血液培养结果呈阳性而确诊的激动性菌血症被认为是导致死亡的一个可能因素。我们假设，一些死前器官损伤（如肾脏损伤）会加重激动性菌血症：我们对 30 具尸体进行了死后血液和肺泡液培养研究，并评估了血液培养结果与临床参数（包括器官损伤（脑、心、肺、肾、肝和胃肠道））之间的关系：共有 23 例（76.7%）血液培养呈阳性；培养出的菌种数量为 1 种占 12 例，2 种占 7 例，3 种占 4 例。心脏损伤患者（100%，13 人）和肾脏损伤患者（终末期肾脏损伤、急性肾损伤、梗阻性肾衰竭或转移性肾肿瘤）（100%，13 人）的激动菌血症比例明显更高。心脏或肾脏受损者培养物种的平均数量为 0.67 ± 0.98，仅心脏受损者为 1.40 ± 0.55，仅肾脏受损者为 1.40 ± 0.55，心脏和肾脏受损者为 2.00 ± 0.93。随着受损器官数量的增加（0 个器官，无心脏/肾脏损伤；1 个器官，心脏或肾脏损伤；2 个器官，心脏和肾脏损伤），培养物种的平均数量也显著增加（趋势 p = 0.001964）：结论：死前肾损伤与激动性菌血症有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical and Experimental Nephrology UROLOGY & NEPHROLOGY-

CiteScore

4.10

自引率

4.30%

发文量

135

审稿时长

4-8 weeks

期刊介绍： Clinical and Experimental Nephrology is a peer-reviewed monthly journal, officially published by the Japanese Society of Nephrology (JSN) to provide an international forum for the discussion of research and issues relating to the study of nephrology. Out of respect for the founders of the JSN, the title of this journal uses the term “nephrology,” a word created and brought into use with the establishment of the JSN (Japanese Journal of Nephrology, Vol. 2, No. 1, 1960). The journal publishes articles on all aspects of nephrology, including basic, experimental, and clinical research, so as to share the latest research findings and ideas not only with members of the JSN, but with all researchers who wish to contribute to a better understanding of recent advances in nephrology. The journal is unique in that it introduces to an international readership original reports from Japan and also the clinical standards discussed and agreed by JSN.