Feline Bos, Romain Gueneau, Thomas Crepin, Claire Tinévez, Benjamin Taton, Lionel Couzi, Karine Moreau, Betoul Schvartz, Peggy Perrin, Philippe Gatault, Anne Scemla, Valérie Chatelet-Pouliquen, Charlène Levi, Nassim Kamar, Fanny Lanternier, Didier Neau, Pierre Merville, Philippe Lehours, Mathilde Puges, Hannah Kaminski
{"title":"Epidemiology of Campylobacter spp. infection in kidney transplant recipients: a retrospective multicentric case-control study in France","authors":"Feline Bos, Romain Gueneau, Thomas Crepin, Claire Tinévez, Benjamin Taton, Lionel Couzi, Karine Moreau, Betoul Schvartz, Peggy Perrin, Philippe Gatault, Anne Scemla, Valérie Chatelet-Pouliquen, Charlène Levi, Nassim Kamar, Fanny Lanternier, Didier Neau, Pierre Merville, Philippe Lehours, Mathilde Puges, Hannah Kaminski","doi":"10.1093/ofid/ofae498","DOIUrl":null,"url":null,"abstract":"Background Campylobacteriosis in kidney transplant recipients (KTR) is the most common identified bacterial cause of diarrhoea. Risk factors in KTR are unknown. Methods 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 Campylobacter-related infection in KTR. The KTR with a functional graft and campylobacteriosis (positive stool culture and/or blood culture and/or positive nucleic amplification test) and their control matched on transplantation date within the same center were included. Results We identified 326 patients with campylobacteriosis. The estimated incidence-rate of campylobacteriosis was 2.3/1000 patients-years. The infection occurred at a median of 2.4 years post-transplantation. The independent risk factors for campylobacteriosis were (i) use of corticosteroids as maintenance regimen (75.8 vs 66%; p < 0.001), (ii) acute rejection (8.9 vs 4%; p = 0.048), (iii) low lymphocyte count (0.96 vs 1.4 G/L; p < 0.001) and (iv) low basal eGFR (44.2 mL/min/1.73m2 vs 57.5 mL/min/1.73m2; p<0.001). Fluoroquinolone was initiated in 64 (21.4%) patients, with 51.1% of antimicrobial resistance, whereas almost all strains were erythromycin sensitive. Conclusion Campylobacteriosis has a higher incidence in the two 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 azythromycin.","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":3.8000,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Open Forum Infectious Diseases","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/ofid/ofae498","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"IMMUNOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background Campylobacteriosis in kidney transplant recipients (KTR) is the most common identified bacterial cause of diarrhoea. Risk factors in KTR are unknown. Methods 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 Campylobacter-related infection in KTR. The KTR with a functional graft and campylobacteriosis (positive stool culture and/or blood culture and/or positive nucleic amplification test) and their control matched on transplantation date within the same center were included. Results We identified 326 patients with campylobacteriosis. The estimated incidence-rate of campylobacteriosis was 2.3/1000 patients-years. The infection occurred at a median of 2.4 years post-transplantation. The independent risk factors for campylobacteriosis were (i) use of corticosteroids as maintenance regimen (75.8 vs 66%; p < 0.001), (ii) acute rejection (8.9 vs 4%; p = 0.048), (iii) low lymphocyte count (0.96 vs 1.4 G/L; p < 0.001) and (iv) low basal eGFR (44.2 mL/min/1.73m2 vs 57.5 mL/min/1.73m2; p<0.001). Fluoroquinolone was initiated in 64 (21.4%) patients, with 51.1% of antimicrobial resistance, whereas almost all strains were erythromycin sensitive. Conclusion Campylobacteriosis has a higher incidence in the two 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 azythromycin.
期刊介绍:
Open Forum Infectious Diseases provides a global forum for the publication of clinical, translational, and basic research findings in a fully open access, online journal environment. The journal reflects the broad diversity of the field of infectious diseases, and focuses on the intersection of biomedical science and clinical practice, with a particular emphasis on knowledge that holds the potential to improve patient care in populations around the world. Fully peer-reviewed, OFID supports the international community of infectious diseases experts by providing a venue for articles that further the understanding of all aspects of infectious diseases.