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":"肾移植受者感染弯曲杆菌属的流行病学:法国的一项回顾性多中心病例对照研究","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":"{\"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}","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
摘要
背景 肾移植受者(KTR)中的弯曲杆菌病是最常见的细菌性腹泻病因。KTR的风险因素尚不清楚。方法 2010 年至 2020 年期间在法国进行了一项为期 10 年的多中心、1:1 病例对照回顾性研究。主要目的是确定 KTR 中弯曲杆菌相关感染的相关因素。研究对象包括在同一中心接受功能性移植且患有弯曲杆菌病(粪便培养和/或血液培养呈阳性和/或核酸扩增试验呈阳性)的 KTR 及其与移植日期匹配的对照组。结果 我们发现了 326 名弯曲杆菌病患者。弯曲杆菌病的估计发病率为 2.3/1000。感染发生的时间中位数为移植后 2.4 年。弯曲杆菌病的独立风险因素是:(i) 使用皮质类固醇作为维持治疗方案(75.8 vs 66%;p < 0.001);(ii) 急性排斥反应(8.9 vs 4%; p = 0.048),(iii) 低淋巴细胞计数(0.96 vs 1.4 G/L;p<0.001)和(iv) 低基础 eGFR(44.2 mL/min/1.73m2 vs 57.5 mL/min/1.73m2;p<0.001)。64例(21.4%)患者开始使用氟喹诺酮类药物,51.1%的患者对其产生抗菌药耐药性,而几乎所有菌株都对红霉素敏感。结论 弯曲状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包括皮质类固醇作为维持性免疫抑制方案、低淋巴细胞计数、低 eGFR 和急性排斥史。由于氟喹诺酮类抗生素的耐药性较高,一线治疗应使用阿奇霉素。
Epidemiology of Campylobacter spp. infection in kidney transplant recipients: a retrospective multicentric case-control study in France
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.