Statins are associated with improved outcomes of bloodstream infection in solid-organ transplant recipients |
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Authors: | J Hsu D R Andes V Knasinski J Pirsch and N Safdar |
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Institution: | (1) Section of Infectious Diseases, Department of Medicine, University of Wisconsin, Room H4/572 CSC, 600 Highland Avenue, Madison, WI 53792, USA;(2) Department of Medical Microbiology, University of Wisconsin, Madison, WI, USA;(3) Division of Transplantation, Department of Surgery, University of Wisconsin, Madison, WI, USA; |
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Abstract: | Among recipients of intra-abdominal solid-organ transplants, bloodstream infections (BSIs) are a major cause of mortality.
We undertook a retrospective cohort study of recipients of kidney, pancreas, and/or liver transplants with BSIs at a single
center over an 11-year period. Multivariate analysis using logistic regression was used to determine independent predictors
of 15-day mortality and clinical cure, with a focus on the use of statins. Three hundred and eleven recipients of solid-organ
transplants had 604 episodes of BSI. Forty-four (14%) died within 15 days of BSI. Sixteen percent did not achieve clinical
cure. In the multivariate model, each one point increase in the APACHE score was associated with a 1.09-fold increased risk
of death (95% confidence interval CI] 1.00–1.18, P = 0.03). The lack of appropriate antibiotic therapy was associated with a four-fold higher risk of death within 15 days (odds
ratio OR] 4.65, 95% CI 1.46–14.78, P = 0.009). Statin use was protective (OR 0.18, 95% CI 0.04–0.78). Patients with high APACHE scores, nosocomial rather than
community source of BSI, lack of appropriate antibiotic therapy, and mental status changes were less likely to achieve clinical
cure of their BSIs. In conclusion, appropriate antibiotic therapy and statin use are associated with lower risk of mortality
from BSIs in this patient population. |
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