Early healthcare-associated infections following kidney and kidney–pancreas transplantation

Results from a 6-year, single-center, prospective surveillance study, evaluating early healthcare-associated infections (HAIs) following kidney (n = 944) or kidney–pancreas (n = 128) transplantation, were published in the American Journal of Infection Control by Marion et al. Patients were evaluated for ≥30 days or until hospital discharge post-transplantation. The primary objective was to report the incidence of early HAIs; secondary objectives included evaluating temporal trends and comparing infection patterns by transplant type. 

Key data: Overall, 12.8% of patients developed ≥1 HAI, corresponding to an incidence of 4.5 cases per 1,000 patient-days (95% confidence interval [CI], 3.8–5.3), with rates decreasing over time (adjusted incidence rate ratio [aIRR], 0.95; 95% CI, 0.90–0.99, per semester). Urinary tract infection (UTI) was the most frequent HAI (2.7 per 1,000 patient-days; 95% CI, 2.2–3.3), followed by bacteremia (1.4; 95% CI, 1.0–1.8), surgical site infection (SSI; 1.2; 95% CI, 0.8–1.6), and pneumonia (0.2; 95% CI, 0.1–0.5). Kidney–pancreas recipients had higher HAI rates than kidney-only recipients (aIRR, 2.28; 95% CI, 1.66–2.61), driven by bacteremia (aIRR, 2.04; 95% CI, 1.33–3.14) and SSI (aIRR, 4.66; 95% CI, 3.09–7.34). 

Key learning: Early HAIs were frequent following kidney and kidney–pancreas transplantation, with UTIs presenting the most common infection and kidney–pancreas recipients demonstrating higher infection burden overall. These data highlight the importance of continued surveillance and prevention efforts during the early post-transplant period.