High Mortality and Graft Loss after Infective Endocarditis in Kidney Transplant Recipients: A Case-Controlled Study from Two Centers
1
Kidney Transplantation Department, Assistance Publique—Hôpitaux de Paris APHP, Pitié-Salpêtrière Hospital, FR-75013 Paris, France
2
Kidney Transplantation Departement, Limoges University Hospital, Inserm Umr 1092, Resinfit, FR-87000 Limoges, France
3
Department of Bacteriology and Hygiene, Sorbonne Université, Assistance Publique—Hôpitaux de Paris APHP, Pitié-Salpêtrière Hospital, (Cimi-Paris), Inserm U1135, FR-75013 Paris, France
4
Department of Nephrology and Dialysis, Sorbonne Université, Assistance Publique—Hôpitaux de Paris APHP, Tenon Hospital, FR-75019 Paris, France
5
Infectious Diseases and Tropical Medicine Department, Limoges University Hospital, INSERM, University Limoges, IRD, U1094, Institute of Epidemiology and Tropical Neurology, GEIST, FR-87000 Limoges, France
6
Département D’information Médicale (DIM), Sorbonne Université, Assistance Publique—Hôpitaux de Paris APHP, Pitié-Salpêtrière Hospital, FR-75013 Paris, France
7
Nephrology Department, Université Paris Saclay, Assistance Publique—Hôpitaux de Paris APHP, Ambroise Paré Hospital, FR-92100 Boulogne Billancourt France, CESP Inserm 1018, FR-94800 Villejuif, France
8
Kidney Transplantation Department, Sorbonne Université, Assistance Publique—Hôpitaux de Paris APHP, Pitié-Salpêtrière Hospital, INSERM UMR 1082, FR-75013 Paris, France
9
Department of Nephrology, Transplantation and Dialysis, University Hospital of Limoges, INSERM, CNRS UMR7276, U1262, CRIBL, FR-87000 Limoges, France
10
Kidney Transplantation Department, Sorbonne Université, Assistance Publique—Hôpitaux de Paris APHP, Pitié-Salpêtrière Hospital, INSERM UMR 1138, FR-75013 Paris, France
*
Author to whom correspondence should be addressed.
†
These two authors contributed equally to this work.
Academic Editor: Carlo Alfieri
Pathogens 2021, 10(8), 1023; https://doi.org/10.3390/pathogens10081023
Received: 16 June 2021
/
Revised: 3 August 2021
/
Accepted: 9 August 2021
/
Published: 13 August 2021
(This article belongs to the Special Issue Infectious Complications in Chronic Kidney Disease and Renal Transplant Patients: Prevention, Diagnosis, Management, and Emerging Trends)
Kidney transplant recipients (KTRs) tend to develop infections with characteristic epidemiology, presentation, and outcome. While infective endocarditis (IE) is among such complications in KTRs, the literature is scarce. We describe the presentation, epidemiology, and factors associated with IE in KTRs. We performed a retrospective case/control study which included patients from two centers. First episodes of definite or possible IE (Duke criteria) in adult KTRs from January 2010 to December 2018 were included, as well as two controls per case, and followed until 31 December 2019. Clinical, biological, and microbiological data and the outcome were collected. Survival was studied using the Kaplan–Meier method. Finally, we searched for factors associated with the onset of IE in KTRs by the comparison of cases and controls. Seventeen cases and 34 controls were included. IE was diagnosed after a mean delay of 78 months after KT, mostly on native valves of the left heart only. Pathogens of digestive origin were most frequently involved (six Enterococcus spp, three Streptococcus gallolyticus, and one Escherichia coli), followed by Staphylococci (three cases of S. aureus and S. epidermidis each). Among the risk factors evaluated, age, vascular nephropathy, and elevated calcineurin inhibitor through levels were significantly associated with the occurrence of IE in our study. Patient and death-censored graft survival were greatly diminished five years after IE, compared to controls being 50.3% vs. 80.6% (p < 0.003) and 29.7% vs. 87.5% (p < 0.002), respectively. IE in KTRs is a disease that carries significant risks both for the survival of the patient and the transplant.
View Full-Text
Keywords:
infective endocarditis; kidney transplantation; survival analysis; graft failure; transplant infectious diseases
▼
Show Figures
Figure 1
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited
- Supplementary File 1:
ZIP-Document (ZIP, 81 KiB)
MDPI and ACS Style
Tamzali, Y.; Danthu, C.; Aubry, A.; Brousse, R.; Faucher, J.-F.; El Ouafi, Z.; Rufat, P.; Essig, M.; Barrou, B.; Toure, F.; Tourret, J. High Mortality and Graft Loss after Infective Endocarditis in Kidney Transplant Recipients: A Case-Controlled Study from Two Centers. Pathogens 2021, 10, 1023. https://doi.org/10.3390/pathogens10081023
AMA Style
Tamzali Y, Danthu C, Aubry A, Brousse R, Faucher J-F, El Ouafi Z, Rufat P, Essig M, Barrou B, Toure F, Tourret J. High Mortality and Graft Loss after Infective Endocarditis in Kidney Transplant Recipients: A Case-Controlled Study from Two Centers. Pathogens. 2021; 10(8):1023. https://doi.org/10.3390/pathogens10081023
Chicago/Turabian StyleTamzali, Yanis, Clément Danthu, Alexandra Aubry, Romain Brousse, Jean-François Faucher, Zhour El Ouafi, Pierre Rufat, Marie Essig, Benoit Barrou, Fatouma Toure, and Jérôme Tourret. 2021. "High Mortality and Graft Loss after Infective Endocarditis in Kidney Transplant Recipients: A Case-Controlled Study from Two Centers" Pathogens 10, no. 8: 1023. https://doi.org/10.3390/pathogens10081023
Find Other Styles
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.
