Matched retrospective study of infective endocarditis among solid organ transplant recipients compared to non‐transplant: Seven‐year experience in a US Referral Center. Issue 5 (29th June 2020)

• Record Type: Journal Article
• Authors: Chuang, Sally; Shrestha, Nabin K.; Brizendine, Kyle D.
• Is Part Of: Transplant infectious disease. Volume 22:Issue 5(2020)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2020-06-29
• Subjects: endocarditis -- organ transplant; Transplantation of organs, tissues, etc -- Complications -- Periodicals; Communicable diseases -- Periodicals; Infection -- Periodicals; 617.01
• DOI: 10.1111/tid.13368
• Languages: English
• ISSNs: 1398-2273

Abstract

Abstract: Background: Infective endocarditis (IE) is a rare complication following solid organ transplant (SOT); data on the clinical features and outcomes of IE in SOT recipients in the modern era are limited. Methods: We conducted a single‐center retrospective cohort study of IE diagnosed from 1/2008‐12/2014 in SOT recipients, who were matched by age and microorganism to cases of IE in non‐SOT, to describe the clinical features and outcomes. Results: There were 14 cases of IE identified in SOT recipients matched to 56 non‐SOT controls. Median time from transplant to IE was 1017 days (IQR 379‐1830). Compared to non‐SOT patients, SOT patients were more likely to be undergoing current hemodialysis (16% vs 36%) and to possess indwelling central venous catheters within the 30 days prior to diagnosis of IE (27% vs 50%). No SOT patients had documented drug use as a risk factor for IE whereas 6 (11%) non‐SOT did. Enterococcus was the most common etiologic agent and was isolated in 50% of cases; only one fungal infection was identified, a mixed infection with Candida . Thirty‐day mortality was 14% in SOT patients, significantly higher versus no deaths in non‐SOT ( P = .037). Conclusions: The present study illustrates a change in epidemiology of IE in SOT patients characterized by IE that generally occurs more than one‐year post‐transplant, is due to bacterial infection rather than fungus, and appears to be health care associated. Multicenter studies are merited to explore transplant‐specific risk factors for IE in the special population of SOT patients.