Epidemiology and Outcomes of Fever During the First 2 Months after Simultaneous Pancreas–Kidney (SPK) Transplant. (4th October 2017)

• Record Type: Journal Article
• Authors: Slagle, Dustin; Ison, Michael
• Is Part Of: Open forum infectious diseases. Volume 4(2017)Supplement 1
• Page Start: S726
• Page End: S727
• Publication Date: 2017-10-04
• Subjects: Communicable diseases -- Periodicals; Medical microbiology -- Periodicals; Infection -- Periodicals; 616.9
• DOI: 10.1093/ofid/ofx163.1960
• Languages: English
• ISSNs: 2328-8957

Abstract

Abstract: Background: SPK transplant recipients frequently experience fevers early post-transplant resulting in the use of multiple studies and antibiotics. Understanding the epidemiology of early fevers post-SPK could reduce antibiotic exposures. Methods: All SPK transplants between January 1, 2005 and April 1, 2015 that had developed a fever 3 100.4¡ in the first 60 days post-op were studied retrospectively after IRB approval. Culture-negative fever (CNF) was defined as the absence of positive bacterial cultures, viral studies, and lack of a clinical diagnosis of infection. Data collected included patient demographic information of: sex, age, BMI, and race; fever characteristics and hospital stay statistics. Results: Of the 82 identified patients (see Table 1), 67 (81.7%) had CNF while 15 (18.3%) were culture positive fever (CPF). Of the CPF patients, the breakdown was: 8 had + urine cultures 2 with + blood cultures, 1 case of C. difficile, and 1 case of H1N1 flu. Most patients presented between 12 and 16 days post-transplant with fever with similar onset between CNF and CPF (see Table 2 and Figure 1). There were no significant differences between groups in terms of demographics or hospital stay details (see Table 2). Patients CNF received more doses of metronidazole and fewer doses of piperacillin/tazobactam (see Table 2). Conclusion: Most patients who develop fevers in the first 60 days post-SPK had CNF, with fever likely from pancreatitis in these patients. Outcomes are generally excellent in CNF patients, but increased antibiotic use is a concern. Future studies should attempt to identify biomarkers (i.e., procalcitonin) that would allow for lower use of antibiotics, admissions and clinical studies. Disclosures: All authors: No reported disclosures.