Bacterial infections as complications in patients within 3 months after simultaneous pancreas-kidney transplantation

Pol Arch Med Wewn. 2008 Dec;118(12):700-4.

Abstract

Introduction: Simultaneous pancreas-kidney transplantation (SPK) is associated with high risk of infectious complications.

Objectives: The aim of the study was to evaluate the incidence of bacterial infections within 3 months after SPK transplantation.

Patients and methods: 17 patients with type 1 diabetes at the age of 32-54 years (mean age 42.5 +/- 7.1) were retrospectively analyzed within 3 months after SPK.

Results: No septic complications were observed in 2 patients (12%). In the remaining 15 patients (88%), at least 1 (from 1 to 5, a total of 30) infection episode was observed during follow-up. The infections were located: only at the surgical site (1 patient--6.7%), only in the urinary tract (6 patients--40%), both at the surgical site and in the urinary tract (7 patients--46.7%), at the surgical site and in blood (1 patient--6.7%). 2 groups of microbes were predominant, namely enterococci represented by 1 species, E. faecium (13 isolates) and the so-called intestinal bacilli, Enterobacteriaceae (19 isolates). No methicillin resistant Staphylococcus aureus strains were isolated. Candida species fungi were isolated only 3 times.

Conclusions: In our study only 2 types of infections were observed (urinary tract and surgical site infections) and each of them comprised nearly half of all the septic episodes recorded. Gram-negative bacilli were collected more often than Gram-positive cocci, both from the surgical site and urinary tract infections. All infections ended with full recovery.

MeSH terms

  • Adult
  • Diabetes Mellitus, Type 1 / complications
  • Diabetes Mellitus, Type 1 / surgery
  • Female
  • Gram-Negative Bacterial Infections / drug therapy
  • Gram-Negative Bacterial Infections / microbiology*
  • Gram-Positive Bacterial Infections / drug therapy
  • Gram-Positive Bacterial Infections / microbiology*
  • Humans
  • Kidney Failure, Chronic / etiology
  • Kidney Failure, Chronic / surgery
  • Kidney Transplantation / adverse effects*
  • Male
  • Middle Aged
  • Pancreas Transplantation / adverse effects*
  • Poland
  • Retrospective Studies
  • Sepsis / microbiology
  • Surgical Wound Infection / diet therapy
  • Surgical Wound Infection / microbiology*
  • Treatment Outcome
  • Urinary Tract Infections / microbiology*