Hospitalizations for bacterial septicemia after renal transplantation in the United States

Background: It is common belief in the transplant community that rates of s epticemia in transplant recipients have declined, but this has not been stu died in a national population. Methods: Therefore, 33,479 renal transplant recipients in the United States Renal Data System from July 1, 1994 to June 30, 1997 were analyzed in a retrospective registry study of the incidence, associated factors, and mortality of hospitalizations with a primary disch arge diagnosis of septicemia (ICD9 Code 038.x). Results: Renal transplant r ecipients had an adjusted incidence ratio of hospitalizations for septicemi a of 41.52 (95% CI 35.45-48.96) compared to the general population. Hospita lizations for septicemia were most commonly associated with urinary tract i nfection as a secondary diagnosis (30.6%). In multivariate analysis, diabet es and urologic disease, female gender, delayed graft function, rejection, and pre-transplant dialysis, but not induction antibody therapy, were assoc iated with hospitalizations for septicemia. Recipients hospitalized for sep ticemia had a mean patient survival of 9.03 years (95% CI 7.42-10.63) compa red to 15.73 years (95% CI 14.77-16.69) for all other recipients. Conclusio ns: Even in the modern era, renal transplant recipients remain at high risk for hospitalizations for septicemia, which are associated with substantial ly decreased patient survival. Newly identified risks in this population we re female recipients and pre-transplant dialysis. Copyright (C) 2001 S. Kar gerAG, Basel.