Bacteremia in solid organ transplant recipients as compared to immunocompetent patients: Acute phase cytokines and outcomes in a prospective,matched cohort study |
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Authors: | Emily M Eichenberger Felicia Ruffin Michael Dagher Reginald Lerebours Sin-Ho Jung Batu Sharma-Kuinkel Andrew N Macintyre Joshua T Thaden Matthew Sinclair Lauren Hale Celia Kohler Scott M Palmer Barbara D Alexander Vance G Fowler Jr Stacey A Maskarinec |
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Affiliation: | 1. Division of Infectious Diseases, Department of Medicine, Duke University, Durham, North Carolina, USA;2. Department of Biostatistics & Bioinformatics, Duke University, Durham, North Carolina, USA;3. Duke Human Vaccine Institute, Duke University School of Medicine, Durham, North Carolina, USA;4. Department of Nephrology, Duke University, Durham, North Carolina, USA
Duke Clinical Research Institute, Duke University, Durham, North Carolina, USA;5. Department of Transplant Pulmonology, Duke University, Durham, North Carolina, USA |
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Abstract: | We undertook a prospective, matched cohort study of patients with Staphylococcus aureus bacteremia (SAB) and gram-negative bacteremia (GNB) to compare the characteristics, outcomes, and chemokine and cytokine response in transplant recipients to immunocompetent, nontransplant recipients. Fifty-five transplant recipients (GNB n = 29; SAB n = 26) and 225 nontransplant recipients (GNB n = 114; SAB n = 111) were included for clinical analysis. Transplant GNB had a significantly lower incidence of septic shock than nontransplant GNB (10.3% vs 30.7%, p = .03). Thirty-day mortality did not differ significantly between transplant and nontransplant recipients with GNB (10.3% vs 15.8%, p = .57) or SAB (0.0% vs 11.7%, p = .13). Next, transplant patients were matched 1:1 with nontransplant patients for the chemokine and cytokine analysis. Five cytokines and chemokines were significantly lower in transplant GNB vs nontransplant GNB: IL-2 (median IQR]: 7.1 pg/ml 7.1, 7.1] vs 32.6 pg/ml 7.1, 88.0]; p = .001), MIP-1β (30.7 pg/ml 30.7, 30.7] vs 243.3 pg/ml 30.7, 344.4]; p = .001), IL-8 (32.0 pg/ml 5.6, 53.1] vs 59.1 pg/ml 39.2, 119.4]; p = .003), IL-15 (12.0 pg/ml 12.0, 12.0] vs 12.0 pg/ml 12.0, 126.7]; p = .03), and IFN-α (5.1 pg/mL 5.1, 5.1] vs 5.1 pg/ml 5.1, 26.3]; p = .04). Regulated upon Activation, Normal T Cell Expressed and Secreted (RANTES) was higher in transplant SAB vs nontransplant SAB (mean SD]: 750.2 pg/ml 194.6] vs 656.5 pg/ml 147.6]; p = .046). |
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Keywords: | clinical research/practice cytokines/cytokine receptors immunosuppression/immune modulation infection and infectious agents – bacterial infectious disease organ transplantation in general translational research/science |
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