Objectives: Describe clinical and epidemiological differences and risk factors for death among Bloodstream Infections\n(BSI) caused by Gram Negative (GN) and Gram Positive (GP) bacteria in the setting of solid organ transplantation.\nMethods: We performed a retrospective analysis of medical records, which were evaluated patients undergoing solid\norgan transplantation with BSI in the period from January 2000 to January 31, 2006 at Hospital SÃ?£o Paulo and Hospital do\nRim e HipertensÃ?£o (Universidade Federal de SÃ?£o Paulo, Brazil). It was also performed the analysis of risk factors for death.\nResults: 195 patients were included in this study with a mean age of 43.3 (Ã?± 0.90) years, 114 (58.5 %) were male and, 81\n(41.5 %) were female. 168 (86.2 %) were kidney transplants, 16 (8.2 %) kidney-pancreas, 5 (2.6 %) heart, 5 (2.6 %) liver and\n1 (0.5 %) liver-kidney. The mean hospital stay was 34.2 (Ã?± 62.7) days. GN accounted for 147 (75.4 %) of the BSI episodes,\nwhereas 48 (24.6 %) were caused by GP. In the group with BSI by GN the most common site of infection was the urinary\ntract in 68 (46.3 %) cases, and in the group with BSI by GP the most common was the primary source in\n14 (29.1%) of the cases. The overall mortality of patients with BSI by GN was 19.7 % (29 cases) and by GP was 35.4 %\n(17 cases) (p = 0.03). In multiple logistic regression analysis, the variables associated independently with death in patients\nwith BSI by GN were those who developed respiratory failure requiring mechanical ventilation Odds Ratio (OR) 13,2 95 %\nConfidence Interval (CI) = 3.07ââ?¬â??57.19 (p = 0.001), beyond those which had number equal to or greater than two\ncomorbidities OR 12.4 95 % CI = 1.90ââ?¬â??80.35 (p = 0.008). In the population with BSI by GP only the respiratory failure\nrequiring mechanical ventilation OR 28.3 CI 95=2.53ââ?¬â??317.1 (p = 0.007) was independently associated with death.\nConclusions: Patients with BSI showed the urinary source as the main site of infection. Death within 30 days occurred in\n29 (19.7 %) patients with GN and 7 (35.4 %) patients with GP BSI (p = 0.03). Respiratory failure was a risk factor for death in\npatients with BSI by GN and GP.
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