Infectious complications in the Southern Tasmanian kidney transplant population

Aim: Examine the incidence of suspected and proven infections, the range of infections, antimicrobial use, hospital admissions in kidney transplant recipients in southern Tasmania.

Method: An audit of the medical records of kidney transplant recipients managed by the Royal Hobart Hospital for the period 1st of January 2015 to 31st of December 2016. Data was collected on positive microbiological investigations, antimicrobial use and hospital admissions.

Results: Of the 151 evaluable kidney transplant recipients, there were 339 episodes of suspected infection in 95 (63%) patients with a preponderance of urinary tract infections. Overall these 95 kidney transplant recipients received a total of 249 courses of antimicrobials, with predominantly monotherapy (n=101, 65%). There were eleven vaccine preventable infections, including herpes zoster (n=7), Influenza A (n=3) and invasive pneumococcal disease (n=1). Hospitalisation was required for 50 infectious episodes, for a total of 227 admitted bed days (median 4; IQR 2‐7; range 1‐18 days).

Conclusion: In conclusion, episodes of infection, hospitalization, antimicrobial use and development of multi‐resistant organisms are common following kidney transplantation in this southern Tasmanian cohort. This study has identified several areas of focus for improved patient care including antimicrobial management of urinary tract infections, implementation of programmes to vaccinate KTx prior to transplantation, and development of transplantation specific antimicrobial stewardship programmes.