Monday, January 26, 2015

Bacteremic Sepsis in Transplant vs Non-Transplant Patients- Paradigm Challenge

The conventional thought is that sepsis and bacteremia is more severe and life threatening in transplant recipient patients. The immunocompromised state of the transplant recipient theoretically heightens the severity of illness and increases the risk of a poor outcome.

This recent paper in Clinical Infectious Diseases suggests otherwise. The investigators reported a 78% relative decrease in 28 day mortality between bacteremic sepsis in transplant recipients versus non-transplant recipients.

Although transplant recipients may be immunosuppressed and at risk for opportunistic infections, particularly from viruses and fungi, in the event of bacteremic sepsis they fare better than non-transplanted hosts.Why? It is quite likely that the immunocompromised state down regulates the inflammatory response of sepsis, improving survival.

Once again, empiric data and observation contradict intuition.

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