Specificities of Meningitis and Meningo-Encephalitis After Kidney Transplantation: A French Retrospective Cohort Study - ARAMISLAB - Algorithms, models and methods for images and signals of the human brain Access content directly
Journal Articles Transplant International Year : 2023

Specificities of Meningitis and Meningo-Encephalitis After Kidney Transplantation: A French Retrospective Cohort Study

1 CHU Pitié-Salpêtrière [AP-HP]
2 SU - Sorbonne Université
3 Hôpital Necker - Enfants Malades [AP-HP]
4 UPD5 - Université Paris Descartes - Paris 5
5 CHU Bordeaux
6 CHU Nantes - Centre Hospitalier Universitaire de Nantes
7 CHRU Lille - Centre Hospitalier Régional Universitaire [CHU Lille]
8 LA CONCEPTION - Hôpital de la Conception [CHU - APHM]
9 AMU - Aix Marseille Université
10 CHU Rouen
11 INFINITE (Ex-Liric) - Institute for Translational Research in Inflammation - U 1286
12 Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM]
13 IMRB - Institut Mondor de Recherche Biomédicale
14 Hôpital Henri Mondor
15 CHU Henri Mondor [Créteil]
16 DYNAMIC - Dynamic Microbiology - EA 7380
17 Hôpital Edouard Herriot [CHU - HCL]
18 CHU Montpellier
19 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
20 Irset - Institut de recherche en santé, environnement et travail
21 CIC - Centre d'Investigation Clinique [Rennes]
22 CHU Tenon [AP-HP]
23 HEGP - Hôpital Européen Georges Pompidou [APHP]
24 iPLESP - Institut Pierre Louis d'Epidémiologie et de Santé Publique
25 ARAMIS - Algorithms, models and methods for images and signals of the human brain = Algorithmes, modèles et méthodes pour les images et les signaux du cerveau humain [ICM Paris]
26 Agence de la biomédecine [Saint-Denis la Plaine]
27 Infinity - Institut Toulousain des Maladies Infectieuses et Inflammatoires
28 CRC (UMR_S_1138 / U1138) - Centre de Recherche des Cordeliers
Thomas Bonduelle
  • Function : Author
Tristan de Nattes
  • Function : Author
Hannah Kaminski
  • Function : Author
Dominique Bertrand
  • Function : Author

Abstract

Kidney transplant recipients develop atypical infections in their epidemiology, presentation and outcome. Among these, meningitis and meningoencephalitis require urgent and adapted anti-infectious therapy, but published data is scarce in KTRs. The aim of this study was to describe their epidemiology, presentation and outcome, in order to improve their diagnostic and management. We performed a retrospective, multicentric cohort study in 15 French hospitals that included all 199 cases of M/ME in KTRs between 2007 and 2018 (0.9 case per 1,000 KTRs annually). Epidemiology was different from that in the general population: 20% were due to Cryptococcus neoformans, 13.5% to varicella-zoster virus, 5.5% to Mycobacterium tuberculosis, and 4.5% to Enterobacteria (half of which produced extended spectrum beta-lactamases), and 5% were Post Transplant Lymphoproliferative Disorders. Microorganisms causingM/ME in the general population were infrequent (2%, for Streptococcus pneumoniae) or absent (Neisseria meningitidis). M/ME caused by Enterobacteria, Staphylococci or filamentous fungi were associated with high and early mortality (50%–70% at 1 year). Graft survival was not associated with the etiology of M/ME, nor was impacted by immunosuppression reduction. Based on these results, we suggest international studies to adapt guidelines in order to improve the diagnosis and the probabilistic treatment of M/ME in SOTRs.
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hal-03996962 , version 1 (20-02-2023)

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Yanis Tamzali, Anne Scemla, Thomas Bonduelle, Claire Garandeau, M. Gilbert, et al.. Specificities of Meningitis and Meningo-Encephalitis After Kidney Transplantation: A French Retrospective Cohort Study. Transplant International, 2023, 36, pp.10765. ⟨10.3389/ti.2023.10765⟩. ⟨hal-03996962⟩
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