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Meta-Analysis
. 2024 Dec;56(1):2314236.
doi: 10.1080/07853890.2024.2314236. Epub 2024 Mar 5.

A comprehensive evaluation of risk factors for mortality, infection and colonization associated with CRGNB in adult solid organ transplant recipients: a systematic review and meta-analysis

Siyu Gao  1 , Xiaoli Huang  2 , Xiaolin Zhou  2 , Xiangcheng Dai  2 , Jing Han  2 , Yandong Chen  2 , Hongliang Qiao  3 , Yi Li  4 , Yifan Zhou  2 , Ting Wang  2 , Huiqing He  5 , Qiang Liu  2 , Shenjie Tang  1
Affiliations
Meta-Analysis

A comprehensive evaluation of risk factors for mortality, infection and colonization associated with CRGNB in adult solid organ transplant recipients: a systematic review and meta-analysis

Siyu Gao et al. Ann Med. 2024 Dec.

Abstract

Background: The burden of carbapenem-resistant gram-negative bacteria (CRGNB) among solid organ transplant (SOT) recipients has not been systematically explored. Here, we discern the risk factors associated with CRGNB infection and colonization in SOT recipients.

Methods: This study included observational studies conducted among CRGNB-infected SOT patients, which reported risk factors associated with mortality, infection or colonization. Relevant records will be searched in PubMed, Embase and Web of Science for the period from the time of database construction to 1 March 2023.

Results: A total of 23 studies with 13,511 participants were included, enabling the assessment of 27 potential risk factors. The pooled prevalence of 1-year mortality among SOT recipients with CRGNB was 44.5%. Prolonged mechanical ventilation, combined transplantation, reoperation and pre-transplantation CRGNB colonization are salient contributors to the occurrence of CRGNB infections in SOT recipients. Renal replacement therapy, post-LT CRGNB colonization, pre-LT liver disease and model for end-stage liver disease score increased the risk of infection. Re-transplantation, carbapenem use before transplantation and ureteral stent utilization increaesd risk of CRGNB colonization.

Conclusion: Our study demonstrated that SOT recipients with CRGNB infections had a higher mortality risk. Invasive procedure may be the main factor contribute to CRGNB infection.

Keywords: CRGNB; Solid organ transplant; colonization; infection; mortality.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1.
Figure 1.
Flow diagram for literature search and study selection.
Figure 2.
Figure 2.
Forest plots for pooled mortality (1-year) of SOT recipients with CRGNB infections in included studies.
See this image and copyright information in PMC

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