Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 May 24;24(1):526.
doi: 10.1186/s12879-024-09413-x.

Can the pan-immune-inflammation value predict gram negative bloodstream infection-related 30-day mortality in solid organ transplant patients?

Çağlayan Merve Ayaz  1 , Özge Turhan  2 , Vural Taner Yılmaz  3 , Haydar Adanır  4 , Beyza Sezer  1 , Dilara Öğünç  5
Affiliations

Can the pan-immune-inflammation value predict gram negative bloodstream infection-related 30-day mortality in solid organ transplant patients?

Çağlayan Merve Ayaz et al. BMC Infect Dis. .

Abstract

Background: The recently used pan-immune-inflammation value (PIV) has not been adequately studied as a predictive marker for mortality in immunosuppressed patients. The aim of this study was to evaluate the usefulness of baseline PIV level as a predictor of 30-day mortality in solid organ transplant (SOT) recipients with gram negative bloodstream infections (GN-BSI).

Methods: This retrospective, cross-sectional study was conducted between January 1, 2019, and December 31, 2022, in 1104 SOT recipients. During the study period, 118 GN-BSI were recorded in 113 patients. Clinical, epidemiological, and laboratory data were collected, and mortality rates (30-day and all-cause) were recorded.

Results: The 113 recipients had a median age of 50 years [interquartile range (IQR) 37.5-61.5 years] with a male predominance (n = 72, 63.7%). The three most common microorganisms were as follows: 46 isolates (38.9%) of Escherichia coli, 41 (34.7%) of Klebsiella pneumoniae, and 12 (10.2%) of Acinetobacter baumannii. In 44.9% and 35.6% of the isolates, production of extended-spectrum beta-lactamases and carbapenem resistance were detected, respectively. The incidence of carbapenem-resistant GN-BSI was higher in liver recipients than in renal recipients (n = 27, 69.2% vs n = 13, 17.6%, p < 0.001). All-cause and 30-day mortality rates after GN-BSI were 26.5% (n = 30), and 16.8% (n = 19), respectively. In the group with GN-BSI-related 30-day mortality, the median PIV level was significantly lower (327.3, IQR 64.8-795.4 vs. 1049.6, IQR 338.6-2177.1; p = 0.002). The binary logistic regression analysis identified low PIV level [hazard ratio (HR) = 0.93, 95% confidence interval (CI) 0.86-0.99; p = 0.04], and increased age (HR = 1.05, 95% CI 1.01-1.09; p = 0.002) as factors associated with 30-day mortality. The receiver operating characteristic analysis revealed that PIV could determine the GN-BSI-related 30-day mortality with area under curve (AUC): 0.723, 95% CI 0.597-0.848, p = 0.0005.

Conclusions: PIV is a simple and inexpensive biomarker that can be used to estimate mortality in immunosuppressed patients, but the results need to be interpreted carefully.

Keywords: Gram negative bacterial infection; Mortality; Multidrug resistance; Pan-immune-inflammation value; Solid organ transplantation.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
The ROC curve of PIV to predict GN-BSI-related 30-day mortality in SOT patients. Abbreviations: PIV: Pan-immune-inflammation; AUC: Area under curve
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Ferreira LD, Goff C, Kamepalli S, Montgomery AE, Miggins JJ, Goss JA, Rana A. Survival Benefit of Solid-Organ Transplantation: 10-Year Update. Dig Dis Sci. 2023;68(9):3810–3817. doi: 10.1007/s10620-023-08012-1. - DOI - PubMed
    1. Sanromán Budiño B, Vázquez Martul E, Pértega Díaz S, Veiga Barreiro A, Carro Rey E, Mosquera RJ. Autopsy-determined causes of death in solid organ transplant recipients. Transplant Proc. 2004;36(3):787–789. doi: 10.1016/j.transproceed.2004.03.044. - DOI - PubMed
    1. Guenette A, Husain S. Infectious Complications Following Solid Organ Transplantation. Crit Care Clin. 2019;35(1):151–168. doi: 10.1016/j.ccc.2018.08.004. - DOI - PMC - PubMed
    1. Shao M, Wan Q, Xie W, Ye Q. Bloodstream infections among solid organ transplant recipients: epidemiology, microbiology, associated risk factors for morbility and mortality. Transplant Rev (Orlando) 2014;28(4):176–181. doi: 10.1016/j.trre.2014.02.001. - DOI - PubMed
    1. Carlberg C, Velleuer E, Molnár F. Innate Immunity and Inflammation. In: Carlberg C, Velleuer E, Molnár F, editors. Molecular Medicine: How Science Works. Cham: Springer International Publishing; 2023. pp. 229–252.

LinkOut - more resources