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Volume 23, Number 3—March 2017
Dispatch

Rhodococcus Infection in Solid Organ and Hematopoietic Stem Cell Transplant Recipients1

Pascalis Vergidis2Comments to Author , Ella J. Ariza-Heredia, Anoma Nellore, Camille N. Kotton, Daniel R. Kaul, Michele I. Morris, Theodoros Kelesidis, Harshal Shah, Seo Young Park, M. Hong Nguyen, and Raymund R. Razonable
Author affiliations: University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA (P. Vergidis, S.Y. Park, M.H. Nguyen); University of Texas MD Anderson Cancer Center, Houston, Texas, USA (E.J. Ariza-Heredia); University of Alabama, Birmingham, Alabama, USA (A. Nellore); Massachusetts General Hospital, Boston, Massachusetts, USA (C.N. Kotton); University of Michigan Medical School, Ann Arbor, Michigan, USA (D.R. Kaul); University of Miami Miller School of Medicine, Miami, Florida, USA (M.I. Morris); University of California David Geffen School of Medicine, Los Angeles, California, USA (T. Kelesidis); Mayo Clinic, Jacksonville, Florida, USA (H. Shah); Mayo Clinic, Rochester, Minnesota, USA (R.R. Razonable)

Main Article

Table 2

Univariate analysis of risk factors associated with Rhodococcus infection in solid organ and hematopoietic stem cell transplant recipients, United States*

Variable Case-patients, n = 18 Control patients, n = 36 Univariate OR (95% CI) p value
Mean age, y (range) 55 (3–78) 50 (2–78) 1.05 (0.99–1.11) 0.13
Male sex 12/18 (66.7) 22/36 (61.1) 1.21 (0.42–3.45) 0.72
White race
 15/18 (83.3)
 23/36 (63.9)
 3.17 (0.65–15.43)
 0.15
Diabetes mellitus† 9/18 (50.0) 6/34 (17.6) 9.90 (1.20–81.62) 0.03
Chronic kidney disease‡
 3/16 (18.8)
 5/35 (14.3)
 1.15 (0.19–7.03)
 0.88
Immunosuppressant
Tacrolimus 10/18 (55.6) 25/35 (71.4) 0.15 (0.02–1.39) 0.10
Sirolimus 3/18 (16.7) 2/35 (5.7) 4.65 (0.46–46.89) 0.19
Mycophenolate mofetil 10/18 (55.6) 18/35 (5.4) 1.36 (0.20–9.0) 0.75
Prednisone 13/18 (72.2) 25/35 (71.4) 1.00 (0.25–4.0) 1.00
Cyclosporine
 2/18 (11.1)
 3/35 (8.6)
 2.00 (0.13–31.98)
 0.62
Increased calcineurin inhibitor level§
 2/13 (15.4)
 4/32 (13.3)
 1.20 (0.16–9.20)
 0.86
History of allograft rejection
 2/12 (16.7)
 1/24 (4.2)
 4.00 (0.36–44.11)
 0.26
Augmented immunosuppression¶
 7/18 (38.9)
 13/37 (35.1)
 1.28 (0.24–6.89)
 0.77
TMP/SMX prophylaxis
 10/18 (55.6)
 19/36 (52.7)
 1.15 (0.33–4.03)
 0.83
History of opportunistic infection# 7/18 (38.9) 4/36 (11.1) 10.57 (1.25–89.0) 0.03

*Values are no. (%) unless otherwise indicated. OR, odds ratio; TMP/SMX, trimethoprim/sulfamethoxazole.
†Requiring treatment with oral antidiabetic agent(s) or insulin.
‡Creatinine level >2 mg/dL.
§Tacrolimus >12 μg/mL or cyclosporine >250 μg/mL in the preceding 30 days.
¶Use of corticosteroid pulses, alemtuzumab, anti-thymocyte globulin, basiliximab, or rituximab in the 6 months preceding infection.
#Opportunistic infections in case-patients were cytomegalovirus viremia (3) or invasive disease (2), pulmonary aspergillosis (1), and BK polyomavirus–associated hemorrhagic cystitis (1).

Main Article

1Results from this study were presented in part at IDWeek 2012, October 17–21, 2012, San Diego, California, USA.

2Current affiliation: University of Manchester, Manchester, UK.

Page created: February 17, 2017
Page updated: February 17, 2017
Page reviewed: February 17, 2017
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