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Kidney damage relates to agonal bacteremia: a single-center retrospective study

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Abstract

Background

Agonal bacteremia, diagnosed with postmortem positive blood culture results, is considered a possible contributing factor to death. We hypothesized that some premortem organ damage, such as kidney damage, can enhance agonal bacteremia.

Methods

We performed a postmortem blood and alveolar fluid culture study in 30 cadavers and evaluated the relationship between blood culture results and clinical parameters, including organ damage (brain, heart, lung, kidney, liver and gastrointestinal tract).

Results

A total of 23 cases (76.7%) were positive for blood culture; the number of cultured species was one in 12 cases, two in 7 cases, and three in 4 cases. The ratio of agonal bacteremia was significantly higher in patients with heart damage (100%, n = 13) and those with kidney damage (end-stage kidney damage, acute kidney injury, obstructive kidney failure, or metastatic kidney tumours) (100%, n = 13). The mean number of cultured species was 0.67 ± 0.98 in heart or kidney damage, 1.40 ± 0.55 in heart damage only, 1.40 ± 0.55 in kidney damage only, and 2.00 ± 0.93 in heart and kidney damage. As the number of damaged organs increased (0 organs, no heart/kidney damage; 1 organ, heart or kidney damage; and 2 organs, heart and kidney damage), the mean number of cultured species increased significantly (p for trend = 0.001964).

Conclusion

Premortem kidney damage relates to agonal bacteremia.

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Data availability

All data generated or analyzed during this study are included in this article. Further inquiries can be directed to the corresponding authors.

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Acknowledgements

The authors thank Dr. Genji Izumi for critical review and advice.

Author information

Authors and Affiliations

  1. Clinical Laboratory Department, St. Luke’s International University, 9-1 Akashi-Cho, Chuo-City, Tokyo, Japan

    Yumiko Mikami, Yuuki Hayasaka, Asuka Yamakami, Kanako Hattori, Chizumi Fukazawa & Hiroyuki Terawaki

  2. Department of Pathology, St. Luke’s International Hospital, Tokyo, Japan

    Meiko Ogawa & Naoki Kanomata

  3. Department of Nephrology, Teikyo University Chiba Medical Hospital, Chiba, Japan

    Takafumi Ito & Hiroyuki Terawaki

Authors
  1. Yumiko Mikami
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  2. Meiko Ogawa
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  3. Yuuki Hayasaka
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  4. Asuka Yamakami
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  5. Kanako Hattori
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  6. Chizumi Fukazawa
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  8. Naoki Kanomata
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  9. Hiroyuki Terawaki
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Contributions

All authors contributed to the conception of the study. YM, NK, and HT designed the study. MO and NK collected samples for culture, and YM, YH, and AY performed the culture procedure under the supervision of KH and CF. YM created the initial database, and HT performed the statistical analyses. TI reviewed the manuscript thoroughly and gave critical suggestions. All authors have read and approved the final manuscript, which was mainly modified by HT.

Corresponding author

Correspondence to Hiroyuki Terawaki.

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Conflict of interest

The authors have declared that no conflict of interest exists.

Ethics approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee at which the studies were conducted (IRB approval number 23-R061, the institutional review board of St. Luke’s International University) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent (Consent for publication)

Informed consent was not obtained from individual patients because the laboratory data used in this study were extracted from routine examination files and analyzed retrospectively. However, we posted the research content at the hospital and gave all participants the opportunity to refuse to participate.

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Cite this article

Mikami, Y., Ogawa, M., Hayasaka, Y. et al. Kidney damage relates to agonal bacteremia: a single-center retrospective study. Clin Exp Nephrol (2024). https://doi.org/10.1007/s10157-024-02485-8

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  • DOI: https://doi.org/10.1007/s10157-024-02485-8

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