Bacterial zoonoses uncommon after solid organ transplantation, mostly occurring beyond one year

A multicenter observational study in Clinical Transplantation examined bacterial zoonotic infections among adult solid organ transplant recipients in the TriNetX database during 2014–2024. Investigators used ICD-10 codes to identify 12 bacterial zoonoses and assessed incidence, timing, associated factors, hospitalization, and mortality. The abstract does not report the total transplant cohort size.

Sixty-one recipients (0.03%) developed a bacterial zoonotic infection, corresponding to 4.87 cases per 100,000 person-years. Median time from transplantation to infection was 736 days (IQR, 298–1970), and 72.1% occurred more than one year after transplantation. The hospitalization rate was 41.0%, and 90-day all-cause mortality was 6.6%. Q fever, cat scratch disease, and pasteurellosis were the most frequent infections; no anthrax, tularemia, plague, or rat-bite fever cases were identified.

Black recipients had a reported 49% lower infection risk than White recipients. The authors attributed this association to differences in animal and environmental exposure rather than biological susceptibility, but those exposures were not measured, so that explanation remains unconfirmed. The findings support extending animal safety counseling into long-term transplant care. Interpretation is limited by reliance on diagnostic codes, the small number of infections, and availability of only the abstract; all-cause mortality should not be interpreted as infection-attributable mortality.