Infections after liver transplantation in adults: data from a university hospital in southern Brazil (1996-2000)

Abstract

-Background -Infections after liver transplantations are the most important cause of morbi-mortality. In this study, we assessed the main characteristics of these infections in a southern Brazilian university hospital. Methods -We conducted a retrospective cohort with 55 patients who underwent orthotopic liver transplantation between 1996 and 2000 in the "Hospital de Clínicas de Porto Alegre", Porto Alegre, RS, Brazil, to characterize the infections that occurred in the group. Results -One or more infections (average 2.10) were diagnosed in 47 patients, especially during the first month after transplantation. The most common were bacteremia, intra-abdominal infections and pneumonia, predominantly with bacteria, especially Staphylococcus sp (and particularly S. aureus) and E. coli. The mortality rate attributed to infections was high: 17 cases of all deaths (total 27 deaths). Significant risk factors for infections included reoperation, diabetes, biliary stenosis and higher Child-Pugh scores. Conclusion -Infections remain a severe threat in liver transplant patients, and special efforts should be made to prevent and manage them correctly.

MRSA outbreak at a transplantation unit

“…Mortality: although high mortality rates associated with S. aureus infections are described in several studies, 1,2,11,12 no deaths associated with MRSA SSI occured during this outbreak. The majority of SSI were superficial, presenting low severity with better treatment response.…”

“…Up to 60% of these infections are caused by Gram-positive microorganisms, mainly Staphylococcus aureus (S. aureus). 1,2 These infections vary according to microorganism virulence and antimicrobial resistance profile. 3 Many transplanted patients are colonized by S. aureus.…”

“…Colonization can occur in the pre-or post-transplantation period and is associated with several factors, such as surgery duration, altimicrobial use, permanency in the Intensive Care Unity (ICU), drains and catheter use, excessive manipulation, and disease severity. 1,4,5 S. aureus profile resistance depends on methicillin susceptibility. Methicillin-resistant S. aureus (MRSA) displays a mecA gene, which orders a modified penicillinbinding protein -PBP-2 that decreases its affinity for penicillin.…”

Infections After Liver Transplantation: A Retrospective, Single-center Study

“…These data are in general accordance with that described in the literature, although other authors describe a higher incidence of infections. Piselli et al [14] described a rate of 56.3% and Souza et al [15] reported a rate of 55.3%, whereas Vera et al [16] reported an incidence of 55.3%. In another period, after 1 year post LT, Aberjet et al [17] described an incidence of 31% of infections.…”

Infecciones tempranas en pacientes trasplantados en un hospital de alta complejidad

“…Los trasplantes de órganos son uno de los avances más significativos del progreso científico de la medicina actual y constituyen una de las alternativas terapéuticas más importantes en el campo de las ciencias de la salud, pues han permitido mejorar la calidad de vida de muchos pacientes con disfunción de un órgano afectado por una enfermedad grave o terminal, además de prolongar la vida. Sin embargo, la condición clínica del paciente previa al trasplante y la necesidad de terapias inmunosupresoras para evitar el rechazo del órgano trasplantado, facilitan la aparición de infecciones, las cuales a pesar de los avances en las técnicas quirúrgicas y el desarrollo de terapias profilácticas eficaces, continúan siendo una frecuente causa de morbilidad y mortalidad en el periodo pos trasplante 1,2 . Las infecciones que afectan a los pacientes trasplantados ocurren dentro de periodos bien definidos de riesgo posterior al trasplante.…”