Bacterial and Fungal Infections in the Early Post-transplantation Period After Liver Transplantation: Etiologic Agents and Their Susceptibility

Kawecki, D.; Pacholczyk, Marek; Łągiewska, B; Sawicka-Grzelak, A.; Durlik, M.; Młynarczyk, G.; Chmura, A.

doi:10.1016/j.transproceed.2014.08.031

Cited by 39 publications

(23 citation statements)

References 22 publications

(14 reference statements)

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“…10 In a similar study of patients before liver transplant, the proportion of gram-positive bacteria accounted for 52.2%, with gram-negative accounting for 40.8% and fungi for 7.0%. 11 In our study, 79.5% of isolates were gram positive, 20.4% were gramnegative, and 4.5% were fungi.…”

Section: Discussionsupporting

confidence: 44%

Untitled

2016

Exp Clin Transplant

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Objectives: Chronic infections can cause serious complications and create morbidity and mortality for affected patients during immunosuppressive therapy in the posttransplant period. Here, we studied the microbiologic screening results of patients before living-donor liver transplant. Materials and Methods:The microbiologic screening results of 25 patients during 2015 at National Scientific Research Center (Astana, Kazakhstan) before livingdonor liver transplant were prospectively analyzed. Sputum samples, swabs from throat and nose, and urine samples were collected for quantitative microbiologic examination. Identification of isolates and antibiotic susceptibility testing were performed using the Vitek 2 automated system (bioMérieux, Marcy l'Etoile, France). Results: Of the patients, 16 (64%) were female and the average age was 46.8 ± 2.2 years. Of 97 clinical samples collected, 80 samples (82.4%) showed bacterial growth. A total of 88 isolates to 15 different species was isolated. The greatest number of bacteria was isolated from throat swabs (35.2%). Of 88 isolates, 70 isolates (79.5%) were gram-positive, with α-hemolysis streptococci being the major isolate (39.7%). Coagulase-negative staphylococci were found in 13.6% of isolates, Staphylococcus aureus in 11.3%, and both Klebsiella pneumoniae and Streptococcus pneumoniae in 10.2%. Results of antibiotic susceptibility testing showed that the resistance rate of Staphylococcus aureus to oxacillin was 10%. About 87.5% of isolates of Klebsiella pneumoniae were resistant to inhibitor-protected penicillin, 85.7% to quinolones, and more than 60% to cephalosporins and aminoglycosides groups of antibiotics.Conclusions: Microbiologic monitoring of recipients before living-donor liver transplant showed higher prevalence of opportunistic pathogens. These results suggest establishing quality preoperative preparations with a view to possible improvements in the health status of intended recipients and elimination of factors that could adversely affect the transplant and cause complications during the postoperative period.

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Section: Discussionsupporting

confidence: 44%

Untitled

2016

Exp Clin Transplant

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“…6 A recent study from the Medical University of Warsaw, on infections after orthotopic liver transplantation, showed a high proportion of isolates of antibiotic-resistant bacteria. 7 Common infections in neonatal intensive care are increasingly becoming extremely difficult, and sometimes impossible, to treat. 8 Staphylococcal species, most notably S. epidermidis and S. aureus, cause *60%-70% of infections, and numerous outbreaks of methicillin-resistant S. aureus (MRSA) have been reported in these units.…”

Section: Impact Of Antibiotic Resistancementioning

confidence: 99%

Antimicrobial resistance: a global multifaceted phenomenon

Prestinaci

Pezzotti

Pantosti

2015

Pathogens and Global Health

2,077

1,370

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Antimicrobial resistance (AMR) is one of the most serious global public health threats in this century. The first World Health Organization (WHO) Global report on surveillance of AMR, published in April 2014, collected for the first time data from national and international surveillance networks, showing the extent of this phenomenon in many parts of the world and also the presence of large gaps in the existing surveillance. In this review, we focus on antibacterial resistance (ABR), which represents at the moment the major problem, both for the high rates of resistance observed in bacteria that cause common infections and for the complexity of the consequences of ABR. We describe the health and economic impact of ABR, the principal risk factors for its emergence and, in particular, we illustrate the highlights of four antibiotic-resistant pathogens of global concern -Staphylococcus aureus, Klebsiella pneumoniae, non-typhoidal Salmonella and Mycobacterium tuberculosis -for whom we report resistance data worldwide. Measures to control the emergence and the spread of ABR are presented.

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“…2,10,11 Higher rates of yeast like fungi (21%) have been reported in other studies of LT patients. 10 Using fluconazole as prophylaxis in all patients may have led to selection pressure and an increased rate of isolation of nonCandida albicans species, which can be fluconazole resistant.…”

Section: Discussionmentioning

confidence: 76%

“…In other studies, the incidence of UTI during the first 4 weeks after LT is reportedly between 7.1% and 16.7%. 2,8 In nonkidney transplant recipients, bacterial UTI is usually an early complication during 4 weeks after transplant and associated mainly with malnutrition and factors related to postoperative patient care, such as urinary catheterization and stays in the ICU. 9 In the present study, multivariate analysis showed that female sex, hospitalization 2 to 7 days before LT, frequency of abdominal exploration, and high body mass index increased the risk of infection.…”

Section: Discussionmentioning

confidence: 99%

“…1 Infections, especially in the first month after transplant, remain grave complications after LT despite all measures to reduce their risk. 2,3 Urinary tract infections (UTIs) and bacteriuria are among the most common infections experienced by solid-organ transplant recipients. 4 However, a limited number of published studies have investigated the prevalence, risk factors, and causes of UTIs in LT recipients worldwide and especially in Iran.…”

Section: Introductionmentioning

confidence: 99%

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Pouladfar¹,

Jafarpour²,

Firoozifar³

et al. 2017

Exp Clin Transplant

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Objectives: Urinary tract infections are among the most common infections after liver transplant, especially soon after surgery. This study analyzed urinary tract infections or bacteriuria, their causative agents, and related risk factors in the early period after liver transplant in hospitalized adult transplant recipients in the main liver transplant referral center in Iran. Results: Seventy-nine episodes of urinary tract infections or bacteriuria occurred in the infection group. Multiple logistic regression analysis showed that female sex, hospitalization 2 to 7 days before transplant, and frequency of abdominal exploration were 11.0, 5.9, and 3.0 times more common in the infection group than in the control group. The chance of infection rises 1.1 times with each one unit increase of body mass index. The most common infection causes were gram-negative bacteria (n = 50; 63.3%), predominantly Escherichia coli (n = 24; 30.4%); followed by gram-positive bacteria (n = 20; 25.3%), predominantly Enterococcus species (n = 14; 17.8%) that had a high incidence of vancomycin resistance (n = 10; 71.4%); and non-Candida albicans species isolates (n = 9; 11.4%). Conclusions: Urinary tract infections are a common infection in hospitalized adult patients soon after liver transplant. Female sex, hospitalization shortly before transplant, more frequent abdominal exploration, and higher body mass index substantially increased the risk of developing such infections in this period.

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Bacterial and Fungal Infections in the Early Post-transplantation Period After Liver Transplantation: Etiologic Agents and Their Susceptibility

Cited by 39 publications

References 22 publications

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Antimicrobial resistance: a global multifaceted phenomenon

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