Bloodstream infection after living donor liver transplantation

Abstract

There are no detailed studies on the prevalence or clinical magnitude of bloodstream infection (BSI) following living donor liver transplantation (LDLT). The study aimed to assess the incidence and analyze the risk factors for BSI after LDLT. Univariate and multivariate analyses were performed to identify the independent risk factors for postoperative BSI. Postoperatively, 26 episodes of BSI occurred in 21 of 242 studied adult patients by median postoperative d 35. Five patients had primary BSI. The source was unknown in 3 patients and an intravascular catheter in 2. The other 16 patients had secondary BSI. Secondary BSI was caused by surgical site infection in 8 patients, followed by intra-abdominal infection in 5, pneumonia in 2, and both surgical site infection and intra-abdominal infection in 1. The most frequent pathogen isolated was MRSA, which was detected in 4 patients. Surveillance culture detected the same isolates prior to BSI in 14 of 26 (50%) episodes. Diabetes mellitus and serum albumin level less than 2.4 g/dl independently predicted postoperative BSI. Perioperatively, screening for and taking actions against pathogen including MRSA should be performed in LDLT patients.

Clinical practice guidelines for antimicrobial prophylaxis in surgery

“…894,933,935,937,938,940,943,[945][946][947]951,952,955,964,965,969 S. aureus (frequently MRSA) and coagulasenegative staphylococci are also common causes of postoperative SSIs. [936][937][938]940,942,943,[945][946][947][948][949]955,[957][958][959][960][961]964,965,970,971 Candida species commonly cause both early and late postoperative infections. 933,936,937,940,942,943,[945][946][947]949,951,969 Several studies have noted incre...…”

Severe Intraoperative Hyperglycemia Is Independently Associated With Surgical Site Infection After Liver Transplantation

“…Many SSIs advance to systemic infection, which can lead to a fatal outcome (3)(4)(5). Additionally, SSI is associated with longer hospital stay, reoperation, hospital readmission, graft failure, and higher overall cost (2,6).…”

Standardization of perioperative management on hepato-biliary-pancreatic surgery

“…Close monitoring and early intervention is mandatory in every aspect for better survival of the recipient. In case of suspected infectious complications, treatment with prophylactic administration of antibiotics, and antiviral or antifungal drugs may be justified (39)(40)(41). Of note is the novel approach with plasma (1 → 3) β-D-glucan measurement for preemptive treatment of fungal diseases that may often become fatal once becoming symptomatic (41).…”