Etiological Agents of Bacteremia in the Early Period After Liver Transplantation

Kawecki, D.; Chmura, A.; Pacholczyk, Marek; Łągiewska, B; Adadyński, L; Wasiak, Dariusz; Małkowski, Piotr; Rokosz, A; Sawicka-Grzelak, A.; Szymanowska, Amelia; Swoboda-Kopeć, Ewa; Wróblewska, Marta; Rowińskí, W; Durlik, M.; Łuczak, M.

doi:10.1016/j.transproceed.2007.08.048

Cited by 36 publications

(22 citation statements)

References 17 publications

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“…A. baumannii , a usually multidrug-resistant pathogen [24], has been unfortunately uncommonly found in posttransplant infections [25]–[27]. In agreement with other transplant series [28]–[31], a substantial number of Gram-positive microbes normally considered cutaneous flora were found to be pathogens in ours, and this is not surprising in view that all of the immediate posttransplant recipients were indwelling central-venous catheter and/or other draining catheter/tube of which the exit potentially served as a portal of entry for bacteria normally inhabit in skin.…”

Section: Discussionsupporting

confidence: 84%

Impacts of Pretransplant Infections on Clinical Outcomes of Patients with Acute-On-Chronic Liver Failure Who Received Living-Donor Liver Transplantation

et al. 2013

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BackgroundLiver transplantation is the only therapeutic modality for patients with acute-on chronic liver failure (ACLF). These patients are at high risk for bacterial infections while awaiting transplantation. The aim of this study was to elucidate whether an adequately treated bacterial infection influences the outcomes after transplantation in this patient population.Methodology/Principal Findings54 recipients (median age, 49.5 years [range, 22–60]) of adult-to-adult living donor liver transplant (LDLT) for ACLF were categorized as those with pretransplant infection (Group 1, n = 34) or without pretransplant infection (Group 2, n = 20) for retrospective analyses. With the exception of a higher male-female ratio (P = 0.046) and longer length of pretransplant hospital stay (P = 0.026) in Group 1, similar demographic, laboratory and clinical features were found in both groups. Patients in Group 1 (totally 42 pretransplant infection episodes) were adequately treated with effective antibiotic(s) before receiving LDLT. All included patients were followed up until one year after transplantation or death. Sixty-one posttransplant infection episodes were found in an overall of 44 ACLF patients (27 in Group 1 vs. 15 in Group 2; P = 0.352). Frequently encountered posttransplant infections were intraabdominal infection, pneumonia, bloodstream infection and urinary tract infection. Two patients died in each group (P = 0.622). No significant difference was found in the length of posttransplant ICU stay, and in one-year survival, graft rejection, and posttransplant infection rate between both groups. The longer overall hospital stay (mean day, 89.0 vs. 65.5, P = 0.024) found in Group 1 resulted from a longer pretransplant hospital stay receiving treatment for pretransplant infection(s) and/or awaiting transplantation.ConclusionsThese data suggested that an adequately treated pretransplant infection do not pose a significant risk for clinical outcomes including posttransplant fatality in recipients in adult-to-adult LDLT for ACLF.

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Section: Discussionsupporting

confidence: 84%

Impacts of Pretransplant Infections on Clinical Outcomes of Patients with Acute-On-Chronic Liver Failure Who Received Living-Donor Liver Transplantation

et al. 2013

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“…The occurrence of opportunistic infections is in accordance with that described in the literature [21]. Fungal infections appeared earlier, but other opportunistic infections appeared later [22,23].…”

Section: Discussionsupporting

confidence: 90%

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

Antunes

Teixeira

Fortuna

et al. 2015

Transplantation Proceedings

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Objective. To access the incidence of infectious problems after liver transplantation (LT).Design. A retrospective, single-center study. Materials and Methods. Patients undergoing LT from January 2008 to December 2011 were considered. Exclusion criterion was death occurring in the first 48 hours after LT. We determined the site of infection and the bacterial isolates and collected and compared recipient's variables, graft variables, surgical data, post-LT clinical data. Results. Of the 492 patients who underwent LT and the 463 considered for this study, 190 (Group 1, 41%) developed at least 1 infection, with 298 infections detected. Of these, 189 microorganisms were isolated, 81 (51%) gram-positive bacteria (most frequently Staphylococcus spp). Biliary infections were more frequent (mean time of 160.4 AE 167.7 days after LT); from 3 months after LT, gram-negative bacteria were observed (57%). Patients with infections after LT presented lower aminotransferase levels, but higher requirements in blood transfusions, intraoperative vasopressors, hemodialysis, and hospital stay. Operative and cold ischemia times were similar. Conclusion. We found a 41% incidence of all infections in a 2-year follow-up after LT. Gram-positive bacteria were more frequent isolated; however, negative bacteria were commonly isolated later. Clinical data after LT were more relevant for the development of infections. Donors' variables should be considered in future analyses.

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“…Bu sonuçlar, nötropenik hastalar ve solid organ nakli sonrası erken dönem hastalardaki bakteriyemilerin en sık etkenlerinin Gram-pozitif bakteriler olduğunu bildiren Amerika, Avrupa ve Asya kaynaklı çalışmaların sonuçlarından farklı bulunmuştur (7)(8)(9)(10). Brezilya'dan Silva ve arkadaşları (11) Çalışmamızda, kaynağına göre bakteriyemi sınıflaması yapıldığında sekonder bakteriyemiler (%47.9) en sık görü-len grubu ve karın içi infeksiyonlar (%42.5) da en sık kaynağı oluşturdu.…”

Section: İrdelemeunclassified

The Distribution and Antimicrobial Susceptibility Profiles of Etiologic Agents Isolated From Bacteremia Episodes Among Immunocompromised Patients

Demirkaya¹,

Yeşilkaya²,

Ok³

et al. 2017

Klimik Dergisi

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Objective: Bacteremia is the leading cause of morbidity and mortality among immunocompromised patients. The aim of this study is to evaluate the etiology of bacteremia and the antibiotic susceptibilities of etiologic agents among immunocompromised patients followed up from January 1, 2012 to July 30, 2013. Methods: Immunocompromised patients, both inpatient and outpatient treated in our hospital, were followed prospectively. The definition of "immunocompromised patients" consisted of solid organ (kidney, liver) transplantation recipients and hemato-oncologic malignancy patients with a history of chemotherapy in the previous month before bacteremia. Results: This prospective study comprised of 167 bacteremia episodes of 130 consecutive immunocompromised patients. The most isolated group of bacteria was Gram-negative bacteria. Escherichia coli was the most commonly (30.8%) isolated bacteria and the second was coagulase-negative staphylococci (15.1%). Fifty one percent of the E. coli isolates were extended-spectrum β-lactamasepositive. Acinetobacter baumannii was the second most common bacteria of Gram-negative agents and the ratio of multiple drugresistant (MDR) isolates among Acinetobacter isolates was 73%. Conclusions: Gram-negative bacteria are the most common causative agents of bacteremia in immunocompromised patients in our hospital. The rising ratio of MDR A. baumannii is a striking problem which causes difficult-to-treat infections.

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Etiological Agents of Bacteremia in the Early Period After Liver Transplantation

Cited by 36 publications

References 17 publications

Impacts of Pretransplant Infections on Clinical Outcomes of Patients with Acute-On-Chronic Liver Failure Who Received Living-Donor Liver Transplantation

Impacts of Pretransplant Infections on Clinical Outcomes of Patients with Acute-On-Chronic Liver Failure Who Received Living-Donor Liver Transplantation

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

The Distribution and Antimicrobial Susceptibility Profiles of Etiologic Agents Isolated From Bacteremia Episodes Among Immunocompromised Patients

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