Infection Complications and Pattern of Bacterial Resistance in Living-Donor Liver Transplantation: A Multicenter Epidemiologic Study in Egypt

Mukhtar, Ahmed; Abdelaal, Amr; Hussein, Marwa M.; Dabous, Hany; Fawzy, Iman M.; Obayah, Gihan; Hasanin, Ahmed; Adel, Nelly G.; Ghaith, Doaa; Bahaa, Mohamed; Fathy, Mohamed; El-Meteini, Mahmoud

doi:10.1016/j.transproceed.2014.02.022

Cited by 15 publications

(15 citation statements)

References 17 publications

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“…In the current study, 73.3% of included patients developed a nosocomial bacterial infection in the first 3 mo post-LDLT. This finding is in agreement with previous reports, which denoted a high incidence of bacterial infections post-LDLT ranging from 50% to 75%[ 1 , 2 ].…”

Section: Discussionsupporting

confidence: 94%

“…In the current study, the presence of pre-transplant HCC was an independent risk factor for the occurrence of repeated episodes of bacterial infection in the recipients during the early post-transplant period. HCC patients are more susceptible to infection due to poor long-term nutrition, poor physical condition and weak immune system[ 1 ].…”

Section: Discussionmentioning

confidence: 99%

“…Infection following living-donor liver transplantation (LDLT) is a serious problem with a high mortality rate reaching 50%. Many factors were associated with high risks of acquiring infection following LDLT, including the difficulty of surgery, the poor patient’s condition, and the immunosuppressive drugs[ 1 ].…”

Section: Introductionmentioning

confidence: 99%

“…Patients may become infected with antimicrobial-resistant bacteria, especially methicillin-resistant Staphylococcus aureus , vancomycin-resistant Enterococcus faecalis , Clostridium difficile , and gram-negative bacteria[ 3 ]. Currently, multidrug-resistant (MDR) organisms are the most common cause of nosocomial infections in liver transplant recipients[ 1 ].…”

Section: Introductionmentioning

confidence: 99%

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Bacterial infections post-living-donor liver transplantation in Egyptian hepatitis C virus-cirrhotic patients: A single-center study

Montasser¹,

Abdelkader²,

Abdelhakam³

et al. 2017

WJH

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AIMTo determine risk factors, causative organisms and antimicrobial resistance of bacterial infections following living-donor liver transplantation (LDLT) in cirrhotic patients.METHODSThis prospective study included 45 patients with hepatitis C virus-related end-stage liver disease who underwent LDLT at Ain Shams Center for Organ Transplant, Cairo, Egypt from January 2014 to November 2015. Patients were followed-up for the first 3 mo after LDLT for detection of bacterial infections. All patients were examined for the possible risk factors suggestive of acquiring infection pre-, intra- and post-operatively. Positive cultures based on clinical suspicion and patterns of antimicrobial resistance were identified.RESULTSThirty-three patients (73.3%) suffered from bacterial infections; 21 of them had a single infection episode, and 12 had repeated infection episodes. Bile was the most common site for both single and repeated episodes of infection (28.6% and 27.8%, respectively). The most common isolated organisms were gram-negative bacteria. Acinetobacter baumannii was the most common organism isolated from both single and repeated infection episodes (19% and 33.3%, respectively), followed by Escherichia coli for repeated infections (11.1%), and Pseudomonas aeruginosa for single infections (19%). Levofloxacin showed high sensitivity against repeated infection episodes (P = 0.03). Klebsiella, Acinetobacter and Pseudomonas were multi-drug resistant (MDR). Pre-transplant hepatocellular carcinoma (HCC) and duration of drain insertion (in days) were independent risk factors for the occurrence of repeated infection episodes (P = 0.024).CONCLUSIONMDR gram-negative bacterial infections are common post-LDLT. Pre-transplant HCC and duration of drain insertion were independent risk factors for the occurrence of repeated infection episodes.

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Section: Discussionsupporting

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Bacterial infections post-living-donor liver transplantation in Egyptian hepatitis C virus-cirrhotic patients: A single-center study

Montasser¹,

Abdelkader²,

Abdelhakam³

et al. 2017

WJH

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“…Infection may be primary, due to reactivation of already transferred earlier infection, or related to infection by opportunistic microorganisms. [1][2][3] In general, any bacteria can cause infection after liver transplant, although a vast majority are caused by Enterococcus species, Streptococcus species, and Staphylococcus aureus, as well as gram-negative bacilli from the family Enterobacteriaceae. 4 During posttransplant, patients receive massive immunosuppressive therapy, which increases the risk of infectious complications.…”

Section: Introductionmentioning

confidence: 99%

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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Gastrointestinal Infections After Solid Organ or Hematopoietic Cell Transplantation

Damman

McDonald

2016

Transplant Infections

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Infection Complications and Pattern of Bacterial Resistance in Living-Donor Liver Transplantation: A Multicenter Epidemiologic Study in Egypt

Cited by 15 publications

References 17 publications

Bacterial infections post-living-donor liver transplantation in Egyptian hepatitis C virus-cirrhotic patients: A single-center study

Bacterial infections post-living-donor liver transplantation in Egyptian hepatitis C virus-cirrhotic patients: A single-center study

Untitled

Gastrointestinal Infections After Solid Organ or Hematopoietic Cell Transplantation

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