Multidrug resistant gram‐negative bacilli as predominant bacteremic pathogens in liver transplant recipients

Shi, Shaohua; Kong, Haishen; Xu, Jian; Zhang, W.J.; Jia, Chang; Wang, W.L.; Shen, Yan; Zheng, Shusen

doi:10.1111/j.1399-3062.2009.00421.x

Cited by 121 publications

(141 citation statements)

References 33 publications

(29 reference statements)

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“…BSI caused by Acinetobacter strains only susceptible to colistin, vancomycin-resistant enterococci and carbapenemresistant Enterobacteriaceae are emerging problems in our centre in the last five years in accordance with previous studies (3,15,16). Carbapenem resistance in Enterobacteriaceae are due to OXA-48 type carbapenemases in Turkey.…”

Section: Discussionsupporting

confidence: 52%

“…The Turkish National Nosocomial Surveillance Report revealed carbapenem resistance rate among P. aeruginosa isolates of ICU as 32.9% in 2011 (13). Shi et al (15) reported resistance rates among Pseudomonas spp. against ceftazidime, ciprofloxacin and imipenem as 18%, 33% and 32%, respectively, in China.…”

Section: Discussionmentioning

confidence: 99%

“…However, the widespread use of antibiotics both for prophylaxis and treatment in the pre-and posttransplant periods is of pivotal importance for the emergence of these resistant strains. Other factors probably associated with the emergence of antimicrobial resistant pathogens were reported as severity of underlying disease, cross-infection, post-transplant reoperation, post-transplant abdominal infection, and high dose immunosuppressive therapy for acute rejection (15).…”

Section: Discussionmentioning

confidence: 99%

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Bloodstream Infections among Solid Organ Transplant Recipients: Eight Years’ Experience from a Turkish University Hospital

Yeşilkaya¹,

Azap²,

Demirkaya³

et al. 2013

Balkan Med J

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Background: Bloodstream infections (BSI) are frequently seen after solid organ transplantation. The incidence of bloodstream infections differs among the types of transplantation. The microbiological features and antimicrobial resistance patterns change from centre to centre. Aims: To evaluate the incidence and spectrum of aetiological agents of bloodstream infections among solid organ transplantation recipients.Study Design: Retrospective descriptive study.Methods: Medical records of solid organ transplant recipients in the period between January 1 st 2004 and August 15 th 2012 were assessed retrospectively. The study population comprised 927 (64 heart, 556 kidney, 307 liver) consecutive recipients. Bloodstream infections were divided into three groups according to the onset time of bloodstream infections after transplantation: early, mid-term and late. The incidence and microbiological features of bloodstream infections were evaluated.Results: The number of bloodstream infection episodes was 317 in 191 recipients which was distributed as 228 (72%) in liver, 70 (22%) in kidney and 19 (6%) in heart transplantation. Ninety-eight 98 (30.9%) of the episodes were diagnosed within the early period, 134 (42.3%) within the mid-term and 85 (26.8%) in the late period. Early and mid-term bloodstream infections were seen statistically more often in liver than in kidney or heart transplantation (p=0.01 and p=0.031, respectively). Late bloodstream infections were also common in liver transplant recipients which was not statistically significant (p=0.229).Conclusion: Liver transplant recipients are at the highest risk for developing BSI after transplantation in early, mid-term and late periods.

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Section: Discussionsupporting

confidence: 52%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Bloodstream Infections among Solid Organ Transplant Recipients: Eight Years’ Experience from a Turkish University Hospital

Yeşilkaya¹,

Azap²,

Demirkaya³

et al. 2013

Balkan Med J

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“…Another problem is antimicrobial resistance, for instance vancomycin-resistant Enterococcus, methicillin-resistant Staphylococcus aureus, Pseudomonas, Stenotrophomonas, fungi (both yeasts and moulds) and ganciclovirresistant cytomegalovirus. (4,5) Even though all patients received prophylactic antibiotic treatment, nine patients (29%) developed early infection (during the first postoperative month). All infections were bacterial, including pneumonia and peritonitis as the primary site of the infection.…”

Section: Discussionmentioning

confidence: 99%

Outcome of liver transplant patients at the University Hospital Centre Zagreb

Brajković

Babel

Vegar

et al. 2015

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At the University Hospital Centre Zagreb, 37 patients underwent liver transplantation in the period from 2010 to 2014. Six patients had fatal complications in the early post-transplantation period and deceases in the surgical intensive care unit (ICU). All other patients (31) were transferred to the medical ICU and later to the medical ward. The most common indications for liver transplantation were alcoholic liver disease (9 patients) and hepatitis C (8 patients). Two-thirds of the patients were male (67.7%) with an average age of 51 years. Thirty patients were discharged alive from the hospital. Infections developed in nine patients, mostly pneumonia and peritonitis. Only one patient experienced infection caused by multi-drug resistant bacteria, namely peritonitis due to methicillin-resistant Staphylococcus aureus (MRSA). All infections were successfully treated with antibiotics and none of them caused graft rejection.

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“…The high prevalence of multidrug-resistance among bacterial pathogens causing infections in solid organ transplant recipients is an additional concern. In a recent report, infections with multidrug-resistant Gram negative bacteria were associated with higher mortality among liver transplant recipients (Shi et al, 2009). Emergence of nosocomial infections, especially Acinetobacter baumannii, Pseudomonas aeruginosa with multidrug resistance have become a major problem among transplant recipients in hospital settings (Diab et al, 2002(Diab et al, , 2004Patel et al, 2010).…”

Section: Introductionmentioning

confidence: 99%

Influence of multi drug resistance Gram negative bacteria in liver transplant recipient

Aziz¹,

El-Kholy²,

Abdo³

et al. 2013

Afr. J. Microbiol. Res.

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Infection is a common cause of morbidity and mortality after liver transplantation, which are often caused by Gram negative bacteria and the most frequently occurring infectious complications after liver transplantation (LT). The aim of this study was to investigate, incidence, pathogenic spectrum, and risk factors for bacteria due to multidrug resistant (MDR) Gram-negative bacteria, and its impact on mortality after LT. In total, 150 consecutive patients who underwent liver transplantation between January 2012 and March 2013, 115 isolates of bacteria and 10 isolates fungal from 80 patients. MicroScan® microbiology and API20 were used to identify the all isolates. Bacterial infections represented the most frequent event (92.0%) and fungal infections (8.0%). The presumed sources of infection were the Urine (41 events, 51%), followed by the bail drain (14 events, 17.5%). Infections of the sputum, ascetic fluid, and blood site accounted for 13.8, 5.0 and 6.3%, respectively. Antibiotics the most susceptible antibiotic against Pseudomonas aeruginosa was colistin (94.1%). Patients with Gramnegative bacilli after liver transplantation show a significantly worse prognosis. Gram-negative bacteria after liver transplantation have been a major problem in our center.

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Multidrug resistant gram‐negative bacilli as predominant bacteremic pathogens in liver transplant recipients

Abstract: Post-LT bacteremias caused by MDR gram-negative bacilli are common, and associated with allograft acute rejection, post-LT reoperation, and abdominal infection. The increasing isolates of MDR gram-negative bacilli pose a great challenge for clinical treatment.

Cited by 121 publications

References 33 publications

Bloodstream Infections among Solid Organ Transplant Recipients: Eight Years’ Experience from a Turkish University Hospital

Bloodstream Infections among Solid Organ Transplant Recipients: Eight Years’ Experience from a Turkish University Hospital

Outcome of liver transplant patients at the University Hospital Centre Zagreb

Influence of multi drug resistance Gram negative bacteria in liver transplant recipient

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