Incidence and Timing of Infections After Liver Transplant in Italy

Piselli, Pierluca; Zanfi, Chiara; Corazza, Valentina; Ferretti, Stefano; Scuderi, M; Arana, Maite; Secchia, S. Barzoni; Lauro, Augusto; Dazzi, A.; Pinna, A.D.; Ettorre, Giuseppe Maria; Vennarecci, Giovanni; Santoro, Rosanna; Ferretti, G.; Gusman, Nakada D.; Berloco, P.B.; Grossi, Paolo; Angeletti, Claudio; Bellelli, Stefania; Costa, Alessandro Nanni; Ippolito, Giuseppe; Girardi, Enrico; Serraino, Diego

doi:10.1016/j.transproceed.2007.05.056

Cited by 22 publications

(31 citation statements)

References 7 publications

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“…Infection by Gram-negative enteric organisms was the main cause of bacterial infection in our population, which shows that the epidemiology of infections at our hospital is similar to those of Western Europe and the United States. In accordance with other studies (Piselli et al, 2007, Garbino et al, 2005, most bacterial infections occurred within the first month, and the bloodstream was the leading infection site. Other significant locations were urinary tract infections, and abdominal and surgical site infections.…”

Section: Discussionsupporting

confidence: 91%

“…In our study, the proportion of bacterial events was higher (92.0%) in comparison with 47% observed in the Swiss study (Garbino et al, 2005), 48% reported by Torbenson et al (1998), about 54% at the Pittsburgh Medical Center, or 57% in the Italian study (Piselli et al, 2007). Infection by Gram-negative enteric organisms was the main cause of bacterial infection in our population, which shows that the epidemiology of infections at our hospital is similar to those of Western Europe and the United States.…”

Section: Discussioncontrasting

confidence: 71%

“…Fungal infections accounted for 8.0% in our patients which compared with other studies that showed infection rates between 12 and 29% (Piselli et al, 2007). Pappas et al (2006) reported a rate of 4% of invasive fungal infections during the first 100 days post transplantation.…”

Section: Discussionsupporting

confidence: 60%

“…Studies of infectious complications after liver transplantation exist in the literature (Piselli et al, 2007). However, most of these data are older than 10 years and all of the studies were performed in the United States and Europe.…”

Section: Discussionmentioning

confidence: 99%

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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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Section: Discussionsupporting

confidence: 91%

Section: Discussioncontrasting

confidence: 71%

Section: Discussionsupporting

confidence: 60%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

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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“…These data are in general accordance with that described in the literature, although other authors describe a higher incidence of infections. Piselli et al [14] described a rate of 56.3% and Souza et al [15] reported a rate of 55.3%, whereas Vera et al [16] reported an incidence of 55.3%. In another period, after 1 year post LT, Aberjet et al [17] described an incidence of 31% of infections.…”

Section: Discussionmentioning

confidence: 99%

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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Procalcitonin as a prognostic marker for infectious complications in liver transplant recipients in an intensive care unit

et al. 2010

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Clinically significant infections (CSIs) are life-threatening but difficult to diagnose after liver transplantation (LTx). This study investigates the value of procalcitonin (PCT) in addition to c-reactive protein (CRP) and the leukocyte count (LC) as a prognostic marker for CSIs in LTx recipients. The clinical course of 135 LTx recipients was prospectively studied. CSIs were defined as pulmonary, bloodstream, or intra-abdominal infections. Independent risk factors for CSIs were determined by Cox proportional hazard analysis. The concordance statistics (c-statistics) were used to assess the discrimination effect of PCT. Thirty recipients (22%) experienced a CSI. They had significantly higher peak PCT (27.2 versus 12.7 ng/mL, P = 0.014) and peak CRP (13.7 versus 9.9 mg/dL, P < 0.001) and a tendency toward a higher peak LC (19.3 versus 14.2 cells/nL, P = 0.051) in comparison with recipients without CSIs. Independent risk factors for CSIs were male sex [hazard ratio (HR) = 6.4], a body mass index (BMI) < 20 kg/m(2) (versus a BMI > 25 kg/m(2), HR = 13.8), acute liver failure as an indication for LTx (HR = 7.1), a cold ischemic time > 420 minutes (HR = 3.5), and peak CRP (HR = 1.1) but not peak PCT. The addition of peak PCT marginally improved the c-statistic from 0.815 to 0.827. In conclusion, although peak PCT differed significantly between recipients with and without CSIs, it was not an independent risk factor for CSIs and added little prognostic accuracy. Interestingly, the parameters peak CRP, male sex, low BMI, acute liver failure, and long cold ischemic time were independent risk factors for CSIs. They could serve as risk stratifiers directing medical therapy in clinical practice.

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Incidence and Timing of Infections After Liver Transplant in Italy

Cited by 22 publications

References 7 publications

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

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

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

Procalcitonin as a prognostic marker for infectious complications in liver transplant recipients in an intensive care unit

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