Microbial epidemiology and outcome of bloodstream infections in liver transplant recipients: An analysis of 259 episodes

Abstract

Bloodstream infections (BSIs) are a major cause of mortality in liver transplant recipients. The incidence, microbiology, and outcome of BSIs in the first year after liver transplantation were analyzed in 704 patients who underwent transplantation at a single center between 1997 and 2007. BSIs occurred in 205 (29.1%) of the 704 patients. Overall, 259 episodes were documented, and they resulted in an incidence rate of 36.8%. Of these episodes, 39.4%, 27.8%, 17%, and 15.8% occurred in the very early period (10 days after liver transplantation), the early period (days 11-30), the intermediate period (days 31-90), and the late period (days 91-365), respectively. The most frequent pathogens were Enterobacteriaceae members (41%), Staphylococcus aureus (19.8%), enterococci (13.1%), Pseudomonas aeruginosa (8.8%), and yeasts (7.1%). The median time of onset ranged from 7 days for methicillin-resistant S. aureus to 25 days for Enterobacteriaceae. Mortality at 15 days after BSIs was 16.2%. Kaplan-Meier survival curves showed that patients with BSIs had a significantly higher 1-year mortality rate than those without BSIs (28.3% versus 16.6%, P < 0.001 with the log-rank test). When the time of BSI onset was considered, 1-year mortality was significantly associated with very early and early episodes (P < 0.001) but not with intermediate and late episodes (P ¼ 0.47). In conclusion, BSIs are frequent and early complications after liver transplantation and are mostly caused by gram-negative bacilli. A BSI in the first posttransplant month is a significant predictor of 1-year survival. Liver Transpl 16:393-401,

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

“…The percentage of candidaemia after SOT in our centre (2.9%) was similar to previous reports (1.7%-7%) (1,6,10,11). The results of both the identification and antifungal susceptibilities of five Candida isolates yielded no fluconazole resistance.…”

Impact of Antibiotic Resistance on the Development of Recurrent and Relapsing Symptomatic Urinary Tract Infection in Kidney Recipients

“…Some studies have reported a high frequency of infection caused by MDR organisms in solid organ recipients, ranging from 6.5% to 56% (4,5,7,9,11,(25)(26)(27)(28)(29)(30)(31). In this regard, intense immunosuppressive therapy could leave immunocompromised patients more susceptible to infections caused by MDR organisms.…”

Infections in Liver Transplant Recipients

“…These infections predominantly involve the surgical site, the abdominal cavity, bloodstream, urinary system, and the respiratory tract. [8][9][10][11] Pathogens isolated from the majority of the bacterial infections are enterococci, viridans streptococci, Staphylococcus aureus, and members of the Enterobacteriaceae family. 2 …”