Pathogenesis of Early Operative Site Infections After Orthotopic Liver Transplantation

Abstract

Our findings suggest that systemic antibiotic prophylaxis for more than 2 days may be beneficial in cases with bacterial contamination of the operative site but may not be necessary in other cases.

Surgical Site Infection in Liver Transplant Recipients: Impact of the Type of Perioperative Prophylaxis

“…The previously described origins of SSI infection are mainly bacteria with a low incidence of fungi (9,10,14,20,21). We did not find any cases of fungal infection.…”

Infections after liver transplantation in adults: data from a university hospital in southern Brazil (1996-2000)

“…Thus over four-fifths of patients had non-mucocutaneous infections, and almost two-thirds of all deaths were related to them. Like others, we found that the most dangerous period for infections was the first month after transplantation (1,9) , when a "first infection" was most common. Infections have been recognized as a major cause of morbidity and death in liver transplant recipients since the early days of organ transplantation.…”

“…Serious infections are likely to occur during the first 6 months post-OLT and most of them have bacterial etiology (9,17,26) . In this phase, infections are related to the surgical procedure itself, so liver-biliary tract infections are frequent (1,10,15) , as well as lower respiratory and vascular catheter infections (15,17) . Other agents as cytomegalovirus (CMV), and herpes virus (HSV) are also prevalent.…”

Clinical practice guidelines for antimicrobial prophylaxis in surgery

“…The pathogens most commonly associated with early SSIs and intraabdominal infections are those derived from the normal flora of the intestinal lumen and the skin. Aerobic gram-negative bacilli, including E. coli, 935,937,939,940,942,945,[947][948][949]951,967,968 Klebsiella species, 933,936,937,939,940,945,[947][948][949][967][968][969] Enterobacter species, 936,939,940,942,945,947,952,959,964,967,968 Acinetobacter baumannii, [935][936][937]942,951 and Citrobacter species, 939,940,945,947,952,959,967,968 are common...…”

“…Infections due to P. aeruginosa may also occur but are much less common in the early postoperative period. 936,937,939,940,942,945,947,948,952,959,969 Enterococci are particularly common pathogens and may be responsible for 20-46% of SSIs and intraabdominal infections. 894,933,935,937,938,940,943,[945][946][947]951,952,955,964,965,969 S. aureus (frequently MRSA) and coagulasenegative staphylococci are also common causes of postoperative SSIs.…”