Bacterial infections in the early period after liver transplantation: etiological agents and their susceptibility

Med Sci Monit. 2009 Dec;15(12):CR628-37.

Abstract

Background: The study comprises an analysis of bacterial infections in the early period after liver transplantation (LT) in adults.

Material/methods: Eighty-three patients were followed for four weeks after LT. Samples comprised mainly blood, urine, surgical-site specimens, sputum, and stool. Culture and identification of the isolated microorganisms was done in accordance with standard microbiological procedures. Susceptibility testing was carried out using CLSI guidelines. Statistical analysis was done with Medi-Stat.

Results: In total, 913 samples from LT recipients were cultured. Of the 469 isolated strains, 331 (70.6%) were Gram-positive bacteria, 133 (28.4%) were Gram-negative bacteria, and 5 (1.0%) were yeast-like fungal strains. Of the 284 surgical-site isolates, 222 (78%) were Gram-positive and 61 (21.5%) were Gram-negative bacteria. Of the 99 blood culture isolates, 75 (75.8%) were Gram-positive and 22 (22.2%) of Gram-negative bacterial strains. Of the 73 urine samples, 46 (63.0%) were strains of Gram-negative, 25 (34.0%) of Gram-positive bacteria, and 2 (3.0%) fungal strains. In the 13 respiratory tract samples were 9 (69.0%) Gram-positive and 4 (31.0%) Gram-negative strains. In the 54 stool samples, 63.0% and 16.7% were C. difficile toxin- and culture-positive, respectively. In total, 138 strains of MRCNS, 10 of MRSA, 80 of HLAR, and 19 ESBL(+) were detected.

Conclusions: The isolation of MDR bacterial strains such as MRSA (52.6%), MRCNS (81.7%), HLAR (86.0%), and ESBL(+) Gram-negative rods (12.5%) from patients after LT indicates the need for strict adherence to infection control procedures.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Bacterial Infections / drug therapy
  • Bacterial Infections / etiology*
  • Bacterial Infections / microbiology
  • Female
  • Fungi / drug effects
  • Fungi / isolation & purification
  • Gram-Negative Bacteria / drug effects
  • Gram-Negative Bacteria / isolation & purification
  • Gram-Positive Bacteria / drug effects
  • Gram-Positive Bacteria / isolation & purification
  • Humans
  • Infection Control
  • Liver Transplantation / adverse effects*
  • Male
  • Microbial Sensitivity Tests
  • Middle Aged
  • Poland
  • Postoperative Complications / drug therapy
  • Postoperative Complications / etiology*
  • Postoperative Complications / microbiology
  • Prospective Studies
  • Surgical Wound Infection / drug therapy
  • Surgical Wound Infection / etiology
  • Surgical Wound Infection / microbiology
  • Time Factors
  • Young Adult