Etiological Agents of Bacteremia in the Early Period After Liver Transplantation

• Published in: Transplantation proceedings 2007-11, Vol.39 (9), p.2816-2821
• Main Authors: Kawecki, D, Chmura, A, Pacholczyk, M, Łagiewska, B, Adadynski, L, Wasiak, D, Malkowski, P, Rokosz, A, Sawicka-Grzelak, A, Szymanowska, A, Swoboda-Kopec, E, Wroblewska, M, Rowinski, W, Durlik, M, Luczak, M
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Bacteremia - epidemiology; Bacteremia - etiology; Bacteria - classification; Bacteria - isolation & purification; Bacterial diseases; Bacterial sepsis; Biological and medical sciences; Cadaver; Enterobacter - classification; Enterobacter - isolation & purification; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Gram-Negative Bacteria - isolation & purification; Gram-Negative Bacterial Infections - epidemiology; Gram-Positive Bacteria - isolation & purification; Gram-Positive Bacterial Infections - epidemiology; Human bacterial diseases; Humans; Infectious diseases; Liver Transplantation - adverse effects; Liver, biliary tract, pancreas, portal circulation, spleen; Medical sciences; Middle Aged; Mycoses - epidemiology; Postoperative Period; Retrospective Studies; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Tissue Donors; Tissue, organ and graft immunology
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2007.08.048

Abstract Bacteremia is one of the major infections in orthotopic liver transplantation (OLT). The study of 83 adults who underwent OLT from 2001 to 2004, included patients followed prospectively from the day of transplantation to 4 weeks after the procedure by bacteriological cultures. The microorganisms were investigated according to standard National Committee for Clinical Laboratory Standards (NCCLS) procedures. Blood samples were examined in 59 recipients (71.1%) before and in 76 patients (91.6%) during the month after transplantation. Among 249 investigated samples, 96 were positive, as cultured from 19 recipients before OLT and 48 patients afterward. The most common were Gram-positive cocci (n = 71) and coagulase-negative staphylococci (n = 52), including methicillin-resistant coagulase-negative staphylococci (MRCNS). Enterococcus spp. occurred in 9 isolates (high-level aminoglycoside-resistant enterococci [HLAR] strains were cultured). We cultured the Enterobacteriaceae family (n = 16 isolates) and (n = 15 isolates), Gram-negative nonfermenting rods some of which were extended spectrum beta-lactamase producing [ESBL(+)] strains. The predominance of Gram-positive cocci was caused by CNS, and the use of prophylaxis to reduce Gram-negative bacteria. The increased rate of isolation of bacteria with multidrug resistance (MDR) to antimicrobial agents may be due to their frequent use for prophylaxis of bacterial infections in OLT. These MDR bacterial strains caused severe BSI after OLT.