Shifts of Etiology in Patients with in Bacteremic Liver Transplant Recipients.

S. Kim,¹ Y. Kim,¹ J. Choi,¹ S. Yoon,¹ G. Na,² J. Kim,² I. Moon,² Y. Yoo,² D. Kim.²

¹Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
²Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.

Meeting: 2016 American Transplant Congress

Abstract number: D101

Keywords: Bacterial infection, Infection, Liver transplantation, Post-operative complications

Session Information

Session Name: Poster Session D: Fungi, PJP, Mycobacteria, Infection Risk Factors, Vaccination and Donor Derived Infections

Session Type: Poster Session

Date: Tuesday, June 14, 2016

Session Time: 6:00pm-7:00pm

Presentation Time: 6:00pm-7:00pm

Location: Halls C&D

Background

Bacteremias are the most frequently occurring infectious complications after liver transplantation. The spectrum of pathogens and patters of antibiotics susceptibility can vary owing to the variable local epidemiologic data and antibiotics modality. The aim of this study was to investigate bacteremic incidence, pathogenic spectrum, and changes of the pathogens associated with bacteremia in liver transplant recipients.

Methods

We retrospectively analyzed 439 subjects (298 male, 141 female) who had undergone living-donor liver transplant from 2005 to May 2013, and compared between periods (Period 1: 2005-2007, Period 2: 2008-2010, Period 3: 2011-2013).

Results

In 439 living-donor liver transplants, 130 episodes of bacteremia with 135 pathogens occurred in 83 patients(18.9%) during the follow-up periods. Within 1 month after transplant, 43 % of all bacteremic episodes occurred. Percentage of bacteremic patients was decreased between periods (23.6%(34/144) vs. 21.5%(26/121) vs. 13.2%(23/174), p=0.05). Gram positive bacteria accounted for 57.5%(23/40) in Period1, and 46.1%(24/52) in Period 2, and 55.8%(24/43) (p=0.45). The most common gram positive pathogens were enterococcus species (n=10 vs. 13 vs. 10) and Coagulase-negative staphylococci (n=9 vs. 9 vs. 10). In period 1, E. coli (n=4) was most predominant gram negative pathogen, Klebsiella species was most predominant in Period 2 (n=8), and Acinetobacter baumannii in period 3 (n=7). In period 2 and period 3, all of the A. baumannii was resistant to carbapenem. The 30-days mortality among bacteremia patients was 8.4% (7/83) and overall mortality in bacteremic patients after liver transplant was higher than non-bacteremic patients (26.5% vs 9.5%, p<0.001). The overall mortality was not different between periods (11.8% vs. 9.1% vs. 16.7%, p=0.14).

Conclusion

Bacteremia remains the important cause of mortality after liver transplant recipients, however the percentage of bacteremia tends to be decreased. Our data showed that carbapenem-resistant bacteria especially A. baumannii has emerged.

CITATION INFORMATION: Kim S, Kim Y, Choi J, Yoon S, Na G, Kim J, Moon I, Yoo Y, Kim D. Shifts of Etiology in Patients with in Bacteremic Liver Transplant Recipients. Am J Transplant. 2016;16 (suppl 3).

To cite this abstract in AMA style:

Kim S, Kim Y, Choi J, Yoon S, Na G, Kim J, Moon I, Yoo Y, Kim D. Shifts of Etiology in Patients with in Bacteremic Liver Transplant Recipients. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/shifts-of-etiology-in-patients-with-in-bacteremic-liver-transplant-recipients/. Accessed November 22, 2024.

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