A Mukhtar1, A Abdelaal8, M Hussein3, H Dabous4, I Fawzy4, G Obayah5, A Hasanin5, N Adel6, D Ghaith7, M Bahaa8, A Abdelaal8, M Fathy8, M El Meteini8. 1. Department of Anesthesia and Critical Care, Cairo University, Cairo, Egypt. Electronic address: ahmed.mukhtar@kasralainy.edu.eg. 2. Department of Anesthesia and Critical Care, Beni Suef University, Egypt. 3. Department of Anesthesia and Critical Care, Theodor Bilharz Research Institute, Egypt. 4. Department of Hepatology, Ain Shams University, Cairo, Egypt. 5. Department of Anesthesia and Critical Care, Cairo University, Cairo, Egypt. 6. Department of Critical Care, Egypt Air Hospital, Egypt. 7. Department of Clinical Bacteriology, Cairo University, Cairo, Egypt. 8. Department of Surgery, Ain Shams University, Cairo, Egypt.
Abstract
INTRODUCTION: Data on the prevalence and pattern of infection after living-donor liver transplantation (LDLT) are scarce in Egypt. We therefore conducted this study to quantify the incidence, risk factors, and pattern of bacterial resistance post-LDLT in 3 hospitals in Egypt. PATIENTS AND METHODS: We conducted a retrospective, multicenter study of the medical records of 246 patients who underwent LDLT between January 2006 and April 2011 at 3 transplant centers in Egypt. RESULTS: Of 246 patients enrolled in this study, 127 (52%) developed infectious complications after LDLT, with 416 episodes of infection occurring within 3 months of transplantation. Biliary tract infection was the most common, occurring in 169 (40.6%) patients. The rate of infection with Gram-negative bacteria was higher than that of infection with Gram-positive bacteria (310 [74%] vs 87 [21%]; P < .001). Overall, 75% of Gram-negative isolates were multidrug resistant. Significant independent risk factors for infection were portal vein thrombosis (odds ratio, 2.4; P = .037) and biliary complications (odds ratio, 5.4; P < .001). CONCLUSIONS: Our data showed a high-resistance pattern of bacterial infection after LDLT in Egypt. Early biliary complications were an independent risk factor for bacterial infection.
INTRODUCTION: Data on the prevalence and pattern of infection after living-donor liver transplantation (LDLT) are scarce in Egypt. We therefore conducted this study to quantify the incidence, risk factors, and pattern of bacterial resistance post-LDLT in 3 hospitals in Egypt. PATIENTS AND METHODS: We conducted a retrospective, multicenter study of the medical records of 246 patients who underwent LDLT between January 2006 and April 2011 at 3 transplant centers in Egypt. RESULTS: Of 246 patients enrolled in this study, 127 (52%) developed infectious complications after LDLT, with 416 episodes of infection occurring within 3 months of transplantation. Biliary tract infection was the most common, occurring in 169 (40.6%) patients. The rate of infection with Gram-negative bacteria was higher than that of infection with Gram-positive bacteria (310 [74%] vs 87 [21%]; P < .001). Overall, 75% of Gram-negative isolates were multidrug resistant. Significant independent risk factors for infection were portal vein thrombosis (odds ratio, 2.4; P = .037) and biliary complications (odds ratio, 5.4; P < .001). CONCLUSIONS: Our data showed a high-resistance pattern of bacterial infection after LDLT in Egypt. Early biliary complications were an independent risk factor for bacterial infection.
Authors: Mohamed F Montasser; Nadia A Abdelkader; Sara M Abdelhakam; Hany Dabbous; Iman F Montasser; Yasmine M Massoud; Waleed Abdelmoaty; Shereen A Saleh; Mohamed Bahaa; Hany Said; Mahmoud El-Meteini Journal: World J Hepatol Date: 2017-07-18