Bacterial infection as a complication of liver transplantation: Epidemiology and risk factors

D. L. George, P. M. Arnow, Amy S. Fox, A. L. Baker, J. R. Thistlethwaite, J. C. Emond, P. F. Whitington, C. E. Broelsch

Research output: Contribution to journalArticle

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Abstract

A retrospective survey was undertaken to characterize the epidemiology of bacterial infection in 79 patients who underwent 103 operations for orthotopic liver transplantation. Fifty-four patients (68%) developed 115 bacterial infections (1.46 episodes per patient), and seven patients died as a result of these infections. Fifty-three percent of bacterial infections occurred within 2 weeks after transplantation and were designated as early infections. The most common sites of infection were the abdomen (35 cases), the bloodstream (31 cases), and the surgical wound (19 cases). Aerobic enteric gram-negative bacilli were the predominant pathogens, and other pathogenic organisms were enterococci, staphylococci, and Pseudomonas bacteria. Logistic regression analysis identified prolonged duration of surgery (≥8 hours) and an elevated bilirubin level (≥12 mg/dL) as risk factors for early bacterial infection at any site; risk factors for abdominal or wound infection were prolonged duration of surgery, increased operative transfusion requirement (≥2 blood volumes), and prior hepatobiliary surgery. Awareness of the sites, pathogens, and time of onset of bacterial infection provides a basis for improved prophylaxis and empiric therapy.

Original languageEnglish (US)
Pages (from-to)387-396
Number of pages10
JournalReviews of Infectious Diseases
Volume13
Issue number3
StatePublished - 1991
Externally publishedYes

Fingerprint

Bacterial Infections
Liver Transplantation
Epidemiology
Infection
Enterococcus
Wound Infection
Pseudomonas
Blood Volume
Staphylococcus
Bilirubin
Abdomen
Bacillus
Transplantation
Logistic Models
Regression Analysis
Bacteria
Therapeutics

ASJC Scopus subject areas

  • Microbiology (medical)

Cite this

George, D. L., Arnow, P. M., Fox, A. S., Baker, A. L., Thistlethwaite, J. R., Emond, J. C., ... Broelsch, C. E. (1991). Bacterial infection as a complication of liver transplantation: Epidemiology and risk factors. Reviews of Infectious Diseases, 13(3), 387-396.

Bacterial infection as a complication of liver transplantation : Epidemiology and risk factors. / George, D. L.; Arnow, P. M.; Fox, Amy S.; Baker, A. L.; Thistlethwaite, J. R.; Emond, J. C.; Whitington, P. F.; Broelsch, C. E.

In: Reviews of Infectious Diseases, Vol. 13, No. 3, 1991, p. 387-396.

Research output: Contribution to journalArticle

George, DL, Arnow, PM, Fox, AS, Baker, AL, Thistlethwaite, JR, Emond, JC, Whitington, PF & Broelsch, CE 1991, 'Bacterial infection as a complication of liver transplantation: Epidemiology and risk factors', Reviews of Infectious Diseases, vol. 13, no. 3, pp. 387-396.
George DL, Arnow PM, Fox AS, Baker AL, Thistlethwaite JR, Emond JC et al. Bacterial infection as a complication of liver transplantation: Epidemiology and risk factors. Reviews of Infectious Diseases. 1991;13(3):387-396.
George, D. L. ; Arnow, P. M. ; Fox, Amy S. ; Baker, A. L. ; Thistlethwaite, J. R. ; Emond, J. C. ; Whitington, P. F. ; Broelsch, C. E. / Bacterial infection as a complication of liver transplantation : Epidemiology and risk factors. In: Reviews of Infectious Diseases. 1991 ; Vol. 13, No. 3. pp. 387-396.
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