000133083 001__ 133083
000133083 005__ 20240711085511.0
000133083 0247_ $$2doi$$a10.1016/j.jhep.2024.02.023
000133083 0248_ $$2sideral$$a137773
000133083 037__ $$aART-2024-137773
000133083 041__ $$aeng
000133083 100__ $$aMartin-Mateos, Rosa
000133083 245__ $$aMultidrug-resistant bacterial infections after liver transplantation: prevalence, impact, and risk factors
000133083 260__ $$c2024
000133083 5203_ $$aBackground and Aims
Multidrug-resistant (MDR) bacterial infections are an increasing healthcare problem worldwide. This study analyzes the incidence, burden, and risk factors associated with MDR infections after liver transplantation (LT).
Methods
This retrospective, multicenter cohort study included adult patients who underwent LT between January 2017 and January 2020. Risk factors related to pre-LT disease, surgical procedure, and postoperative stay were analyzed. Multivariate logistic regression analysis was performed to identify independent predictors of MDR bacterial infections within the first 90-days after LT.
Results
We included 1,045 LT (960 patients) performed at nine centers across Spain. The mean age was 56.8 ± 9.3 years, 75.4% (n=782) were male. Alcohol-related liver disease was the most prevalent underlying etiology (43.2.%, n=451). Bacterial infections occurred in 432 patients (41.3%), who presented with a total of 679 episodes of infection (respiratory infections, 19.3%; urinary tract infections, 18.5%; bacteremia, 13.2% and cholangitis 11%, among others). MDR bacteria were isolated in 227 LT (21.7%) (348 episodes). Enterococcus faecium (22.1%), E. coli (18.4%), and Pseudomonas aeruginosa (15.2%) were the most frequently isolated microorganisms. In multivariate analysis, previous intensive care unit admission (0-3 months before LT), previous MDR bacterial infections (0-3 months before LT), and an increasing number of packed red blood cell units transfused during surgery were identified as independent predictors of multi-resistant infections. Mortality at 30, 90, 180, and 365 days was significantly higher in patients with MDR isolates.
Conclusion
MDR infections are highly prevalent after LT and have a significant impact on prognosis. E. faecium is the most frequently isolated MDR microorganism. New pharmacological and surveillance strategies aimed at preventing MDR infections after LT should be considered for patients with high-risk factors.
000133083 540__ $$9info:eu-repo/semantics/openAccess$$aAll rights reserved$$uhttp://www.europeana.eu/rights/rr-f/
000133083 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000133083 700__ $$aMartínez-Arenas, Laura
000133083 700__ $$aCarvalho-Gomes, Ángela
000133083 700__ $$aAceituno, Laia
000133083 700__ $$aCadahía, Valle
000133083 700__ $$aSalcedo, María Magdalena
000133083 700__ $$aArias, Ana
000133083 700__ $$0(orcid)0000-0003-4672-8083$$aLorente Pérez, Sara$$uUniversidad de Zaragoza
000133083 700__ $$aOdriozola, Aitor
000133083 700__ $$aZamora, Javier
000133083 700__ $$aBlanes, Marino
000133083 700__ $$aLen, Óscar
000133083 700__ $$aBenítez, Laura
000133083 700__ $$aCampos-Varela, Isabel
000133083 700__ $$aGonzález Diéguez, María Luisa
000133083 700__ $$aRojo Lázaro, Diego
000133083 700__ $$aFortún, Jesús
000133083 700__ $$aCuadrado, Antonio
000133083 700__ $$aMarcos Carrasco, Natalia
000133083 700__ $$aRodríguez-Perálvarez, Manuel
000133083 700__ $$aNavascues, Carmen
000133083 700__ $$aFábrega, Emilio
000133083 700__ $$0(orcid)0000-0002-7119-2244$$aSerrano, Trinidad$$uUniversidad de Zaragoza
000133083 700__ $$aCuervas Mons, Valentín
000133083 700__ $$aRodríguez, Manuel
000133083 700__ $$aCastells, Lluis
000133083 700__ $$aBerenguer, Marina
000133083 700__ $$aGraus, Javier
000133083 700__ $$aAlbillos, Agustín
000133083 7102_ $$11007$$2610$$aUniversidad de Zaragoza$$bDpto. Medicina, Psiqu. y Derm.$$cArea Medicina
000133083 773__ $$g80, 6 (2024), 904-912$$pJ. hepatol.$$tJOURNAL OF HEPATOLOGY$$x0168-8278
000133083 8564_ $$s7955975$$uhttps://zaguan.unizar.es/record/133083/files/texto_completo.pdf$$yVersión publicada
000133083 8564_ $$s1581652$$uhttps://zaguan.unizar.es/record/133083/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000133083 909CO $$ooai:zaguan.unizar.es:133083$$particulos$$pdriver
000133083 951__ $$a2024-07-11-08:52:28
000133083 980__ $$aARTICLE