Related Experiment Video
Updated: Aug 8, 2026
Reduced Complications after Arterial Reconnection in a Rat Model of Orthotopic Liver Transplantation
Published on: November 7, 2020
Drug resistance of infectious pathogens after liver transplantation
Jian-Dang Zhou1, Jian-Jun Guo, Qin Zhang
1Department of Clinical Laboratory, the Third Xiangya Hospital of Central South University, Changsha 410013, China. jiandangzhou@126.com
Background:
Infection in liver recipients is related to high risk of transplantation failure and mortality. Infectious agents isolated from 55 liver recipients from January 2003 through June 2005 were studied to improve the anti-infectious therapy.
Methods:
Pathogens were isolated from routine culture. K-B method was used to examine the drug susceptibility. Extended spectrum beta-lactamase, AmpC beta-lactamase and Van gene in E.coli were examined by the agar-dilution susceptibility test and Nitrocefin test.
Results:
Thirty-nine of the 55 recipients got infection. The 513 strains of pathogens isolated from 1861 specimens were predominantly Gram negative bacteria and over 40% of them showed resistance to more than 4 drugs. The positive rates of extended spectrum beta-lactamse and AmpC beta-lactamse production in E.cloacae were 32.4% and 36.8%, in E.coli were 33.8% and 10.5%, but the rates of these 2 bacteria producing both lactamses were 24.3% and 7.0%. The beta-lactamse production rates of Enterococcus faecalis and Enterococcus faecium were 8.8% and 11.1%, and the resistance rates to vancomycin were 11.2% and 18.5%, respectively.
Conclusions:
Infectious pathogens isolated from liver recipients are potent and multiple drug resistant. ESBLs and AmpC beta-lactamases are the major factors associated with Gram negative drug resistance. The infection of Enterococcal species presents as a particular challenge.
Insights
Infections in liver transplant recipients are often caused by drug-resistant bacteria, particularly Gram-negative strains producing extended-spectrum beta-lactamases (ESBLs) and AmpC beta-lactamases. Enterococcal infections also pose a significant challenge.
Area of Science:
- Microbiology
- Infectious Diseases
- Transplantation
Background:
- Infections significantly increase the risk of graft failure and mortality in liver transplant recipients.
- Understanding the spectrum of infectious agents is crucial for optimizing anti-infective therapies.
Purpose of the Study:
- To characterize infectious pathogens and their antimicrobial resistance patterns in liver transplant recipients.
- To identify key resistance mechanisms contributing to treatment challenges.
Main Methods:
- Pathogen isolation from clinical specimens of liver recipients.
- Antimicrobial susceptibility testing using the K-B method.
- Detection of specific resistance genes, including extended-spectrum beta-lactamase (ESBL), AmpC beta-lactamase, and vancomycin resistance genes in Gram-negative bacteria and enterococci.
Main Results:
- 39 out of 55 recipients experienced infections, with 513 bacterial strains isolated.
- Predominantly Gram-negative bacteria were identified, with over 40% exhibiting multi-drug resistance (resistance to >4 drugs).
- High rates of ESBL and AmpC beta-lactamase production were observed in E. cloacae and E. coli; vancomycin resistance was noted in Enterococcus faecalis and E. faecium.
Conclusions:
- Infectious pathogens in liver transplant recipients are frequently potent and multi-drug resistant.
- ESBLs and AmpC beta-lactamases are primary drivers of Gram-negative bacterial resistance.
- Enterococcal infections represent a significant and challenging aspect of post-transplant infections.
Related Concept Videos
01:40Cell-mediated Immune Responses
01:29Pulmonary Tuberculosis I
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...
01:26Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow
01:28Kidney Transplant I: Introduction
01:31Defense Against Bacterial Pathogens
Phagocytes
Phagocytes are the frontline soldiers of the immune system. They include neutrophils and macrophages. Neutrophils are the most abundant type of white blood cell and are quickly mobilized to the site of infection. Macrophages are larger cells that patrol...
01:10Retrovirus Life Cycles