Acinetobacter infection in a liver transplantation intensive care unit

Despite the advances in surgical technique and postoperative care, infectious complications are associated with high mortality rates. Acinetobacter species are emerging as a leading worldwide nosocomial pathogen in intensive care unit (ICU) patients. This study was designed to evaluate the results of the patients who developed Acinetobacter infection in the ICU after liver transplantation.

We retrospectively analyzed 220 patients who had undergone liver transplantation between August 2011 and August 2012. Among the 55 positive culture results with clinical signs of infection, Acinetobacter was the single infectious agent for 10 of them, who were included in the study.

The mean age of the patients was 43.1 ± 11.79 years with a male dominance (70%, n = 7). Eighty percent of the patients underwent living donor liver transplantations (n = 8). Mean Model for End-stage Liver Disease score was 28.5 ± 14.99. Graft dysfunction was present in 50% (n = 5), all of whom had a history of preoperative hospitalization (100%, n = 10). Forty percent (n = 4) of patients had a history of diabetes mellitus and 60% were subject to extended mechanical ventilation. Mean platelet count was 20.32 ± 8.1 × 10(9)/mL. The majority of the patients had multiple culture-positive sites (90%, n = 9). Positive culture results for Acinetobacter species included bloodstream (n = 8), drain fluid (n = 5), sputum (n = 3), paracenthesis material (n = 3), and catheter (n = 1). The mean period of postoperative positive culture results was 12.7 ± 9.5 days. Mortality was 90% (n = 9).

Acinetobacter infections in the ICU after liver transplantation were asociated with a high mortality presenting with thrombocytopenia.