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Distribution and resistance of pathogens in liver transplant recipients with Acinetobacter baumannii infection
Fei Gao1, Qifa Ye2, Qiquan Wan3
1Infectious Disease Department of Henan Province People's Hospital, Zhengzhou, People's Republic of China.
Background:
Drug-resistant Acinetobacter baumannii has become a major problem in liver transplant recipients. The aim of this study was to investigate the clinical presentation, distribution, and drug susceptibility characteristics in liver recipients with A. baumannii infection.
Methods:
We retrospectively investigated 17 liver recipients who developed A. baumannii infection between January 1, 2007 and December 31, 2014. The distribution of A. baumannii and drug susceptibility characteristics were reviewed.
Results:
Infectious complications due to A. baumannii appeared in 17 liver recipients, with a total of 24 episodes. Approximately 63% (15/24) of A. baumannii infections occurred within 2 weeks after transplantation. The most common source of infection was multiple culture-positive sites (35.3%, n=6), followed by the intra-abdominal/biliary tract (23.5%, n=4) and lung (23.5%, n=4). Eight patients (47.1%) had a body temperature of 38°C or higher at the onset of A. baumannii infection. Nine, seven, and 12 recipients had a serum creatinine level of >1.5 mg/dL, a white blood cell count of >15,000/mm(3), and a platelet count of <50,000/mm(3), respectively. There were five (29.4%) cases of septic shock and eight (47.1%) deaths. The rate of antibiotic resistance of A. baumannii to ten of 12 antibiotics investigated was more than 60%. Among the 24 infections caused by A. baumannii, 75% were carbapenem-resistant. The rods were relatively sensitive to tigecycline and cefoperazone-sulbactam.
Conclusion:
The clinical manifestations of A. baumannii infection included a high body temperature, a decreased platelet count, an elevated white blood cell count, and onset in the early period after transplantation as well as high mortality. The antibiotic resistance rate of A. baumannii was extremely high. Prevention measures and combination antibiotic therapy are needed to improve the outcomes of liver recipients with A. baumannii infections.
Insights
Drug-resistant Acinetobacter baumannii infections are a significant threat to liver transplant recipients, often occurring early post-transplant. High mortality and extreme antibiotic resistance necessitate improved prevention and combination therapies.
Area of Science:
- Infectious Diseases
- Transplant Surgery
- Microbiology
Background:
- Drug-resistant Acinetobacter baumannii poses a critical challenge in liver transplant recipients.
- Understanding its clinical presentation and resistance patterns is vital for patient outcomes.
Purpose of the Study:
- To investigate the clinical presentation, distribution, and drug susceptibility of Acinetobacter baumannii infections in liver transplant recipients.
- To identify key characteristics and risk factors associated with these infections.
Main Methods:
- Retrospective analysis of 17 liver transplant recipients with Acinetobacter baumannii infection between 2007 and 2014.
- Review of clinical data, infection sources, and antibiotic susceptibility profiles.
Main Results:
- Acinetobacter baumannii infections commonly occurred within two weeks post-transplantation, with multiple culture sites being the most frequent source.
- High rates of antibiotic resistance, including 75% carbapenem resistance, were observed.
- Clinical manifestations included fever, leukocytosis, thrombocytopenia, with a high mortality rate of 47.1% and 29.4% septic shock.
Conclusions:
- Acinetobacter baumannii infections in liver recipients present with severe clinical signs and high mortality.
- Extremely high antibiotic resistance rates underscore the need for novel therapeutic strategies.
- Enhanced prevention and combination antibiotic therapies are crucial for improving survival rates.
