Pseudomonas Aeruginosa Infection Among Liver Transplant Recipients: A Clinical Analysis of 15 Cases

The aim of this study was to describe the incidence, time of onset, clinical characteristics, and outcomes of Pseudomonas aeruginosa infection after liver transplantation (LT) and to investigate the drug resistance of P aeruginosa to frequently used antibiotics to provide evidence for clinical prevention and therapy.

Patients undergoing LT from January 1, 2003, through June 30, 2015, were considered. We determined the site of infection and the drug susceptibility of P aeruginosa isolates and collected these patients' data to confirm post-LT clinical and laboratory characteristics.

Of the 303 patients who underwent cadaveric LT, 15 (5.0%) developed 20 episodes of P aeruginosa infection. All episodes of P aeruginosa infection were early-onset, with the bloodstream being the most common source of infection. The majority (86.7%) of these recipients were in intensive care unit stay, and 7 (46.7%) patients had a body temperature of ≥38°C at the onset of infection and an inappropriate antibiotic therapy. In 14 (93.3%) patients, P aeruginosa infection was nosocomial infection. Platelet numbers of <50 × 10(9)/L and lymphocyte count of <300/mm(3) developed in 33.3% and 46.7% of patients, respectively. Seven (46.7%) deaths were attributable to P aeruginosa infection. Of these 20 P aeruginosa isolates, 10 (50%) each were carbapenem-resistant and multidrug-resistant. P aeruginosa was relatively susceptible to amikacin, levofloxacin, or cefoperazone-sulbactam (resistance rate, 30%).

The bloodstream was the most common site of infection; a high body temperature, nosocomial origin, decreased platelet and lymphocyte count occurring in the early period after LT, high antibiotic resistance rate, and high morbidity and mortality rates were the main characteristics of P aeruginosa infection.