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Evaluation of Perioperative Risk Factors for Infection by Multidrug-Resistant Bacteria in Patients Undergoing Liver
Rafael Ramos Fernández1,2, Alberto Calvo García1,2, Ainhoa Fernández Yunkera2,3
1Department of Anesthesiology and Resuscitation, Gregorio Marañón University Hospital, 28007 Madrid, Spain.
Abstract:
Background: Liver transplantation (LT) is a critical intervention for patients with end-stage liver disease. Infections caused by multidrug-resistant bacteria (MDRB) significantly worsen post-transplant outcomes. The main objective of this study was to analyze perioperative risk factors associated with MDRB infections within six months following LT. Methods: A retrospective analysis was conducted on 133 medical records of patients who underwent liver transplantation between October 2018 and May 2022. Data collected included the presence of MDRB colonization and infection, as well as various perioperative variables. These were analyzed to identify potential risk factors for MDRB infection and colonization. Results: Univariate analysis identified several perioperative variables associated with MDRB infection within six months after LT. Multivariate logistic regression revealed that pre-transplant MDRB colonization (OR 5.72, 95% CI 1.7-18.7, p = 0.005) and the requirement for dialysis during postoperative ICU stay (OR 6.42, 95% CI 1.7-23.4, p = 0.009) were independent risk factors for developing MDRB infections. MDRB infection occurred in 9.4% of patients and was not significantly associated with increased mortality (p = 0.126). Conclusions: These findings contribute to a better understanding of the epidemiology and pathophysiology of MDRB infections in the postoperative period of liver transplantation. This knowledge is essential for developing effective prevention and treatment strategies that may improve outcomes in this patient population.
Insights
Pre-transplant multidrug-resistant bacteria (MDRB) colonization and postoperative dialysis are key risk factors for MDRB infections after liver transplantation (LT). Identifying these factors can improve patient outcomes.
Area of Science:
- Transplantation Medicine
- Infectious Diseases
- Critical Care
Background:
- Liver transplantation (LT) is vital for end-stage liver disease.
- Multidrug-resistant bacteria (MDRB) infections pose a significant threat to post-LT outcomes.
Purpose of the Study:
- To identify perioperative risk factors for MDRB infections within six months post-LT.
- To analyze the association between MDRB colonization and infection in LT recipients.
Main Methods:
- Retrospective analysis of 133 liver transplant patient records (Oct 2018 - May 2022).
- Collected data on MDRB colonization, infection, and perioperative variables.
- Statistical analysis to determine independent risk factors for MDRB infection.
Main Results:
- Pre-transplant MDRB colonization (OR 5.72) and postoperative dialysis (OR 6.42) were independent risk factors for MDRB infection.
- MDRB infection occurred in 9.4% of patients.
- MDRB infection was not significantly associated with increased mortality (p=0.126).
Conclusions:
- Pre-transplant MDRB colonization and postoperative dialysis are critical risk factors for post-LT MDRB infections.
- Findings enhance understanding of MDRB infection epidemiology in LT patients.
- Knowledge is crucial for developing targeted prevention and treatment strategies to improve LT outcomes.
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