Early Infections in Liver Transplant (LT) Recipients: Analysis of 149 Transplantation Procedures.

I. LOSADA, V. CUERVAS-MONS, I. MILLAN, and D. DAMASO

Abstract: 

A descriptive retrospective study was analyzed the infections in 149 consecutive LT recipients over 90 posttransplantation days. The procedures, which took place between 1992 and 1996, corresponded to first-time transplantation in 134 cases and to retransplantation in 15. Infections developed during the first 30 days were considered early episodes and those occurring from days 31 to 90 late. The rate of infection was 71.3%(109/149). The 109 patients who developed infections presented a total of 177 episodes: 88 bacterial(49.7%),63 viral(35.5%),18 fungal(10.1%) and 8 mixed(4.51%). The incidence of viral infections (VI) was higher in first-time recipients than in retransplant recipients(p=0.012). During the early stage, bacterial infections (BI)predominated, while VI were the most common infections during the later stage(p=0.001). Mucocutaneous infections were the most frequent type(35), pneumonia(27), urinary infection (25), sepsis(25), intraabdominal infections (16), cytomegalovirus disease(13), wound infection(11), hepatitis(10), biliary infections (8), gastroenteritis(4), otitis(2) and arteritis (1). The rate of mortality in this series was 18.1%(27/149) and 66.7% of the deaths(18/27) were attributed to infection, most often pneumonia (8,80%) or sepsis(10,83.3%). Among the patients with bacterial pneumonia, the mortality rate was 83.3%(5/6), due to Staphylococcus aureus (1), Pseudomonas aeruginosa (2) and an unidentified species(2). Fungal pneumonia was associated with 100% mortality(3/3) caused by Aspergillus sp(2) and Candida glabrata (1). The mortality rate among patients with bacterial sepsis was 75%(6/8) caused by S. aureus and Streptococcus sanguis and Enterococcus faecalis (1), P. aeruginosa (2), S. epidermidis plus Stenotrophomonas maltophilia (1) and an unidentified species (2). Fungal sepsis was associated with 100% mortality (3/3) and was produced in all three cases by Aspergillus sp. A mixed infection involving herpes simplex virus and C. glabrata was responsible for one death due to sepsis. In conclusion, BI are a common complication during the first 30 post-transplantation days, while VI are more frequent from days 31 to 90. Infection was the cause of 66.7% of the deaths. Pneumonia and sepsis are the only infections responsible for mortality. Fungal infections, whether producing pneumonia or sepsis, are associated with a mortality rate of 100.
1998

abstract No: 

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Full conference title: 

38th Interscience Conference on Antimicrobial Agents and Chemotherapy
    • ICAAC 38th