Infection complications and pattern of bacterial resistance in living-donor liver transplantation: a multicenter epidemiologic study in Egypt

A Mukhtar; A Abdelaal; M Hussein; H Dabous; I Fawzy; G Obayah; A Hasanin; N Adel; D Ghaith; M Bahaa; A Abdelaal; M Fathy; M El Meteini

doi:10.1016/j.transproceed.2014.02.022

Infection complications and pattern of bacterial resistance in living-donor liver transplantation: a multicenter epidemiologic study in Egypt

Transplant Proc. 2014 Jun;46(5):1444-7. doi: 10.1016/j.transproceed.2014.02.022.

Authors

A Mukhtar¹, A Abdelaal², M Hussein³, H Dabous⁴, I Fawzy⁴, G Obayah⁵, A Hasanin⁵, N Adel⁶, D Ghaith⁷, M Bahaa⁸, A Abdelaal⁸, M Fathy⁸, M El Meteini⁸

Affiliations

¹ Department of Anesthesia and Critical Care, Cairo University, Cairo, Egypt. Electronic address: ahmed.mukhtar@kasralainy.edu.eg.
² Department of Anesthesia and Critical Care, Beni Suef University, Egypt.
³ Department of Anesthesia and Critical Care, Theodor Bilharz Research Institute, Egypt.
⁴ Department of Hepatology, Ain Shams University, Cairo, Egypt.
⁵ Department of Anesthesia and Critical Care, Cairo University, Cairo, Egypt.
⁶ Department of Critical Care, Egypt Air Hospital, Egypt.
⁷ Department of Clinical Bacteriology, Cairo University, Cairo, Egypt.
⁸ Department of Surgery, Ain Shams University, Cairo, Egypt.

PMID: 24935311
DOI: 10.1016/j.transproceed.2014.02.022

Abstract

Introduction: Data on the prevalence and pattern of infection after living-donor liver transplantation (LDLT) are scarce in Egypt. We therefore conducted this study to quantify the incidence, risk factors, and pattern of bacterial resistance post-LDLT in 3 hospitals in Egypt.

Patients and methods: We conducted a retrospective, multicenter study of the medical records of 246 patients who underwent LDLT between January 2006 and April 2011 at 3 transplant centers in Egypt.

Results: Of 246 patients enrolled in this study, 127 (52%) developed infectious complications after LDLT, with 416 episodes of infection occurring within 3 months of transplantation. Biliary tract infection was the most common, occurring in 169 (40.6%) patients. The rate of infection with Gram-negative bacteria was higher than that of infection with Gram-positive bacteria (310 [74%] vs 87 [21%]; P < .001). Overall, 75% of Gram-negative isolates were multidrug resistant. Significant independent risk factors for infection were portal vein thrombosis (odds ratio, 2.4; P = .037) and biliary complications (odds ratio, 5.4; P < .001).

Conclusions: Our data showed a high-resistance pattern of bacterial infection after LDLT in Egypt. Early biliary complications were an independent risk factor for bacterial infection.

Publication types

Multicenter Study

MeSH terms

Adult
Bacterial Infections / complications
Bacterial Infections / drug therapy*
Bacterial Infections / epidemiology
Drug Resistance, Bacterial*
Egypt / epidemiology
Female
Humans
Incidence
Liver Transplantation / adverse effects*
Living Donors*
Male
Middle Aged
Risk Factors