期刊
TRANSPLANT INFECTIOUS DISEASE
卷 16, 期 1, 页码 84-89出版社
WILEY
DOI: 10.1111/tid.12169
关键词
extended-spectrum -lactamase; ESBL; liver transplant; fecal carriage; spontaneous bacterial peritonitis; Enterobacteriaceae
ObjectiveThe aim of the study was to identify risk factors associated with pre-transplant fecal carriage of extended-spectrum -lactamase (ESBL)-producing Enterobacteriaceae in liver transplant recipients. Patients and methodsOver a 3-year period (January 2009-December 2011), 317 patients who underwent liver transplantation were screened preoperatively for fecal carriage of ESBL-producing Enterobacteriaceae. Risk factors for fecal carriage were investigated by univariate analysis and stepwise logistic regression. ResultsOf the 317 patients screened, 50 (15.7%) harbored an ESBL-producing isolate. Previous infection with an ESBL-producing organism had developed during the last 6months in 20% of fecal carriers versus in none of the non-carriers. Other variables associated with fecal carriage were a model for end-stage liver disease score 25, pre-transplant stay in the intensive care unit 48h, hospital stay 10days in the last 6months, a history of spontaneous bacterial peritonitis (SBP), exposure to a -lactam agent in the last month, and prophylaxis with norfloxacin. Independent predictors of fecal carriage in the multivariate logistic regression model were exposure to a -lactam agent in the month preceding transplantation (odds ratio [OR]=7.8, confidence interval [CI]=4-15.5, P<0.001), and a history of SBP (OR=2.4, CI=1.1-4.9, P=0.02). ConclusionsPrevious infection with an ESBL-producing isolate, recent exposure to a -lactam agent, and a history of SBP are risk factors for preoperative fecal carriage of ESBL-producing Enterobacteriaceae in liver transplant recipients. Patients at risk of fecal carriage should receive intraoperative prophylaxis and, when necessary, empiric postoperative antimicrobial treatment that includes coverage for these organisms.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据