Assessment of pathogens and risk factors associated with bloodstream infection in the year after pediatric liver transplantation

BACKGROUND Bloodstream infection (BSI) is one of the most significantly adverse events that can occur after liver transplantation (LT) in children. AIM To analyze the profile of BSI according to the postoperative periods and assess the risk factors after pediatric LT. METHODS Clinical data, collected from medical charts of children (n = 378) who underwent primary LT, were retrospectively reviewed. The primary outcome considered was BSI in the first year after LT. Univariate and multivariate analyses were performed to identify risk factors for BSI and respective odds ratios (ORs). RESULTS Of the examined patients, 106 (28%) experienced 162 episodes of pathogen-confirmed BSI during the first year after LT. There were 1.53 +/- 0.95 episodes per children (mean +/- SD) among BSI-complicated patients with a median onset of 0.4 mo post-LT. The most common pathogenic organisms identified were Coagulase-negative staphylococci, followed by Enterococcus spp. and Streptococcus spp. About half (53%) of the BSIs were of unknown origin. Multivariate analysis demonstrated that young age (<= 1.3 year; OR = 2.1, P = 0.011), growth failure (OR = 2.1, P = 0.045), liver support system (OR = 4.2, P = 0.008), and hospital stay of > 44 d (OR = 2.3, P = 0.002) were independently associated with BSI in the year after LT. CONCLUSION BSI was frequently observed in patients after pediatric LT, affecting survival outcomes. The profile of BSI may inform clinical treatment and management in high-risk children after LT.

Automated summary

This study retrospectively analyzed data from children who underwent liver transplantation and found that bloodstream infections (BSIs) frequently occurred within the first year after transplantation. Factors such as young age, growth failure, the use of a liver support system, and longer hospital stays were independently associated with BSI.