Carbapenem-Resistant Acinetobacter baumannii Acquired Before Liver Transplantation: Impact on Recipient Outcomes

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorFREIRE, Maristela Pinheiro
dc.contributor.authorPIERROTTI, Ligia Camera
dc.contributor.authorOSHIRO, Isabel Cristina Villela Soares
dc.contributor.authorBONAZZI, Patricia Rodrigues
dc.contributor.authorOLIVEIRA, Larissa Marques de
dc.contributor.authorMACHADO, Anna Silva
dc.contributor.authorHEIJDEN, Inneke Marie Van der
dc.contributor.authorROSSI, Flavia
dc.contributor.authorCOSTA, Silvia Figueiredo
dc.contributor.authorD'ALBUQUERQUE, Luiz Augusto Carneiro
dc.contributor.authorABDALA, Edson
dc.date.accessioned2016-07-18T12:13:15Z
dc.date.available2016-07-18T12:13:15Z
dc.date.issued2016
dc.description.abstractInfection with carbapenem-resistant Acinetobacter baumannii (CRAB) after liver transplantation (LT) is associated with high mortality. This study aimed to identify risk factors for post-LT CRAB infection, as well as to evaluate the impact of pre-LT CRAB acquisition on the incidence of post-LT CRAB infection. This was a prospective cohort study of all patients undergoing LT at our facility between October 2009 and October 2011. Surveillance cultures (SCs) were collected immediately before LT and weekly thereafter, until discharge. We analyzed 196 patients who were submitted to 222 LTs. CRAB was identified in 105 (53.6%); 24 (22.9%) of these patients were found to have acquired CRAB before LT, and 85 (81.0%) tested positive on SCs. Post-LT CRAB infection occurred in 56 (28.6%), the most common site being the surgical wound. Multivariate analysis showed that the risk factors for developing CRAB infection were prolonged cold ischemia, post-LT dialysis, LT due to fulminant hepatitis, and pre-LT CRAB acquisition with pre-LT CRAB acquisition showing a considerable trend toward significance (P = 0.06). Among the recipients with CRAB infection, 60-day mortality was 46.4%, significantly higher than among those without (P < 0.001). Mortality risk factors were post-LT infection with multidrug-resistant bacteria, LT performed because of fulminant hepatitis, retransplantation, prolonged cold ischemia, longer LT surgical time, and pre-LT CRAB acquisition, the last showing a trend toward significance (P = 0.08). In conclusion, pre-LT CRAB acquisition appears to increase the risk of post-LT CRAB infection, which has a negative impact on recipient survival.
dc.description.indexMEDLINE
dc.description.sponsorshipFundacao de Amparo a Pesquisa do Estado de Sao Paulo (Sao Paulo Research Foundation) [2010/02267-6]
dc.identifier.citationLIVER TRANSPLANTATION, v.22, n.5, p.615-626, 2016
dc.identifier.doi10.1002/lt.24389
dc.identifier.eissn1527-6473
dc.identifier.issn1527-6465
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/14261
dc.language.isoeng
dc.publisherWILEY-BLACKWELL
dc.relation.ispartofLiver Transplantation
dc.rightsrestrictedAccess
dc.rights.holderCopyright WILEY-BLACKWELL
dc.subject.otherrisk-factors
dc.subject.otherkidney-transplantation
dc.subject.otherinfection
dc.subject.otherbacteremia
dc.subject.othercolonization
dc.subject.otherpathogens
dc.subject.othermortality
dc.subject.othersurvival
dc.subject.otherhealth
dc.subject.wosGastroenterology & Hepatology
dc.subject.wosSurgery
dc.subject.wosTransplantation
dc.titleCarbapenem-Resistant Acinetobacter baumannii Acquired Before Liver Transplantation: Impact on Recipient Outcomes
dc.typearticle
dc.type.categoryoriginal article
dc.type.versionpublishedVersion
dspace.entity.typePublication
hcfmusp.author.externalOSHIRO, Isabel Cristina Villela Soares:Univ Sao Paulo, Infect Control Team, Hosp Clin, Sao Paulo, Brazil
hcfmusp.citation.scopus25
hcfmusp.contributor.author-fmusphcMARISTELA PINHEIRO FREIRE
hcfmusp.contributor.author-fmusphcLIGIA CAMERA PIERROTTI
hcfmusp.contributor.author-fmusphcPATRICIA RODRIGUES BONAZZI
hcfmusp.contributor.author-fmusphcLARISSA MARQUES DE OLIVEIRA
hcfmusp.contributor.author-fmusphcANNA SILVA MACHADO
hcfmusp.contributor.author-fmusphcINNEKE MARIE VAN DER HEIJDEN NATARIO
hcfmusp.contributor.author-fmusphcFLAVIA ROSSI
hcfmusp.contributor.author-fmusphcSILVIA FIGUEIREDO COSTA
hcfmusp.contributor.author-fmusphcLUIZ AUGUSTO CARNEIRO D ALBUQUERQUE
hcfmusp.contributor.author-fmusphcEDSON ABDALA
hcfmusp.description.beginpage615
hcfmusp.description.endpage626
hcfmusp.description.issue5
hcfmusp.description.volume22
hcfmusp.origemWOS
hcfmusp.origem.pubmed26684547
hcfmusp.origem.scopus2-s2.0-84964746077
hcfmusp.origem.wosWOS:000375155700007
hcfmusp.publisher.cityHOBOKEN
hcfmusp.publisher.countryUSA
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hcfmusp.scopus.lastupdate2024-04-12
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