Carbapenem-Resistant Acinetobacter baumannii Acquired Before Liver Transplantation: Impact on Recipient Outcomes
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Citações na Scopus
25
Tipo de produção
article
Data de publicação
2016
Título da Revista
ISSN da Revista
Título do Volume
Editora
WILEY-BLACKWELL
Citação
LIVER TRANSPLANTATION, v.22, n.5, p.615-626, 2016
Resumo
Infection 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.
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Referências
- Tacconelli E, 2014, CLIN MICROBIOL INFEC, V20, P1, DOI 10.1111/1469-0691.12427
- Freire MP, 2015, TRANSPLANTATION, V99, P521, DOI 10.1097/TP.0000000000000381
- Bellier C, 2008, TRANSPL INT, V21, P755, DOI 10.1111/j.1432-2277.2008.00673.x
- Playford EG, 2007, J HOSP INFECT, V65, P204, DOI 10.1016/j.jhin.2006.11.010
- Freire MP, 2013, LIVER TRANSPLANT, V19, P1011, DOI 10.1002/lt.23682
- Marchaim D, 2007, J CLIN MICROBIOL, V45, P1551, DOI 10.1128/JCM.02424-06
- Freire MP, 2014, TRANSPL INFECT DIS, V16, P369, DOI 10.1111/tid.12210
- Kim YJ, 2014, TRANSPL P, V46, P828, DOI 10.1016/j.transproceed.2013.11.030
- Paugam-Burtz C, 2009, LIVER TRANSPLANT, V15, P522, DOI 10.1002/lt.21730
- Zhong L, 2012, J INFECTION, V64, P299, DOI 10.1016/j.jinf.2011.12.005
- Horan TC, 2008, AM J INFECT CONTROL, V36, P309, DOI 10.1016/j.ajic.2008.03.002
- Singh N, 2001, LIVER TRANSPLANT, V7, P100, DOI 10.1053/jlts.2001.21304
- Hsieh CE, 2013, TRANSPL P, V45, P225, DOI 10.1016/j.transproceed.2012.09.114
- Dalben MF, 2010, J HOSP INFECT, V74, P395, DOI 10.1016/j.jhin.2009.06.003
- Shi SH, 2009, TRANSPL INFECT DIS, V11, P405, DOI 10.1111/j.1399-3062.2009.00421.x
- Seifert H, 2005, J CLIN MICROBIOL, V43, P4328, DOI 10.1128/JCM.43.9.4328-4335.2005
- Martin EF, 2012, LIVER TRANSPLANT, V18, P914, DOI 10.1002/lt.23440
- Kim YJ, 2011, TRANSPL P, V43, P2397, DOI 10.1016/j.transproceed.2011.06.011
- Giamarellou H, 2008, INT J ANTIMICROB AG, V32, P106, DOI 10.1016/j.ijantimicag.2008.02.013
- Weintrob AC, 2010, INFECT CONT HOSP EP, V31, P330, DOI 10.1086/651304
- Bodro M, 2013, TRANSPLANTATION, V96, P843, DOI 10.1097/TP.0b013e3182a049fd
- Clinical and Laboratory Standard Institute, 2012, M100S22 CLSI
- desGouvea EF, 2012, BMC INFECT DIS, V12, P351
- Immordino G, 2014, TRANSPL P, V46, P2290, DOI 10.1016/j.transproceed.2014.07.039
- Morise Z, 2014, WORLD J GASTROENTERO, V20, P14381, DOI 10.3748/wjg.v20.i39.14381
- Shields RK, 2012, PLOS ONE, V7, DOI 10.1371/journal.pone.0052349
- Souli M, 2008, EUROSURVEILLANCE, V13, P19045
- vansDuin D, 2013, AM J TRANSPLANT S4, V13, P31
- Ye QF, 2014, TRANSPL INFECT DIS, V16, P767, DOI 10.1111/tid.12278
Coleções
Artigos e Materiais de Revistas Científicas - FM/MIP
Artigos e Materiais de Revistas Científicas - FM/MGT
Artigos e Materiais de Revistas Científicas - HC/ICESP
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - LIM/03
Artigos e Materiais de Revistas Científicas - LIM/37
Carregar mais Artigos e Materiais de Revistas Científicas - FM/MGT
Artigos e Materiais de Revistas Científicas - HC/ICESP
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - LIM/03
Artigos e Materiais de Revistas Científicas - LIM/37