Pathogenesis of early operative site infections after orthotopic liver transplantation

Transplantation
P M ArnowK A Newell

Abstract

We hypothesized that operative site infections after orthotopic liver transplantation arise from bacteria in bile or jejunum. To ascertain the validity of this hypothesis and to assess the effect of systemic antibiotic prophylaxis, we obtained intraoperative cultures of peritoneum, fascia, explant and donor liver bile, and jejunal lumen in 77 liver transplantations, and we monitored outcome. Pathogens were recovered from peritoneum, fascia, or bile in 11 cases. By univariate analysis, a positive culture was significantly associated with choledochojejunostomy (P=0.0002), previous liver transplantation (P=0.0002), and previous hepatobiliary surgery (P=0.002). Operative site infections during the first 2 weeks after transplantation occurred only in cases with positive intraoperative cultures, and three of the four infections were caused by the same bacteria detected intraoperatively. Antibiotic susceptibility of intraoperative isolates was tested in nine cases; infection occurred in two of three cases in which the isolates were resistant to the systemic antibiotic prophylaxis and in none of six cases with susceptible isolates. Our findings suggest that systemic antibiotic prophylaxis for more than 2 days may be beneficial in cases...Continue Reading

References

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Citations

Mar 7, 2013·Surgical Infections·Dale W BratzlerUNKNOWN Society for Healthcare Epidemiology of America (SHEA)
Jun 27, 2008·Transplantation·María E García PradoJosé M Cisneros Herreros
Nov 30, 2005·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Janis E Blair, Shimon Kusne
May 30, 2008·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Angel AsensioUNKNOWN Red de Estudio de la Infección en el Trasplante - Grupo de Estudio de la Infección en el Trasplante
May 30, 2008·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Shimon Kusne
Jun 14, 2014·Journal of Hepato-biliary-pancreatic Sciences·Tomoyuki MinamiKazuaki Chayama
May 28, 2014·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·C CerveraUNKNOWN ESCMID Study Group for Infections in Compromised Hosts
Oct 27, 2007·Arquivos De Gastroenterologia·Mônica Vinhas de SouzaAdão Rogério Leal Machado
Jan 19, 2013·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Dale W BratzlerUNKNOWN Society for Healthcare Epidemiology of America

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