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革兰氏阴性菌感染患者的肝移植:非鲍曼不动杆菌和鲍曼不动杆菌。

Liver transplantation in patients infected with gram-negative bacteria: non-Acinetobacter baumannii and Acinetobacter baumannii.

作者信息

Hsieh C-E, Chen Y-L, Lin P-Y, Lin K-H, Lin H-C, Liu C-E, Wang S-H, Li Y-L

机构信息

Department of Liver Transplantation, Changhua Christian Hospital, Changhua, Taiwan.

出版信息

Transplant Proc. 2013 Jan-Feb;45(1):225-30. doi: 10.1016/j.transproceed.2012.09.114.

Abstract

BACKGROUND

The current study investigated risk factor related to gram-negative bacterial (GNB) infection by Acinetobacter baumannii and non-A baumannii groups, in liver transplantation (OLT) recipients.

MATERIALS AND METHODS

All patients with OLT and their living donors were analyzed retrospectively. After excluding those with Gram-positive and fungal infections 89 patients remained in the study including 59 who were noninfected and 30 with GNB infection. The risk factors for GNB infection were classified into the preoperative versus the postoperative periods.

RESULTS

GNB-infected patients were classified as non-A baumannii versus A baumannii (15 patients per group). A significant difference was observed in the numbers of intensive care and hospitalized days, hemodialysis requirement, and reoperation frequency compared with the noninfected group. Infection also correlated with hospital mortality, overall survival, and Model for End-Stage Liver Disease (MELD) scores with significance upon univariate but only the last feature on multivariate analysis.

CONCLUSIONS

Preoperative MELD scores were more likely to be higher among the non-A baumannii compared with the A baumannii-infected group. However, the 1-year survival of the A baumannii-infected subjects was lower than that of the non-A baumannii infected group.

摘要

背景

本研究调查了肝移植(OLT)受者中与鲍曼不动杆菌和非鲍曼不动杆菌组革兰氏阴性菌(GNB)感染相关的危险因素。

材料与方法

对所有OLT患者及其活体供体进行回顾性分析。排除革兰氏阳性菌和真菌感染患者后,89例患者纳入研究,其中59例未感染,30例发生GNB感染。GNB感染的危险因素分为术前和术后阶段。

结果

GNB感染患者分为非鲍曼不动杆菌组和鲍曼不动杆菌组(每组15例)。与未感染组相比,在重症监护天数、住院天数、血液透析需求和再次手术频率方面观察到显著差异。感染还与医院死亡率、总体生存率和终末期肝病模型(MELD)评分相关,单因素分析时有显著性,但多因素分析时仅最后一个特征有显著性。

结论

与鲍曼不动杆菌感染组相比,非鲍曼不动杆菌组术前MELD评分更可能更高。然而,鲍曼不动杆菌感染患者的1年生存率低于非鲍曼不动杆菌感染组。

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