The incidence of gram-negative bacterial and fungal infections in liver transplant patients treated with selective decontamination.

We have used selective bowel decontamination in 145 consecutive patients undergoing liver transplantation. In these 145 patients undergoing initial transplantation, we have experienced 42 major bacterial infections in 37 patients. Only five patients have experienced a gram-negative infection and only 2 of 26 documented bacteremias were associated with gram-negative organisms. To date, we have experienced only one systemic Candida infection. These results suggest that selective bowel decontamination may play a major role in reducing the previously reported high incidence of gram-negative and Candida sepsis following liver transplantation.