Mukhtar A, Abdelaal A, Hussein M, Dabous H, Fawzy I, Obayah G, Hasanin A, Adel N, Ghaith D, Bahaa M, Abdelaal A, Fathy M, El Meteini M
Department of Anesthesia and Critical Care, Cairo University, Cairo, Egypt.
Department of Anesthesia and Critical Care, Beni Suef University, Egypt.
Transplant Proc. 2014 Jun;46(5):1444-7. doi: 10.1016/j.transproceed.2014.02.022.
Data on the prevalence and pattern of infection after living-donor liver transplantation (LDLT) are scarce in Egypt. We therefore conducted this study to quantify the incidence, risk factors, and pattern of bacterial resistance post-LDLT in 3 hospitals in Egypt.
We conducted a retrospective, multicenter study of the medical records of 246 patients who underwent LDLT between January 2006 and April 2011 at 3 transplant centers in Egypt.
Of 246 patients enrolled in this study, 127 (52%) developed infectious complications after LDLT, with 416 episodes of infection occurring within 3 months of transplantation. Biliary tract infection was the most common, occurring in 169 (40.6%) patients. The rate of infection with Gram-negative bacteria was higher than that of infection with Gram-positive bacteria (310 [74%] vs 87 [21%]; P < .001). Overall, 75% of Gram-negative isolates were multidrug resistant. Significant independent risk factors for infection were portal vein thrombosis (odds ratio, 2.4; P = .037) and biliary complications (odds ratio, 5.4; P < .001).
Our data showed a high-resistance pattern of bacterial infection after LDLT in Egypt. Early biliary complications were an independent risk factor for bacterial infection.
在埃及，关于活体肝移植（LDLT）后感染的发生率和模式的数据匮乏。因此，我们开展了这项研究，以量化埃及3家医院LDLT术后细菌感染的发生率、危险因素及耐药模式。
我们对2006年1月至2011年4月期间在埃及3家移植中心接受LDLT的246例患者的病历进行了一项回顾性多中心研究。
在本研究纳入的246例患者中，127例（52%）在LDLT后发生了感染并发症，在移植后3个月内发生了416次感染发作。胆道感染最为常见，发生在169例（40.6%）患者中。革兰氏阴性菌感染率高于革兰氏阳性菌感染率（310例[74%]对87例[21%]；P <.001）。总体而言，75%的革兰氏阴性菌分离株对多种药物耐药。感染的显著独立危险因素是门静脉血栓形成（比值比，2.4；P = 0.037）和胆道并发症（比值比，5.4；P <.001）。
我们的数据显示埃及LDLT术后细菌感染呈现高耐药模式。早期胆道并发症是细菌感染的独立危险因素。
