Microbiologic Analyses of Patients Before and After Liver Transplant.

OBJECTIVES

The aim of this study was to analyze microbiologic screening results of patients before and after liver transplant.

MATERIALS AND METHODS

We analyzed the microbiologic screening results (throat and nasal swabs and sputum samples) before and after liver transplant of 16 patients who were treated in the Department of Transplantation at the National Scientific Medical Research Center during 2013 and 2014. Identification of isolates and antibiotic susceptibility testing were performed with the Vitek 2 Automated System (bioMerieux, Chemin de l'Orme 69280 Marcy l'Etoile France).

RESULTS

Microbiologic screening results of the respiratory tract before liver transplant showed that 10 of 15 patients (66.6%) had isolates at concentrations of 105 colony-forming units/mL and above. One patient did not receive microbiologic screening. In throat and nasal swabs, 8 patients (53.3%) displayed association of isolates. Throat swab results showed Streptococcus pneumoniae in 6 patients from this group at a concentration of 105 to 106 colony-forming units/mL and above. Enterococcus durans and Enterobacter aerogenes were identified in 1 patient at a concentration of 105 colony-forming units/mL. In nasal swabs, 5 patients (33.3%) showed Staphylococcus aureus and 3 patients (20%) showed Staphylococcus epidermidis (20%) infections. Sputum samples revealed isolates at infectious concentrations in 33.3% of patients. After transplant, microbiologic screening results showed qualitative and quantitative changes in the microbial spectrum of patients. The proportion of patients who had infectious levels of isolates increased to 66.6%. In throat and nasal swabs, isolates were identified as Streptococcus pneumoniae (44.4%), Streptococcus pyogenes (22.2%), Klebsiella pneumoniae (22.2%), and Enterobacter aerogenes (11.1%).

CONCLUSIONS

Before transplant, 66.6% of patients showed Streptococcus pneumoniae and Staphylococcus aureus in their respiratory tract. After transplant, there were qualitative and quantitative changes in the microbial spectrum of patients. We found that 40.0% of patients had multidrug-resistant gram-negative isolates.