Oliveira Ramon Antônio, Mancero Jorge Marcelo Padilla, Faria Dalila Fernanda, Poveda Vanessa de Brito
1 Graduate Program in Adult Health Nursing, School of Nursing, University of São Paulo, São Paulo, Brazil.
2 Liver Transplantation Department, Hospital Santa Casa of São Jose dos Campos, São José dos Campos, São Paulo, Brazil.
Prog Transplant. 2019 Jun;29(2):144-149. doi: 10.1177/1526924819835831. Epub 2019 Mar 7.
Surgical site infection is an important complication in the postoperative period among liver transplant recipients. However, little is known about the risk factors in this patient group. Therefore, the objective of this study was to analyze the incidence and risk factors for surgical site infections among adult liver transplant recipients.
Medical records of adult liver transplant recipients from January 1, 2009, to December 31, 2015, were analyzed in this retrospective cohort study.
We enrolled 156 recipients' medical records. Forty-two (26.9%) cases of surgical site infections were identified. The main isolated microorganisms were methicillin-resistant Staphylococcus species, extended spectrum β-lactamase-producing Klebsiella species, carbapenem-resistant Pseudomonas aeruginosa, carbapenem-resistant Acinetobacter baumannii, and vancomycin-susceptible Enterococcus faecalis. We found that long operative times (≥487 minutes) and differences in body mass index between donor and recipient (≥1.3 kg/m) increased the risk for surgical site infections by approximately 5 times (odds ratio [OR], 5.5; 95% confidence interval [CI], 2.5-11.8), and capillary glycemia ≥175 mg/dL in the first 96 postoperative hours increased the risk by approximately 3 times (OR, 2.97; 95% CI, 1.43-6.17).
There was a high incidence of surgical site infections among the studied population and that some risk factors identified differ from those reported in the scientific literature.
手术部位感染是肝移植受者术后的一种重要并发症。然而,对于该患者群体的危险因素知之甚少。因此,本研究的目的是分析成年肝移植受者手术部位感染的发生率及危险因素。
在这项回顾性队列研究中,分析了2009年1月1日至2015年12月31日成年肝移植受者的病历。
我们纳入了156份受者病历。共识别出42例(26.9%)手术部位感染病例。主要分离出的微生物有耐甲氧西林葡萄球菌属、产超广谱β-内酰胺酶的克雷伯菌属、耐碳青霉烯类铜绿假单胞菌、耐碳青霉烯类鲍曼不动杆菌以及对万古霉素敏感的粪肠球菌。我们发现,手术时间长(≥487分钟)以及供体与受体之间的体重指数差异(≥1.3kg/m²)使手术部位感染风险增加约5倍(比值比[OR],5.5;95%置信区间[CI],2.5 - 11.8),术后96小时内毛细血管血糖≥175mg/dL使风险增加约3倍(OR,2.97;95%CI,1.43 - 6.17)。
在所研究的人群中,手术部位感染的发生率较高,且所确定的一些危险因素与科学文献中报道的不同。