Ramos Fernández Rafael, Calvo García Alberto, Fernández Yunkera Ainhoa, Ramos Cerro Silvia, Garutti Ignacio, Hortal Iglesias Javier, Muñoz García Patricia, García Ramos Sergio, Elvira Rodríguez Adoración, Power Esteban Mercedes, Duque González Patricia, Piñeiro Patricia
Department of Anesthesiology and Resuscitation, Gregorio Marañón University Hospital, 28007 Madrid, Spain.
Instituto de Investigación Sanitaria Gregorio Marañón (ISGM), 28007 Madrid, Spain.
J Pers Med. 2025 Jun 10;15(6):240. doi: 10.3390/jpm15060240.
Liver transplantation (LT) is a critical intervention for patients with end-stage liver disease. Infections caused by multidrug-resistant bacteria (MDRB) significantly worsen post-transplant outcomes. The main objective of this study was to analyze perioperative risk factors associated with MDRB infections within six months following LT. A retrospective analysis was conducted on 133 medical records of patients who underwent liver transplantation between October 2018 and May 2022. Data collected included the presence of MDRB colonization and infection, as well as various perioperative variables. These were analyzed to identify potential risk factors for MDRB infection and colonization. Univariate analysis identified several perioperative variables associated with MDRB infection within six months after LT. Multivariate logistic regression revealed that pre-transplant MDRB colonization (OR 5.72, 95% CI 1.7-18.7, = 0.005) and the requirement for dialysis during postoperative ICU stay (OR 6.42, 95% CI 1.7-23.4, = 0.009) were independent risk factors for developing MDRB infections. MDRB infection occurred in 9.4% of patients and was not significantly associated with increased mortality ( = 0.126). These findings contribute to a better understanding of the epidemiology and pathophysiology of MDRB infections in the postoperative period of liver transplantation. This knowledge is essential for developing effective prevention and treatment strategies that may improve outcomes in this patient population.
肝移植（LT）是终末期肝病患者的关键治疗手段。多重耐药菌（MDRB）引起的感染会显著恶化移植后的预后。本研究的主要目的是分析肝移植术后六个月内与多重耐药菌感染相关的围手术期危险因素。对2018年10月至2022年5月期间接受肝移植的133例患者的病历进行了回顾性分析。收集的数据包括多重耐药菌定植和感染情况，以及各种围手术期变量。对这些数据进行分析以确定多重耐药菌感染和定植的潜在危险因素。单因素分析确定了几个与肝移植术后六个月内多重耐药菌感染相关的围手术期变量。多因素逻辑回归显示，移植前多重耐药菌定植（比值比5.72，95%置信区间1.7 - 18.7，P = 0.005）和术后入住重症监护病房期间需要透析（比值比6.42，95%置信区间1.7 - 23.4，P = 0.009）是发生多重耐药菌感染的独立危险因素。9.4%的患者发生了多重耐药菌感染，且与死亡率增加无显著相关性（P = 0.126）。这些发现有助于更好地了解肝移植术后多重耐药菌感染的流行病学和病理生理学。这些知识对于制定可能改善该患者群体预后的有效预防和治疗策略至关重要。
