Analysis Of Composition,Distribution,Drug Sensitivity And Risk Factors Of Bacterial Infection In Early Stage After Liver Transplantation

Objetive:By analyzing the etiological distribution,drug susceptibility characteristics and risk factors for infection in patients with early bacterial infection after liver transplantation,it provides a theoretical basis for the clinical diagnosis and treatment of bacterial infection after liver transplantation in the Center.Methods:The clinical data of recipients who underwent liver transplantation at the Third Xiangya Hospital of Central South University from January 2019 to December 2021 were collected,and the pathogen composition,distribution and drug resistance and risk factors for infection were analyzed.Results:1.Of the 207 liver transplant recipients,101 strains of bacterial infection occurred within two months of surgery,with a bacterial infection incidence of 32.9%(68/207),and 14 of them died after surgery,with a mortality rate of 6.8%.2.Gram-negative bacteria(60/101;59.4%)are more common than gram-positive bacteria(41/101;40.6%)in pathogenic bacteria..The most common gram-negative bacteria are Klebsiella pneumoniae(15/101,14.9%);the most common gram-positive bacteria are Enterococcus faecalis(28/101;27.7%).3.The most common sites of infection are the abdominal cavity/biliary tract(29/101;28.8%),respiratory tract(28/101;27.7%)and urinary tract(27/101;26.7%).4.Most gram-negative bacteria are more resistant to cephalosporins,βlactam/enzyme inhibitors,carbapenems,quinolones,sulfonamides,and aminoglycosides(gentamicin,tobramycin)and more sensitive to amikacin,minocycline,tigecycline,and polymyxin B;the vast majority of gram-positive bacteria have higher resistance to totobumycin,penicillin G,levofloxacin,ampicillin,erythromycin,and high concentrations of gentamicin,while sensitive to glycopeptides(vancomycin,ticoranine),daptomycin,Tigecycline and linezolid.5.Univariate analysis showed that females,the duration of surgery≥400min,intraoperative blood loss≥3000 ml,agivine aminotransferase on the first day after surgery>1000U/L,postoperative ventilator support and urethral catheters indwelled≥3 days were associated with the occurrence of bacterial infection,and binary Logistic regression analysis revealed that females[OR=2.280,95%CI:1.020-5.097,P=0.045],duration of surgery≥400 mins[OR=2.002,95%CI:1.025-3.911,P=0.042]and urethral catheters indwelled≥3days[OR=2.409,95%CI:1.045-5.552,P=0.039]were independent risk factors for bacterial infections after liver transplantation.Conclusion:1.The incidence of early bacterial infection after liver transplantation is high,and the gram-negative bacteria are the mainstay.The most common sites of infection are the abdominal cavity/biliary tract,respiratory tract,and urinary tract.2.The most common G~-bacteria are Klebsiella pneumoniae,Acinetobacter baumannii and Maltophilus narrow-feeding monocytogenes;The most common G~+bacteria are Enterococcus faecalis and Enterococcus faecalis;The most common fungus is the genus Candida.3.The vast majority of bacteria have a high rate of resistance to commonly used antibiotics.The susceptible antibiotics for G~-bacterial infections are mainly amikacin,minocycline,tigecycline,and polymyxin B;Susceptible antibiotics for G~+bacterial infections are mainly glycopeptides(vancomycin,ticoranin),daptomycin,tigecycline,and linezolid.4.The females,the duration of surgery≥400min and the duration of urinary indwelling≥3 days are independent risk factors for the occurrence of bacterial infection after liver transplantation,and shortening the operation time and removing the catheter as soon as possible may have a positive effect on reducing the incidence of postoperative bacterial infection.Figure:1,Table:8,Reference:62.