Risk Factors for Mortality in Liver Transplant Recipients With ESKAPE Infection

Abstract Background Although infections caused by the pathogens Enterococcus faecium , Staphylococcus aureus , Klebsiella pneumoniae , Acinetobacter baumannii , Pseudomonas aeruginosa , and Enterobacter spp (ESKAPE) have recently been identified as serious emerging problems in solid organ transplant...

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Published inTransplantation proceedings Vol. 46; no. 10; pp. 3560 - 3563
Main Authors Song, S.H, Li, X.X, Wan, Q.Q, Ye, Q.F
Format Journal Article
LanguageEnglish
Published United States Elsevier Inc 01.12.2014
Subjects
China - epidemiology
Female
Gram-Positive Bacterial Infections - mortality
Humans
Klebsiella Infections - mortality
Liver Transplantation - adverse effects
Male
Middle Aged
Odds Ratio
Retrospective Studies
Risk Factors
Shock, Septic - mortality
Staphylococcal Infections - mortality
Surgery
Survival Rate - trends
Transplant Recipients
China
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Abstract Abstract Background Although infections caused by the pathogens Enterococcus faecium , Staphylococcus aureus , Klebsiella pneumoniae , Acinetobacter baumannii , Pseudomonas aeruginosa , and Enterobacter spp (ESKAPE) have recently been identified as serious emerging problems in solid organ transplant, no information in liver transplant (LT) recipients is available. We sought to investigate the risk factors for associated mortality in LT recipients with ESKAPE infections. Methods A retrospective analysis of infection after LT was reviewed. Risk factors for mortality caused by ESKAPE infection were identified. Results Fifty-three episodes of infections caused by ESKAPE were documented in 51 LT recipients. The main sites of infection were the bloodstream (49.0%), the lungs (33.3%), and the intra-abdominal/biliary tract (17.6%). The risk factors for mortality independently associated with ESKAPE infection were female sex (odds ratio [OR] = 6.6, 95% confidence interval [CI] = 1.1–40.8, P  = .042), septic shock (OR = 30.1, 95% CI = 3.7–244.8, P  = .001), and lymphocyte counts <300/mm3 (OR = 20.2, 95% CI = 2.9–142.2, P  = .003). Conclusions To improve the results of LT, more effective therapeutic treatments are of paramount importance when female LT recipients with ESKAPE infection present with septic shock and decreased lymphocyte counts.
AbstractList Although infections caused by the pathogens Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp (ESKAPE) have recently been identified as serious emerging problems in solid organ transplant, no information in liver transplant (LT) recipients is available. We sought to investigate the risk factors for associated mortality in LT recipients with ESKAPE infections. A retrospective analysis of infection after LT was reviewed. Risk factors for mortality caused by ESKAPE infection were identified. Fifty-three episodes of infections caused by ESKAPE were documented in 51 LT recipients. The main sites of infection were the bloodstream (49.0%), the lungs (33.3%), and the intra-abdominal/biliary tract (17.6%). The risk factors for mortality independently associated with ESKAPE infection were female sex (odds ratio [OR] = 6.6, 95% confidence interval [CI] = 1.1–40.8, P = .042), septic shock (OR = 30.1, 95% CI = 3.7–244.8, P = .001), and lymphocyte counts <300/mm3 (OR = 20.2, 95% CI = 2.9–142.2, P = .003). To improve the results of LT, more effective therapeutic treatments are of paramount importance when female LT recipients with ESKAPE infection present with septic shock and decreased lymphocyte counts.
BACKGROUNDAlthough infections caused by the pathogens Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp (ESKAPE) have recently been identified as serious emerging problems in solid organ transplant, no information in liver transplant (LT) recipients is available. We sought to investigate the risk factors for associated mortality in LT recipients with ESKAPE infections.METHODSA retrospective analysis of infection after LT was reviewed. Risk factors for mortality caused by ESKAPE infection were identified.RESULTSFifty-three episodes of infections caused by ESKAPE were documented in 51 LT recipients. The main sites of infection were the bloodstream (49.0%), the lungs (33.3%), and the intra-abdominal/biliary tract (17.6%). The risk factors for mortality independently associated with ESKAPE infection were female sex (odds ratio [OR] = 6.6, 95% confidence interval [CI] = 1.1-40.8, P = .042), septic shock (OR = 30.1, 95% CI = 3.7-244.8, P = .001), and lymphocyte counts <300/mm(3) (OR = 20.2, 95% CI = 2.9-142.2, P = .003).CONCLUSIONSTo improve the results of LT, more effective therapeutic treatments are of paramount importance when female LT recipients with ESKAPE infection present with septic shock and decreased lymphocyte counts.
Although infections caused by the pathogens Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp (ESKAPE) have recently been identified as serious emerging problems in solid organ transplant, no information in liver transplant (LT) recipients is available. We sought to investigate the risk factors for associated mortality in LT recipients with ESKAPE infections. A retrospective analysis of infection after LT was reviewed. Risk factors for mortality caused by ESKAPE infection were identified. Fifty-three episodes of infections caused by ESKAPE were documented in 51 LT recipients. The main sites of infection were the bloodstream (49.0%), the lungs (33.3%), and the intra-abdominal/biliary tract (17.6%). The risk factors for mortality independently associated with ESKAPE infection were female sex (odds ratio [OR] = 6.6, 95% confidence interval [CI] = 1.1-40.8, P = .042), septic shock (OR = 30.1, 95% CI = 3.7-244.8, P = .001), and lymphocyte counts <300/mm(3) (OR = 20.2, 95% CI = 2.9-142.2, P = .003). To improve the results of LT, more effective therapeutic treatments are of paramount importance when female LT recipients with ESKAPE infection present with septic shock and decreased lymphocyte counts.
Abstract Background Although infections caused by the pathogens Enterococcus faecium , Staphylococcus aureus , Klebsiella pneumoniae , Acinetobacter baumannii , Pseudomonas aeruginosa , and Enterobacter spp (ESKAPE) have recently been identified as serious emerging problems in solid organ transplant, no information in liver transplant (LT) recipients is available. We sought to investigate the risk factors for associated mortality in LT recipients with ESKAPE infections. Methods A retrospective analysis of infection after LT was reviewed. Risk factors for mortality caused by ESKAPE infection were identified. Results Fifty-three episodes of infections caused by ESKAPE were documented in 51 LT recipients. The main sites of infection were the bloodstream (49.0%), the lungs (33.3%), and the intra-abdominal/biliary tract (17.6%). The risk factors for mortality independently associated with ESKAPE infection were female sex (odds ratio [OR] = 6.6, 95% confidence interval [CI] = 1.1–40.8, P  = .042), septic shock (OR = 30.1, 95% CI = 3.7–244.8, P  = .001), and lymphocyte counts <300/mm3 (OR = 20.2, 95% CI = 2.9–142.2, P  = .003). Conclusions To improve the results of LT, more effective therapeutic treatments are of paramount importance when female LT recipients with ESKAPE infection present with septic shock and decreased lymphocyte counts.
Author Song, S.H
Li, X.X
Ye, Q.F
Wan, Q.Q
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Snippet Abstract Background Although infections caused by the pathogens Enterococcus faecium , Staphylococcus aureus , Klebsiella pneumoniae , Acinetobacter baumannii...
Although infections caused by the pathogens Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas...
BACKGROUNDAlthough infections caused by the pathogens Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas...
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SubjectTerms China - epidemiology
Female
Gram-Positive Bacterial Infections - mortality
Humans
Klebsiella Infections - mortality
Liver Transplantation - adverse effects
Male
Middle Aged
Odds Ratio
Retrospective Studies
Risk Factors
Shock, Septic - mortality
Staphylococcal Infections - mortality
Surgery
Survival Rate - trends
Transplant Recipients
Title Risk Factors for Mortality in Liver Transplant Recipients With ESKAPE Infection
URI https://www.clinicalkey.es/playcontent/1-s2.0-S0041134514009476
https://dx.doi.org/10.1016/j.transproceed.2014.08.049
https://www.ncbi.nlm.nih.gov/pubmed/25498089
https://search.proquest.com/docview/1637567677
Volume 46
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