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Clinical Investigation of Early Bacterial Infections after Living Donor Liver Transplantation in Children

Author: MaoRenPing
Tutor: ZhuChaoMin
School: Chongqing Medical University
Course: Pediatrics
Keywords: Liver Transplantation Bacterial infection Living Donors Child resisitance
CLC: R446.5
Type: Master's thesis
Year: 2011
Downloads: 19
Quote: 0
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Abstract


Objective:To study the main Bacterial species, distribution and drug sensitivity of early bacterial infections after living donor liver transplantation (LDLT) in children.Methods:The clinical data of the incidence,pathogen distribution and antibiotic-sensitivity of early postoperative bacterial infection occurring in 41 LDLT cases were retrospectively analyzed.Results:(1)33 cases among 41 (80.5%) had bacterial infections after LDLT(1.66 infection episodes per infected patient). Additionally, the median infection time was 10.4 days after LDLT. The most common sites of bacterial infection were lower respiratory tract(46.4%), abdomen (23.3%) and biliary tract(16.0%),and Pseudomonas Aeruginosa , Enterococcus faecium, Escherichia coli were the most common bacterial pathogens, respectively. Mixed infection rates of more than 2 sites and more than 2 species of bacterial were 36.4% and 51.6%, respectively.(2)Overall, 101 microorganisms were found and gram-negative bacteria (74.3%) predominated over Gram-positive bacteria (25.7%). The detectable rate of ESBLs in gram-negative bacteria were 80.0%.Moreover, The detectable rate of MRCNS and Producedβ-lactamases in MRCNS were 69.2% and 27.2%, respectively. And 27.2% of Enterococcus were HLAR.(3)Pseudomonas aeruginosaˊs drug-resistance rate of imipenem and meropenem were 67% and 82%, respectively. Coagulase-negative staphylococcus and Enterococcus faecium also showed drug reisistance to vancomycin and ticoplanin . Intermediate rate of ticoplanin was 25% to 40% and resistance rate of vancomycin was 0% to 20%. One resistant strain to vancomycin in Staphylococcus epidermidis is found.Conclusion:①The bacterial infection rate was high after LDLT in children and most postoperative bacterial infections occurred early. mixed infection trends not only found in infective sites but also in pathogen species.②Most of the pathogens were antibiotics multi-resistant and the main pathogens from different infectious sites were different.③Effective prevention of infection, early diagnosis and appropriate use of antibiotics is the key to control the infection.

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