Resistance rate and epidemiology of gram-negative bacilli in bloodstream infection after liver transplantation / 中华器官移植杂志

ABSTRACT

ObjectiveTo define the resistance rate and epidemiology of Gram-negative bacilli (GNB) of bloodstream infections (BSI) after liver transplantation. MethodsFrom Jan. 1998 to Dec.2009,a retrospective analysis of GNB in liver transplants was conducted. Bacterial, CMV and fungal infections were prevented by piperacillin/tazobactam, ganciclovir, fluconazole postoperatively. Bacterial inoculation,isolation and culture were mandated by national test standard. Vitek 2 Compact was used to evaluate identification and antimicrobial susceptibility testing. ResultsEighty-eight BSI occurred in 83 patients of the 768 patients,in which a total of 88 GNB were isolated. The incidence was 10. 8 ％(83/768) ,and the most frequent pathogens were Escherichia coli (37 strains) and Klebsiella spp (18strains). The rate of infection (23. 9 ％) was high in the interval of 1998-2000, and then decreased to 12. 4 ％ or below. Carbapenems and Piperacillin/tazobactam were the most consistently active against the Escherichia coli and Klebsiella spp, while resistance rate of Escherichia coli to Ciprofloxacin,Gentamycin, Ampicillin-clavulanic acid or Klebsiella spp after 2005 to Ciprofloxacin, Ticarcillinclavulanic acid was over 60 ％. ConclusionGNB after liver transplantation were resistant to agents but active to Carbapenems and Piperacillin/tazobactam commonly, in which Escherichia coli and Klebsiella spp are common.