Pseudomonas Aeruginosa Infection Among Liver Transplant Recipients: A Clinical Analysis of 15 Cases.

BACKGROUND: The aim of this study was to describe the incidence, time of onset, clinical characteristics, and outcomes of Pseudomonas aeruginosa infection after liver transplantation (LT) and to investigate the drug resistance of P aeruginosa to frequently used antibiotics to provide evidence for clinical prevention and therapy. METHODS: Patients undergoing LT from January 1, 2003, through June 30, 2015, were considered. We determined the site of infection and the drug susceptibility of P aeruginosa isolates and collected these patients' data to confirm post-LT clinical and laboratory characteristics. RESULTS: Of the 303 patients who underwent cadaveric LT, 15 (5.0%) developed 20 episodes of P aeruginosa infection. All episodes of P aeruginosa infection were early-onset, with the bloodstream being the most common source of infection. The majority (86.7%) of these recipients were in intensive care unit stay, and 7 (46.7%) patients had a body temperature of ≥38°C at the onset of infection and an inappropriate antibiotic therapy. In 14 (93.3%) patients, P aeruginosa infection was nosocomial infection. Platelet numbers of <50 × 10(9)/L and lymphocyte count of <300/mm(3) developed in 33.3% and 46.7% of patients, respectively. Seven (46.7%) deaths were attributable to P aeruginosa infection. Of these 20 P aeruginosa isolates, 10 (50%) each were carbapenem-resistant and multidrug-resistant. P aeruginosa was relatively susceptible to amikacin, levofloxacin, or cefoperazone-sulbactam (resistance rate, 30%). CONCLUSIONS: The bloodstream was the most common site of infection; a high body temperature, nosocomial origin, decreased platelet and lymphocyte count occurring in the early period after LT, high antibiotic resistance rate, and high morbidity and mortality rates were the main characteristics of P aeruginosa infection.

Public Perception of Cadaver Organ Donation in Hunan Province, China.

OBJECTIVE: Our aim was to (1) survey public' perception and attitudes toward organ donation and (2) analyze the relationship between knowledge, attitudes, and willingness to donate. METHODS: We developed a questionnaire, and conducted the survey with stratified random sampling. Overall, 600 residents, aged ≥18 who resided in Hunan, and 600 undergraduates from 3 universities in Hunan were surveyed randomly. For this study, 1085 valid questionnaires were completed, with a response rate of 90.4%. RESULTS: Of the 1085 participants, 581 (53.5%) were students, 504 (46.5%) were residents, and 519 (47.8%) were male and 566 (52.2%) female. The mean accuracy rate was 71.96%, and the students' mean accuracy rate was slightly higher than that of the resident population (73.06% vs 70.68%, respectively). The results showed that 82.2% of public support organ donation, and 53.5% were willing to donate their organs after death. Students scored higher than the residents (88% vs 75.6% and 55.6% vs 51.2%). Nearly 1.8% felt that organ donation was against their religion, 14.9% thought it was important to ensure the integrity of the body, 71.7% agreed that organ donation allowed a positive outcome after a person's death, and 61.5% agreed that organ donation represented a continuation of life, to help families cope with grief. Age and gender were related to attitudes. Public knowledge of organ donation and their attitudes were correlated positively (r = 0.666). CONCLUSIONS: Public knowledge of organ donation is poor, biased, and incomplete, and based on television, movies, and communication networks. Positive attitudes toward donation displayed in the surveys were not matched by actual organ donation.