Multidrug-Resistant Bacteria and Disease Progression in Patients with End-Stage Liver Disease and after Liver Transplantation.
J Gastrointestin Liver Dis
; 28(3): 303-310, 2019 Sep 01.
Article
in En
| MEDLINE
| ID: mdl-31517327
ABSTRACT
BACKGROUND:
Multidrug-resistant (MDR) pathogens represent an emerging challenge in end-stage liver disease and in liver transplant recipients.METHODS:
We evaluated the impact of MDR bacteria upon clinical outcomes in patients with end-stage liver disease (n = 777) at the time of enrollment on the liver transplant (LTx) waiting list, after first LTx (n = 645), and after second LTx (n = 128).RESULTS:
Colonization/infection with MDR bacteria was present in 72/777 patients on the waiting list, in 98/645 patients at first LTx, and in 46/128 patients at second LTx. While on the LTx waiting list, the time until first hydropic decompensation (p = 0.021), hepatic encephalopathy (p < 0.001) and hepatorenal syndrome (p < 0.001) was reduced in the presence of MDR bacteria, which remained an independent risk factor of poor survival in multivariate analysis (p < 0.001). Following first and second liver transplant, MDR bacteria were associated with an increased risk of infection-related deaths (first LTx p < 0.001; second LTx p = 0.037) and reduced actuarial survival (first LTx p < 0.001; second LTx p = 0.046).CONCLUSIONS:
We showed that MDR pathogens are associated with poor outcomes before, after first and after recurrent LTx.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Bacteria
/
Bacterial Infections
/
Liver Transplantation
/
Drug Resistance, Multiple, Bacterial
/
End Stage Liver Disease
Type of study:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Limits:
Adolescent
/
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
J Gastrointestin Liver Dis
Journal subject:
GASTROENTEROLOGIA
Year:
2019
Document type:
Article
Affiliation country:
Alemania