Abstract |
Bacterial infections, especially cholangitis, are still common complications after liver transplantation (LTx). During recent years, multiresistant enterococci have become a nosocomial problem in transplant units. The present prospective study on 26 patients, including 24 patients with chronic liver disease, demonstrated that enterococci were the predominant micro-organism involved in post-LTx bacterial infections. They were cultured in the feces and in other sites of 10 out of 13 (77%) patients who underwent extensive examinations. Ampicillin-resistant Enterococcus faecium strains were isolated in urine or feces of 2 of the 13 patients prior to LTx. Similarly, resistance to ampicillin and gentamicin, the empirically used antibiotics for patients with fever of unknown origin, was found in E. faecium strains in 3 and 2 patients, respectively. Moreover, multiresistant E. faecium and E. faecalis strains were demonstrated in 46% of the patients in the postoperative period (3 months). However, no vancomycin-resistant enterococci were isolated. The use of antibiotics within 4 months prior to LTx significantly increased the risk of developing ampicillin-resistant bacteria at the time of LTx and of infections with bacteria of enteric origin after LTx (P = 0.03 and 0.01, respectively). We conclude that stool and urine cultures performed prior to LTX may be useful for selecting prophylactic antibiotic regimens.
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Authors | L M Barkholt, J Andersson, B G Ericzon, A C Palmgren, U Broomé, F Duraj, A Bergquist, G Herlenius, C E Nord |
Journal | Transplant international : official journal of the European Society for Organ Transplantation
(Transpl Int)
Vol. 10
Issue 6
Pg. 432-8
( 1997)
ISSN: 0934-0874 [Print] Switzerland |
PMID | 9428116
(Publication Type: Journal Article)
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Chemical References |
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Topics |
- Adult
- Ampicillin
(therapeutic use)
- Ampicillin Resistance
- Antibiotic Prophylaxis
- Bacterial Infections
(blood, prevention & control, urine)
- Cholangitis
(etiology, microbiology)
- Disease Susceptibility
(etiology, microbiology, therapy)
- Drug Resistance, Multiple
- Enterobacteriaceae
(drug effects, isolation & purification)
- Feces
(microbiology)
- Female
- Fever
(drug therapy, etiology, microbiology)
- Gentamicins
(therapeutic use)
- Humans
- Liver Transplantation
(adverse effects)
- Male
- Postoperative Complications
(drug therapy, etiology, microbiology)
- Prospective Studies
- Risk Factors
- Time Factors
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