Abstract | BACKGROUND: METHODS: We isolated and detected bacteria from phlegm, throat swabs, urine, wound or wound secretions, blood, and fecal samples from 221 liver transplant patients in our hospital from January 2007 to April 2010. All isolated bacterial strains were identified and tested by minimal inhibitory concentration (MIC) drug-sensitive detection using the BioMerieux ATB bacterial identification instrument and repetitive extragenic palindromic-polymerase chain reaction (REP-PCR) detection of bacterial homology. Risk factors were calculated by multivariate Logistic regression analysis. RESULTS: We collected 250 specimens from 221 patients hospitalized following liver transplantation surgery, of which 29 patients developed multiple infections. Sixty-five Gram-positive bacterial strains were isolated from different specimens from 53 infectious patients. We detected 29 multidrug-resistant Gram-positive strains from 29 patients (44.62%), including 20 Staphylococcus aureus (S. aureus) strains (68.97%) and nine Enterococcus strains (31.03%). All 20 S. aureus strains were highly resistant to aminoglycosides ( gentamicin), cephalosporins ( cefoxitin), quinolones ( ciprofloxacin and levofloxacin), lincomycins ( clindamycin), penicillin, and erythromycin. The resistance rate reached 100% in some cases. The S. aureus strains were highly sensitive to vancomycin and oxazolidinone ( linezolid), with MIC50 < 2 µg/ml for both. The nine Enterococci strains were also highly resistant to aminoglycosides, quinolones, and penicillins, and highly sensitive to vancomycin (MIC50 < 2 µg/ml) and oxazolidinone (MIC50 < 1 µg/ml). Using REP-PCR detection, S. aureus was divided into five genotypes with 14 B-type strains. Enterococcus was divided into 11 genotypes, with two D-type strains, two G-type strains, and two K-type strains. The risk factors for Gram-positive bacterial infection in patients following liver transplantation were preoperative use of antibiotics (OR = 3.949, P = 0.004), high intra-operative blood input (OR = 1.071, P = 0.005), and postoperative renal failure (OR = 5.427, P = 0.043). CONCLUSIONS:
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Authors | Hong Li, De-Lei Yu, Lei Ren, Lin Zhong, Zhi-Hai Peng, Mu-Jian Teng |
Journal | Chinese medical journal
(Chin Med J (Engl))
Vol. 125
Issue 14
Pg. 2417-21
(Jul 2012)
ISSN: 2542-5641 [Electronic] China |
PMID | 22882913
(Publication Type: Journal Article)
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Chemical References |
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Topics |
- Adult
- Anti-Bacterial Agents
(pharmacology)
- Drug Resistance, Multiple, Bacterial
(genetics)
- Female
- Gram-Positive Bacteria
(drug effects, genetics, pathogenicity)
- Gram-Positive Bacterial Infections
(epidemiology, etiology, microbiology)
- Humans
- Liver Transplantation
(adverse effects)
- Male
- Microbial Sensitivity Tests
- Middle Aged
- Molecular Epidemiology
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