Bacterial Infections after Liver Transplantation in Children: Single Center Study for 16 Years
- Author:
Jae Choon KIM
1
;
Su Ji KIM
;
Ki Wook YUN
;
Eun Hwa CHOI
;
Nam Joon YI
;
Kyung Suk SUH
;
Kwang Woong LEE
;
Hoan Jong LEE
Author Information
- Publication Type:Original Article
- Keywords: Liver transplantation; Child; Bacterial infections; Korea
- MeSH: Anti-Bacterial Agents; Bacterial Infections; Child; Enterococcus; Humans; Immunosuppression; Incidence; Klebsiella; Korea; Liver Transplantation; Liver; Lung; Mortality; Peritoneum; Peritonitis; Pneumonia; Prevalence; Prognosis; Retrospective Studies; Sepsis; Staphylococcus aureus; Steroids; Tacrolimus; Transplants; Urinary Tract
- From:Pediatric Infection & Vaccine 2018;25(2):82-90
- CountryRepublic of Korea
- Language:Korean
- Abstract: PURPOSE: Survival after liver transplantation (LT) has improved over the years, but infection is still a major complication. We aimed to identify the characteristics of bacterial infections in pediatric LT recipients. METHODS: This study is a retrospective review of 189 consecutive children undergoing LT between 2000 and 2015 at a single center. In this study, the incidence of infection was determined for the following periods: within 1 month, between 1–5 months, and between 6–12 months. Patients who underwent liver transplants more than once or multiple organ transplants were excluded. RESULTS: All patients had received postoperative antibiotic for 3 days. Only the maintenance immunosuppression with oral tacrolimus and steroids were performed. As a result, 132 bacterial infections developed in 87 (46.0%) patients (0.70 events per person-year). Bacterial infections occurred most frequently within the first month (n=84, 63.6%) after LT. In the pathogens, Staphylococcus aureus (15.2%), Enterococcus species (15.2%), and Klebsiella species (13.6%) were most common. Regarding the organ infected, bloodstream was most common (n=39, 29.5%), followed by peritoneum (n=28, 21.2%), urinary tract (n=25, 18.9%), and lungs (n=20, 15.2%). We changed prophylactic antibiotics from ampicillin-sulbactam to piperacillin-tazobactam at 2011, October, there were no significant effects in the prevalence of antibiotics resistant bacterial infections. The 1-year mortality was 9.0% (n=17), in which 41.2% (n=7) was attributable to bacterial infection; septicemia (n=4), pneumonia (n=2), and peritonitis (n=1). CONCLUSIONS: The incidence and type of bacterial infectious complications after LT in pediatric patients were similar to those of previous studies. Bacterial complications affecting mortality occur within 6 months after transplantation, so proper prophylaxis and treatment in this period may improve the prognosis of LT.
