Prevention and Treatment of Bacterial Infection Occurred after Orthotopic Liver Transplantation_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

NIU Xiufeng , LIU Jun.

Department of Hepatobiliary Surgery and Organ Transplantation Centre， Shandong Provincial Hospital， Shandong University, Jinan 250021， China;

Corresponding author：

Keywords：

Liver transplantation,Postoperative complications,Bacterial infection

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

【 Abstract 】 Objective To investigate the features and risk factors of bacterial infection after orthotopic liver transplantation (OLT) and summarize the experiences for prevention and treatment of infection. Methods The clinical materials of 79 patients underwent OLT from December 2004 to January 2007 were reviewed. The incidence and sites of postoperative bacterial infections as well as species of bacteria and the situation of drug resistance were retrospectively analyzed. Results Thirty-two (40.5%) out of 79 patients developed bacterial infections. Infection mainly occurred in lung, abdominal cavity and blood, which were mainly caused by Escherichia coli, staphylococcus aureus, klebsiella pneumoniae, staphylococcus epidermidis and enterococcus bacteria. The main risk factors included delayed restoration of gastrointestinal function ( gt;5 d), poorly preoperative liver function (Child C grade), hypoproteinemia and persistent postoperative hyperglycemia ( gt;11.0 mmol/L). Perioperative decontamination in digestive tract was a protective factor in the prevention of bacterial infection. Conclusion Bacterial infection is one of the most severe complications after OLT. Therefore, it is very important to remove those risk factors, make early diagnosis and take effective treatment ．

Citation： NIU Xiufeng,LIU Jun.. Prevention and Treatment of Bacterial Infection Occurred after Orthotopic Liver Transplantation. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2008, 15(3): 162-165. doi: Copy

1.	严律南, 李波. 原位肝移植术后近期并发症的防治 [Ｊ]. 临床外科杂志, 2002; 11(10)∶333.
2.	钟林, 彭志海. 肝移植术后细菌感染的防治 [Ｊ]. 肝胆胰外科杂志, 2007; 19(1)∶4.
3.	Echániz A, Pita S, Otero A, et al. Incidence, risk factors and influence on survival of infectious complications in liver transplantation [Ｊ]. Enferm Infecc Microbiol Clin, 2003; 21(5)∶224.
4.	Hollenbeak CS, Alfrey EJ, Souba WW. The effect of surgical site infections on outcomes and resource utilization after liver transplantation [Ｊ]. Surgery, 2001; 130(2)∶388.
5.	严律南，李波，卢实春，等. 原位肝移植术中体外静脉转流的改进 [Ｊ]. 中华器官移植杂志， 2002; 23(3)∶200.
6.	王潭枫, 符振华, 洪国强. 肝移植患者术后感染革兰阴性杆菌的分布及其耐药性分析 [Ｊ]. 中国微生态学杂志, 2007; 19(1)∶63.
7.	张栋, 张忠涛, 刘建, 等. 肝移植术后的细菌感染 [Ｊ]. 中华肝胆外科杂志, 2004; 10(5)∶297.
8.	成柯，黄祖发，朱晒红，等. 原位肝移植术后近期感染分析 [Ｊ]. 中国普通外科杂志, 2004; 13(3)∶216.
9.	李立，李铸，冉江华，等. 选择性消化道去污联合谷氨酰胺预防兔背驮式肝移植肠道细菌易位 [Ｊ]. 中国普外基础与临床杂志， 2007; 14(2)∶142.
10.	汪雅萍，应春妹，张灏曼, 等. 肝移植患者术后感染细菌分布及耐药性比较 [Ｊ]. 检验医学, 2007; 22(3)∶351.
11.	Singh N, Paterson DL, Chang FY, et al. Methicillin-resistant Staphylococcus aureus: the other emerging resistant gram-positive coccus among liver transplant recipients [Ｊ]. Clin Infect Dis, 2000; 30(2)∶322.
12.	Bakir M, Bova JL, Newell KA, et al. Epidemiology and clinical consequences of vancomycin-resistant enterococci in liver transplant patients [Ｊ]. Transplantation, 2001; 72(6)∶1032.
13.	陈规划, 蔡常洁. 重型肝炎肝移植的治疗进展 [Ｊ]. 中国普外基础与临床杂志, 2007; 14(2)∶132.
14.	Glanemann M， Langrehr J， Kaisers U， et al． Postoperative tracheal extubation after orthotopic liver transplantation [Ｊ]. Acta Anaesthesiol Scand， 2001; 45(3)∶333.
15.	Stefanov CS, Boyadzhiev NP, Uchikov AP, et al． Enteral nutrition in sepsis patients [Ｊ]. Folia Med (Plovdiv), 2005; 47(1)∶11.
16.	Rayes N, Seehofer D, Theruvath T, et al． Effect of enteral nutrition and synbiotics on bacterial infection rates after pylorus-preserving pancreatoduodenectomy: a randomized, double-blind trial [Ｊ]. Ann Surg, 2007; 246(1)∶36.
17.	Albillos A, de la Hera A. Multifactorial gut barrier failure in cirrhosis and bacterial translocation: working out the role of probiotics and antioxidants [Ｊ]. J Hepatol, 2002; 37(4)∶523.
18.	Torres A, Ewig S, Insausti J, et al． Etiology and microbial patterns of pulmonary infiltrates in patients with orthotopic liver transplantation [Ｊ]. Chest, 2000; 117(2)∶494.
19.	Galán Torres JM, Silla Aleixandre I, Chiveli Monleón MA, et al． Premature mortality in the early postoperative period of liver transplantation [Ｊ]. Rev Esp Anestesiol Reanim, 2003; 50(9)∶444.
20.	伊敏，朱曦，张同琳. 肝移植术后肺部感染的临床分析 [Ｊ]. 中华医院感染学杂志, 2007; 17(2)∶154.

1. 严律南, 李波. 原位肝移植术后近期并发症的防治 [Ｊ]. 临床外科杂志, 2002; 11(10)∶333.
2. 钟林, 彭志海. 肝移植术后细菌感染的防治 [Ｊ]. 肝胆胰外科杂志, 2007; 19(1)∶4.
3. Echániz A, Pita S, Otero A, et al. Incidence, risk factors and influence on survival of infectious complications in liver transplantation [Ｊ]. Enferm Infecc Microbiol Clin, 2003; 21(5)∶224.
4. Hollenbeak CS, Alfrey EJ, Souba WW. The effect of surgical site infections on outcomes and resource utilization after liver transplantation [Ｊ]. Surgery, 2001; 130(2)∶388.
5. 严律南，李波，卢实春，等. 原位肝移植术中体外静脉转流的改进 [Ｊ]. 中华器官移植杂志， 2002; 23(3)∶200.
6. 王潭枫, 符振华, 洪国强. 肝移植患者术后感染革兰阴性杆菌的分布及其耐药性分析 [Ｊ]. 中国微生态学杂志, 2007; 19(1)∶63.
7. 张栋, 张忠涛, 刘建, 等. 肝移植术后的细菌感染 [Ｊ]. 中华肝胆外科杂志, 2004; 10(5)∶297.
8. 成柯，黄祖发，朱晒红，等. 原位肝移植术后近期感染分析 [Ｊ]. 中国普通外科杂志, 2004; 13(3)∶216.
9. 李立，李铸，冉江华，等. 选择性消化道去污联合谷氨酰胺预防兔背驮式肝移植肠道细菌易位 [Ｊ]. 中国普外基础与临床杂志， 2007; 14(2)∶142.
10. 汪雅萍，应春妹，张灏曼, 等. 肝移植患者术后感染细菌分布及耐药性比较 [Ｊ]. 检验医学, 2007; 22(3)∶351.
11. Singh N, Paterson DL, Chang FY, et al. Methicillin-resistant Staphylococcus aureus: the other emerging resistant gram-positive coccus among liver transplant recipients [Ｊ]. Clin Infect Dis, 2000; 30(2)∶322.
12. Bakir M, Bova JL, Newell KA, et al. Epidemiology and clinical consequences of vancomycin-resistant enterococci in liver transplant patients [Ｊ]. Transplantation, 2001; 72(6)∶1032.
13. 陈规划, 蔡常洁. 重型肝炎肝移植的治疗进展 [Ｊ]. 中国普外基础与临床杂志, 2007; 14(2)∶132.
14. Glanemann M， Langrehr J， Kaisers U， et al． Postoperative tracheal extubation after orthotopic liver transplantation [Ｊ]. Acta Anaesthesiol Scand， 2001; 45(3)∶333.
15. Stefanov CS, Boyadzhiev NP, Uchikov AP, et al． Enteral nutrition in sepsis patients [Ｊ]. Folia Med (Plovdiv), 2005; 47(1)∶11.
16. Rayes N, Seehofer D, Theruvath T, et al． Effect of enteral nutrition and synbiotics on bacterial infection rates after pylorus-preserving pancreatoduodenectomy: a randomized, double-blind trial [Ｊ]. Ann Surg, 2007; 246(1)∶36.
17. Albillos A, de la Hera A. Multifactorial gut barrier failure in cirrhosis and bacterial translocation: working out the role of probiotics and antioxidants [Ｊ]. J Hepatol, 2002; 37(4)∶523.
18. Torres A, Ewig S, Insausti J, et al． Etiology and microbial patterns of pulmonary infiltrates in patients with orthotopic liver transplantation [Ｊ]. Chest, 2000; 117(2)∶494.
19. Galán Torres JM, Silla Aleixandre I, Chiveli Monleón MA, et al． Premature mortality in the early postoperative period of liver transplantation [Ｊ]. Rev Esp Anestesiol Reanim, 2003; 50(9)∶444.
20. 伊敏，朱曦，张同琳. 肝移植术后肺部感染的临床分析 [Ｊ]. 中华医院感染学杂志, 2007; 17(2)∶154.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Prevention and Treatment of Bacterial Infection Occurred after Orthotopic Liver Transplantation

Abstract Full text Figures/Tables Video References Cited by

Format

Content