【medical-news】研究者指出肝移植后感染的风险因素
发布于 2008-06-14 · 浏览 1308 · IP 北京北京
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June 6, 2008 -- Nearly 9% of patients who recently underwent liver transplantation suffered a subsequent surgical site infection (SSI). Risk factors included having had biliary-enteric anastomosis, previous liver or kidney transplant, and more than 4 red blood cell units transfused. These findings are published in the June issue of Liver Transplantation.
Researchers aimed to determine the incidence, timing, location, and risk factors, including antibiotic prophylaxis, for such infections. They designed a prospective study that included 1,222 consecutive patients who received liver transplants in 11 Spanish hospitals between August 2003 and September 2005. They included all infections that developed up to 6 months after surgery, including both wound incision and organ/space infection, hepatic and intra-abdominal abscess, and peritonitis. To assess risk factors for SSIs, they looked at patients who became ill in the first 30 days following their surgery. They then examined possible risk factors for their infections.
SSIs occurred in 8.8% of patients, most within the first few weeks after the transplant. About 10% of these were fatal. The predominant infection site was the incision. Thirty-nine percent of infections were peritonitis, 16% were intra-abdominal abscesses, and 10% were hepatic abscesses.
Most infections were caused by gram-negative aerobic bacteria. Infection risk was related to choice of antibiotic prophylaxis, with the highest risk seen with the use of cefazolin. Fungal infection occurred in 10 cases, a remarkably high number, because many of the participant institutions used fluconazole.
After multivariate analysis, the authors found that, biliary-enteric anastomosis, previous liver or kidney transplant, and more than 4 red blood cell units transfused were independently associated with the development of SSIs.
The results provide insight into the risk of SSIs in relation to previous transplantation, choledocho-jejunal reconstruction, and red blood cell transfusion, which could motivate new studies to aid in understanding the pathogenesis of SSIs in liver transplantation.
Researchers aimed to determine the incidence, timing, location, and risk factors, including antibiotic prophylaxis, for such infections. They designed a prospective study that included 1,222 consecutive patients who received liver transplants in 11 Spanish hospitals between August 2003 and September 2005. They included all infections that developed up to 6 months after surgery, including both wound incision and organ/space infection, hepatic and intra-abdominal abscess, and peritonitis. To assess risk factors for SSIs, they looked at patients who became ill in the first 30 days following their surgery. They then examined possible risk factors for their infections.
SSIs occurred in 8.8% of patients, most within the first few weeks after the transplant. About 10% of these were fatal. The predominant infection site was the incision. Thirty-nine percent of infections were peritonitis, 16% were intra-abdominal abscesses, and 10% were hepatic abscesses.
Most infections were caused by gram-negative aerobic bacteria. Infection risk was related to choice of antibiotic prophylaxis, with the highest risk seen with the use of cefazolin. Fungal infection occurred in 10 cases, a remarkably high number, because many of the participant institutions used fluconazole.
After multivariate analysis, the authors found that, biliary-enteric anastomosis, previous liver or kidney transplant, and more than 4 red blood cell units transfused were independently associated with the development of SSIs.
The results provide insight into the risk of SSIs in relation to previous transplantation, choledocho-jejunal reconstruction, and red blood cell transfusion, which could motivate new studies to aid in understanding the pathogenesis of SSIs in liver transplantation.
最后编辑于 2009-04-22 · 浏览 1308
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