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Risk Factors for Surgical-site Infections After Liver Transplant: Does Perioperative Antibiotic Regimen Matter?
- Source :
-
Transplantation [Transplantation] 2024 May 01; Vol. 108 (5), pp. 1179-1188. Date of Electronic Publication: 2023 Dec 04. - Publication Year :
- 2024
-
Abstract
- Background: Surgical-site infections (SSIs) are common in liver transplant recipients. The optimal SSI antimicrobial prophylaxis agent and duration are not established. We aimed to explore risk factors for SSIs after transplant, with a particular interest in the impact of perioperative antibiotic regimen on the development of SSIs.<br />Methods: Retrospective study of adults undergoing liver transplant across 3 transplant programs between January 1, 2020, and June 01, 2021.<br />Results: Of 557 patients included in the study, 32 (5.7%) were infected or colonized with a multidrug-resistant organism (MDRO) within 1 y before liver transplant. Narrow-spectrum SSI prophylaxis with ceftriaxone or cefazolin alone was administered in 488 of 577 patients (87.6%); the remaining 69 patients (12.4%) received broad-spectrum prophylaxis with vancomycin and aztreonam (n = 40), piperacillin-tazobactam (n = 11), carbapenems (n = 8), ceftriaxone and another antibiotic (n = 7), and others. Patients with pretransplant MDRO were more likely to receive broad-spectrum coverage than those without pretransplant MDROs (28.1% versus 11.4%, P = 0.005). SSIs were identified in 40 patients (7.2%); 25 (62.5%) were organ-space infections, 3 (7.5%) were deep incisional infections, and 12 (30.0%) were superficial incisional infections. The median time from liver transplant to SSIs was 14 d (interquartile range, 10-20.2). MDROs were identified in 12 SSIs (30%). Multivariable analysis revealed no significant association between antimicrobial spectrum and risk of SSIs ( P = 0.5), whereas surgical leak ( P <0.001) and reoperation ( P = 0.017) were independently associated with increased risk of SSIs. SSIs were not significantly associated with composite risk of death or liver allograft failure.<br />Conclusions: The spectrum of antimicrobial prophylaxis did not impact the development of SSIs in liver transplant recipients.<br />Competing Interests: The authors declare no funding or conflicts of interest.<br /> (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)
- Subjects :
- Humans
Male
Retrospective Studies
Female
Middle Aged
Risk Factors
Aged
Adult
Treatment Outcome
Drug Resistance, Multiple, Bacterial
Time Factors
Risk Assessment
Liver Transplantation adverse effects
Surgical Wound Infection prevention & control
Surgical Wound Infection epidemiology
Surgical Wound Infection microbiology
Antibiotic Prophylaxis methods
Anti-Bacterial Agents administration & dosage
Anti-Bacterial Agents therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1534-6080
- Volume :
- 108
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Transplantation
- Publication Type :
- Academic Journal
- Accession number :
- 38044495
- Full Text :
- https://doi.org/10.1097/TP.0000000000004810