title: Bacteria isolated from bile samples of liver recipients in the early period after transplantation: epidemiology and susceptibility of the bacterial strains.
abstract: OBJECTIVE
  We estimated the frequency and susceptibility to antibacterial agents of bacterial isolates from bile samples obtained from 83 liver recipients in the early period after transplantation.
  
  
  METHODS
  We prospectively collected data on 83 adult patients undergoing orthotopic liver transplantation (OLT), including bile samples taken during the first 30 days after OLT from adult liver recipients suspected to have bile infections. The isolation/identification of cultured bacteria was performed according to standard microbiological procedures and commercially available tests. Susceptibility of the strains to antibacterial agents was determined according to the Clinical and Laboratory Standards Institute (CLSI) guidelines.
  
  
  RESULTS
  Among 210 bile samples obtained from 79 liver recipients, bacterial cultures were positive in 110 samples from 59 (75%) recipients yielding 156 bacterial strains. The most commonly isolated species were as follows: gram-positive cocci (109 isolates) with dominance of coagulase-negative staphylococci (52%) and enterococci (36%); and gram-negative bacteria, 21 strains from the Enterobacteriaceae family and 14 of non-fermenting rods. We identified some multidrug-resistant (MDR) bacterial strains. In the first week after OLT, we investigated samples from 59 patients, yielding 36 bacterial strains. From the second to the end of the fourth week after OLT, 120 bacterial strains were isolated from 65 recipients.
  
  
  CONCLUSIONS
  Gram-positive bacteria comprised 68.5%. The dominance of MDR gram-positive bacteria may be related to selection by perioperative antibiotic prophylaxis.
authors.affiliation: Department of General Surgery and Transplantation, Transplantation Institute, Medical University of Warsaw, Poland. dkawecki@o2.pl
authors.forename: D
authors.initials: D
authors.lastname: Kawecki
authors.forename: A
authors.initials: A
authors.lastname: Chmura
authors.forename: M
authors.initials: M
authors.lastname: Pacholczyk
authors.forename: B
authors.initials: B
authors.lastname: Lagiewska
authors.forename: L
authors.initials: L
authors.lastname: Adadynski
authors.forename: D
authors.initials: D
authors.lastname: Wasiak
authors.forename: P
authors.initials: P
authors.lastname: Malkowski
authors.forename: A
authors.initials: A
authors.lastname: Sawicka-Grzelak
authors.forename: A
authors.initials: A
authors.lastname: Rokosz
authors.forename: A
authors.initials: A
authors.lastname: Szymanowska
authors.forename: E
authors.initials: E
authors.lastname: Swoboda-Kopec
authors.forename: M
authors.initials: M
authors.lastname: Wroblewska
authors.forename: W
authors.initials: W
authors.lastname: Rowinski
authors.forename: M
authors.initials: M
authors.lastname: Durlik
authors.forename: L
authors.initials: L
authors.lastname: Paczek
authors.forename: M
authors.initials: M
authors.lastname: Luczak
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001419:Bacteria / Q000187:drug effects / Q000302:isolation & purification*; D001424:Bacterial Infections / Q000453:epidemiology*; D001646:Bile / Q000382:microbiology*; D005260:Female; D006090:Gram-Negative Bacteria / Q000187:drug effects / Q000302:isolation & purification; D006094:Gram-Positive Bacteria / Q000187:drug effects / Q000302:isolation & purification; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011184:Postoperative Period
chemical_list: D000900:Anti-Bacterial Agents