Surgical site infection in liver transplant recipients: impact of the type of perioperative prophylaxis.
Surgical site infection (SSI) is an important cause of morbidity after orthotopic liver transplantation (OLT). Perioperative antibiotic prophylaxis is one of the main modifiable risk factors. We prospectively investigated the epidemiology, risk factors, and prognosis of SSI in a cohort of 167 OLT. Two different schedules of antibiotic SSI prophylaxis were compared. Fifty-six episodes of SSI were included (0.34 episodes/patient). The SSI incidence among patients who received cefazolin and amoxicillin-clavulanate did not differ. Bacteria caused all episodes. The most common pathogen was Escherichia coli (21.25%), among which 47% were extended-spectrum beta-lactamase producers. The only risk factor for SSI was antibiotic therapy before OLT. Patients with SSI had a longer hospital and intensive care unit stay (P<0.05), but survival did not differ. In conclusion, SSI has a high incidence despite antibiotic perioperative prophylaxis; therefore, an integral perspective of SSI and a multifactorial approach other than antimicrobial prophylaxis are needed to prevent it.
García Prado
María E
ME
Servicio Enfermedades Infecciosas, Hospital Universitario Virgen del Rocío, Avda, Manuel Siurot s/n, Seville, Spain. pharmaelena@hotmail.com
Matia
Elisa Cordero
EC
Ciuro
Felipe Pareja
FP
Díez-Canedo
Juan Serrano
JS
Sousa Martín
José M
JM
Porras López
Francisco M
FM
de la Casa
Angel Cantos
AC
Cisneros Herreros
José M
JM
D000328:Adult; D000368:Aged; D000658:Amoxicillin / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis / Q000379:methods*; D002437:Cefazolin / Q000627:therapeutic use*; D019818:Clavulanic Acid / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007902:Length of Stay; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control*; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control*
D000900:Anti-Bacterial Agents; D019818:Clavulanic Acid; D000658:Amoxicillin; D002437:Cefazolin