[Descriptive study of infectious complications in 109 consecutive liver transplant recipients].
BACKGROUND
Infectious disease is a common, serious complication in liver transplant recipients. The etiology of these infections undergoes changes related with technical advances, prophylaxis, and local epidemiology.


METHODS
Prospective study in patients who underwent liver transplantation from July 2003 to December 2005 at the Hospital Universitario Virgen del Rocío. An observational description of infections occurring during the first 2 years following transplantation was carried out.


RESULTS
The incidence of infection was 1.32 episodes per patient over follow-up (443 +/- 248 days). The most frequent infections were surgical site (16%), cytomegalovirus (CMV) (14%), and urinary tract (11%). Etiologies included bacterial (64%), viral (31%), and fungal (5%) causes. The most common pathogens were CMV (21%), Escherichia coli (20%), among which, 40% were extended-spectrum beta-lactamase ESBL-producers, and Enterococcus spp. (11%). More than half the infectious episodes (58%) occurred in the first 4 months after transplantation. The 30-day mortality rate was 18%. In the group with infection, patient and graft survivals were 75% and 73% at the end of follow-up, and in the group without infection, survival was 80% in both cases (P=NS).


CONCLUSIONS
The most common infectious syndromes following liver transplantation were surgical site infection, CMV infection, and urinary tract infection. Bacteria were the most commonly isolated microorganisms, and there was a high rate of ESBL-producing E. coli.
Servicio de Enfermedades Infecciosas, Hospital Universitario Virgen del Rocío, Sevilla, España. pharmaelena@hotmail.es
Elena
E
García-Prado
Elisa
E
Cordero
José María
JM
Alamo
Miguel Angel
MA
Gómez
Juan Manuel
JM
Pascasio
Magdalena
M
Sánchez
José Miguel
JM
Cisneros
D000293:Adolescent; D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000453:epidemiology; D002177:Candidiasis / Q000453:epidemiology; D003586:Cytomegalovirus Infections / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D016867:Immunocompromised Host; D007239:Infections / Q000453:epidemiology* / Q000382:microbiology / Q000821:virology; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology* / Q000382:microbiology / Q000821:virology; D011446:Prospective Studies; D013030:Spain / Q000453:epidemiology; D013530:Surgical Wound Infection / Q000453:epidemiology; D016019:Survival Analysis; D014552:Urinary Tract Infections / Q000453:epidemiology; D014777:Virus Diseases / Q000453:epidemiology; D055815:Young Adult