title: Early bloodstream infection after pediatric living donor living transplantation.
abstract: To determine the perioperative risk factors for bacterial infections after pediatric living donor liver transplantation (LDLT), we investigated the clinical profiles of 149 children who underwent pediatric LDLT between 1994 and 2008. Bacterial infections were diagnosed based on guidelines proposed by the Centers for Disease Control. We observed 36 bloodstream infections (BSIs) in 32/149 (21.5%) patients (0.24 infections per patient), which, 21 (58.3%) BSIs in 19 patients were due to gram-positive and 15 (41.7%) in 13 patients to gram-negative organisms. The most common pathogens of early BSI were coagulase-negative Staphylococcus; (n = 11; 30.6%) and Klebsiella pneumoniae (n = 8; 22.2%). The most common site of early BSI was catheter-related (n = 14; 38.9%). Multivariate analysis showed that age ≤ 1 year (P < .05; odds ratio [OR] = 3.90; 95% CI, 1.83-15.26) and bile duct complications (P < .05; OR = 6.2, 95% CI = 3.21-35.23) were significant independent risk factors for early BSIs. More cautious management of pediatric LDLTs may be necessary for younger age children particularly with postoperative biliary complications.
authors.affiliation: Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Songpa-Gu, Seoul, Korea.
authors.forename: K W
authors.initials: KW
authors.lastname: Rhee
authors.forename: S H
authors.initials: SH
authors.lastname: Oh
authors.forename: K M
authors.initials: KM
authors.lastname: Kim
authors.forename: D Y
authors.initials: DY
authors.lastname: Kim
authors.forename: Y J
authors.initials: YJ
authors.lastname: Lee
authors.forename: T
authors.initials: T
authors.lastname: Kim
authors.forename: M-N
authors.initials: MN
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D016470:Bacteremia / Q000453:epidemiology* / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007711:Klebsiella pneumoniae / Q000302:isolation & purification; D016031:Liver Transplantation / Q000009:adverse effects*; D019520:Living Donors; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D013210:Staphylococcus / Q000302:isolation & purification