title: Risk factors for early bacterial infections in liver transplantation.
abstract: OBJECTIVE
  Our aim was to determine perioperative risk factors for early bacterial infection after liver transplantation.
  
  
  METHODS
  Retrospectively examining medical records using Centers for Disease Control and Prevention (CDC) definitions to identify nosocomial infections, we analyzed data on 367 adult patients.
  
  
  RESULTS
  The incidence of infection was 37.3% (n = 137): namely, surgical site (n = 74; 20.2%) [corrected], blood stream (n = 64; 17.4%), pulmonary (n = 49; 13.4%), urinary system (n = 26; 7.1%). Significant risk factors within the first 30 days were as follows: deceased donor, Model for End-Stage Liver Disease (MELD) >20, albumin level <2.8 g/dL, intraoperative erythrocyte transfusion >6 U, intraoperative fresh frozen plasma >12 U, bilioenteric anastomosis, postoperative intensive care unit stay >6 days, and postoperative length of stay >21 days. Significant risk factors detected within the first 90 days were as follows: MELD >20, preoperative length of stay >7 days, reoperation, postoperative length of intensive care unit stay >6 days, and postoperative length of stay >21 days. Variability was observed in risk factors according to localization of infection. As a result, except for MELD, type of donor, and biliary anastomosis, the others are preventable factors for early bacterial infection. In addition, the same risk factors showed variability according to the site of infection.
authors.affiliation: Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey. vildan.oguz@deu.edu.tr
authors.forename: V
authors.initials: V
authors.lastname: Avkan-Oguz
authors.forename: S
authors.initials: S
authors.lastname: Ozkardesler
authors.forename: T
authors.initials: T
authors.lastname: Unek
authors.forename: M
authors.initials: M
authors.lastname: Ozbilgin
authors.forename: M
authors.initials: M
authors.lastname: Akan
authors.forename: E
authors.initials: E
authors.lastname: Firuzan
authors.forename: H
authors.initials: H
authors.lastname: Kose
authors.forename: I
authors.initials: I
authors.lastname: Astarcioglu
authors.forename: S
authors.initials: S
authors.lastname: Karademir
mesh_terms: D000328:Adult; D001424:Bacterial Infections / Q000150:complications*; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors