title: Infection complications and pattern of bacterial resistance in living-donor liver transplantation: a multicenter epidemiologic study in Egypt.
abstract: BACKGROUND
  Data on the prevalence and pattern of infection after living-donor liver transplantation (LDLT) are scarce in Egypt. We therefore conducted this study to quantify the incidence, risk factors, and pattern of bacterial resistance post-LDLT in 3 hospitals in Egypt.
  
  
  METHODS
  We conducted a retrospective, multicenter study of the medical records of 246 patients who underwent LDLT between January 2006 and April 2011 at 3 transplant centers in Egypt.
  
  
  RESULTS
  Of 246 patients enrolled in this study, 127 (52%) developed infectious complications after LDLT, with 416 episodes of infection occurring within 3 months of transplantation. Biliary tract infection was the most common, occurring in 169 (40.6%) patients. The rate of infection with Gram-negative bacteria was higher than that of infection with Gram-positive bacteria (310 [74%] vs 87 [21%]; P < .001). Overall, 75% of Gram-negative isolates were multidrug resistant. Significant independent risk factors for infection were portal vein thrombosis (odds ratio, 2.4; P = .037) and biliary complications (odds ratio, 5.4; P < .001).
  
  
  CONCLUSIONS
  Our data showed a high-resistance pattern of bacterial infection after LDLT in Egypt. Early biliary complications were an independent risk factor for bacterial infection.
authors.affiliation: Department of Anesthesia and Critical Care, Cairo University, Cairo, Egypt. Electronic address: ahmed.mukhtar@kasralainy.edu.eg.
authors.forename: A
authors.initials: A
authors.lastname: Mukhtar
authors.affiliation: Department of Anesthesia and Critical Care, Beni Suef University, Egypt.
authors.forename: A
authors.initials: A
authors.lastname: Abdelaal
authors.affiliation: Department of Anesthesia and Critical Care, Theodor Bilharz Research Institute, Egypt.
authors.forename: M
authors.initials: M
authors.lastname: Hussein
authors.affiliation: Department of Hepatology, Ain Shams University, Cairo, Egypt.
authors.forename: H
authors.initials: H
authors.lastname: Dabous
authors.affiliation: Department of Hepatology, Ain Shams University, Cairo, Egypt.
authors.forename: I
authors.initials: I
authors.lastname: Fawzy
authors.affiliation: Department of Anesthesia and Critical Care, Cairo University, Cairo, Egypt.
authors.forename: G
authors.initials: G
authors.lastname: Obayah
authors.affiliation: Department of Anesthesia and Critical Care, Cairo University, Cairo, Egypt.
authors.forename: A
authors.initials: A
authors.lastname: Hasanin
authors.affiliation: Department of Critical Care, Egypt Air Hospital, Egypt.
authors.forename: N
authors.initials: N
authors.lastname: Adel
authors.affiliation: Department of Clinical Bacteriology, Cairo University, Cairo, Egypt.
authors.forename: D
authors.initials: D
authors.lastname: Ghaith
authors.affiliation: Department of Surgery, Ain Shams University, Cairo, Egypt.
authors.forename: M
authors.initials: M
authors.lastname: Bahaa
authors.affiliation: Department of Surgery, Ain Shams University, Cairo, Egypt.
authors.forename: A
authors.initials: A
authors.lastname: Abdelaal
authors.affiliation: Department of Surgery, Ain Shams University, Cairo, Egypt.
authors.forename: M
authors.initials: M
authors.lastname: Fathy
authors.affiliation: Department of Surgery, Ain Shams University, Cairo, Egypt.
authors.forename: M
authors.initials: M
authors.lastname: El Meteini
mesh_terms: D000328:Adult; D001424:Bacterial Infections / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology; D024881:Drug Resistance, Bacterial; D004534:Egypt / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D016031:Liver Transplantation / Q000009:adverse effects*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D012307:Risk Factors