title: Predictors of Mortality in Abdominal Organ Transplant Recipients with Pseudomonas aeruginosa Infections.
abstract: BACKGROUND
  Pseudomonas aeruginosa infection remains a common life-threatening complication after abdominal organ transplantation. The objective of the present study was to determine epidemiology and predictors of mortality in abdominal organ transplant recipients with P. aeruginosa infections.
  
  
  METHODS
  A retrospective, double-center study was performed over a 12-year study period. The epidemiology of P. aeruginosa infections was investigated and the univariate and multivariate analyses were performed to identify the independent risk factors for crude and infection-related 30-day mortality in abdominal organ transplant recipients with P. aeruginosa infections.
  
  
  RESULTS
  In this study, 60 episodes of P. aeruginosa infection occurring in 54 abdominal organ transplant recipients were enrolled. Postoperative P. aeruginosa infection occurred in 54 (2.8%) of 1935 abdominal organ transplant recipients. Most episodes of P. aeruginosa infections were nosocomial (75.9%, n=41). Among those 54 patients, 30 (55.6%) developed pulmonary infection and 13 (24.1%) developed bacteremia. In 25 of the 54 (46.3%) patients, P. aeruginosa isolates were multidrug resistant. There were 6 (11.1%) cases of septic shock, 18 (33.3%) infection-related deaths, and 21 (38.9%) crude 30-day deaths. Septic shock (odds ratio (OR)=13.46, 95% confidence interval (CI)=1.43-126.38, P=0.023) was identified as an independent risk factor for infection-related 30-day mortality. The risk factors independently associated with crude 30-day mortality included P. aeruginosa or concomitant bacteremia (OR=6.79, 95% CI=1.82-25.39, P=0.004) and a serum creatinine level of ≥1.5 mg/dL (OR=4.62, 95% CI=1.11-19.16, P=0.035).
  
  
  CONCLUSIONS
  The morbidity and mortality rates of P. aeruginosa infections were appreciable in abdominal organ transplant recipients. P. aeruginosa or concomitant bacteremia and an elevated serum creatinine level were associated with higher crude mortality, and septic shock independently predicted higher infection-related mortality.
authors: Department of Plastic Surgery, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China (mainland).
authors: Honghui
authors: H
authors: Su
authors: Department of Transplant Surgery, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China (mainland).
authors: Qifa
authors: Q
authors: Ye
authors: Department of Transplant Surgery, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China (mainland).
authors: Qiquan
authors: Q
authors: Wan
authors: Department of Clinical Laboratory of Microbiology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China (mainland).
authors: Jiandang
authors: J
authors: Zhou
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D016031:Liver Transplantation; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D016035:Pancreas Transplantation; D011183:Postoperative Complications / Q000453:epidemiology / Q000401:mortality*; D011552:Pseudomonas Infections / Q000453:epidemiology / Q000209:etiology / Q000401:mortality*; D011550:Pseudomonas aeruginosa; D012189:Retrospective Studies; D012307:Risk Factors