title: Selective intestinal decontamination for the prevention of early bacterial infections after liver transplantation.
abstract: Bacterial infection in the first month after liver transplantation is a frequent complication that poses a serious risk for liver transplant recipients as contributes substantially to increased length of hospitalization and hospital costs being a leading cause of death in this period. Most of these infections are caused by gram-negative bacilli, although gram-positive infections, especially Enterococcus sp. constitute an emerging infectious problem. This high rate of early postoperative infections after liver transplant has generated interest in exploring various prophylactic approaches to surmount this problem. One of these approaches is selective intestinal decontamination (SID). SID is a prophylactic strategy that consists of the administration of antimicrobials with limited anaerobicidal activity in order to reduce the burden of aerobic gram-negative bacteria and/or yeast in the intestinal tract and so prevent infections caused by these organisms. The majority of studies carried out to date have found SID to be effective in the reduction of gram-negative infection, but the effect on overall infection is limited due to a higher number of infection episodes by pathogenic enterococci and coagulase-negative staphylococci. However, difficulties in general extrapolation of the favorable results obtained in specific studies together with the potential risk of selection of multirresistant microorganisms has conditioned controversy about the routinely application of these strategies in liver transplant recipients.
authors.affiliation: Elena Resino, Rafael San-Juan, Jose Maria Aguado, Unit of Infectious Diseases, 12 de Octubre University Hospital, Madrid 28041, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Resino
authors.affiliation: Elena Resino, Rafael San-Juan, Jose Maria Aguado, Unit of Infectious Diseases, 12 de Octubre University Hospital, Madrid 28041, Spain.
authors.forename: Rafael
authors.initials: R
authors.lastname: San-Juan
authors.affiliation: Elena Resino, Rafael San-Juan, Jose Maria Aguado, Unit of Infectious Diseases, 12 de Octubre University Hospital, Madrid 28041, Spain.
authors.forename: Jose Maria
authors.initials: JM
authors.lastname: Aguado
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis / Q000379:methods*; D003666:Decontamination / Q000379:methods*; D016905:Gram-Negative Bacterial Infections / Q000517:prevention & control*; D016908:Gram-Positive Bacterial Infections / Q000517:prevention & control*; D006801:Humans; D007422:Intestines / Q000382:microbiology*; D016031:Liver Transplantation; D011183:Postoperative Complications / Q000517:prevention & control*
chemical_list: D000900:Anti-Bacterial Agents
keywords: Gram-negative bacterial infection; Gram-positive bacterial infection; Infection; Liver transplant; Multirresistant; Selective intestinal decontamination