Bacterial infections in children after liver transplantation: A single‐center surveillance study of 345 consecutive transplantations
Background Infectious complications after pediatric liver transplantation frequently occur and are potentially serious. Data concerning strictly defined bacterial infections and their associated risk factors are lacking. Methods For the pediatric liver transplant postoperative period, we analyzed da...
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| Veröffentlicht in: | Transplant infectious disease 2020-02, Vol.22 (1), p.e13208-n/a |
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| creator | Dohna Schwake, Christian Guiddir, Tamazoust Cuzon, Gaelle Benissa, Mohamed‐Rida Dubois, Cécile Miatello, Jordi Merchaoui, Zied Durand, Philippe Tissieres, Pierre |
| description | Background
Infectious complications after pediatric liver transplantation frequently occur and are potentially serious. Data concerning strictly defined bacterial infections and their associated risk factors are lacking.
Methods
For the pediatric liver transplant postoperative period, we analyzed data from the nosocomial infection surveillance (2006‐2015).
Results
A total of 235 bacterial infections in 162 transplantations (47%) occurred, including 32 bacterial pneumonia cases, 104 surgical site infections, 27 urinary tract infections, and 40 bloodstream infections. Sepsis was diagnosed in 127 cases (54%), severe sepsis in 22 (9%) cases, and septic shock in 41 (17%) cases. Thirty patients (9%) died, and septic shock was the leading cause of death. The carrier status of multi‐drug resistant bacteria and a tacrolimus level >20 ng/mL were independent risk factors for surgical site infections and the occurrence of severe sepsis or septic shock. The length of mechanical ventilation was an independent risk factor for pneumonia and surgical site infection.
Conclusion
Bacterial infections in the early postoperative period after pediatric liver transplantation are associated with high morbidity and mortality. Physicians involved in the medical care of these patients should be aware of the specific risk factors, and further development of prevention programs is highly recommended. |
| doi_str_mv | 10.1111/tid.13208 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_hal_p</sourceid><recordid>TN_cdi_hal_primary_oai_HAL_hal_02359950v1</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2359275740</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3878-e0a648f1e6e7c0644d8c58c082dc8ba5779beae5b4a9005373ba10fe37680f9b3</originalsourceid><addsrcrecordid>eNp1kc9u1DAQhyMEoqVw4AWQJS5wSDu249jmtpT-k1bqpZwtx5lQV95ksZOt9saJM8_Ik-B02yJVqg_2yP70jUe_onhP4ZDmdTT69pByBupFsU-51iWHmr28q1XJmOR7xZuUbgCo1JV-XexxWmsuJd8vfn-1bsTobSC-79CNfuhTLom79qGN2BPb5XcS_CbvY7R9Wgfbj3YGv5AFSb7_EfDvrz8O-xlMU9ygD5lxSNI4tVsydIRXgrhsRjeN2fRUlN4WrzobEr67Pw-K76cnV8fn5fLy7OJ4sSwdV1KVCLauVEexRumgrqpWOaEcKNY61VghpW7QomgqqwEEl7yxFDrkslbQ6YYfFJ933msbzDr6lY1bM1hvzhdLM98B40JrARua2U87dh2HnxOm0ax8cjiPhsOUDOOUKVBCQEY_PkFvhin2eRIz-5gUsoL_zV0cUorYPf6AgpmDNDlIcxdkZj_cG6dmhe0j-ZBcBo52wK0PuH3eZK4uvu2U_wBzkamC</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2359275740</pqid></control><display><type>article</type><title>Bacterial infections in children after liver transplantation: A single‐center surveillance study of 345 consecutive transplantations</title><source>Access via Wiley Online Library</source><creator>Dohna Schwake, Christian ; Guiddir, Tamazoust ; Cuzon, Gaelle ; Benissa, Mohamed‐Rida ; Dubois, Cécile ; Miatello, Jordi ; Merchaoui, Zied ; Durand, Philippe ; Tissieres, Pierre</creator><creatorcontrib>Dohna Schwake, Christian ; Guiddir, Tamazoust ; Cuzon, Gaelle ; Benissa, Mohamed‐Rida ; Dubois, Cécile ; Miatello, Jordi ; Merchaoui, Zied ; Durand, Philippe ; Tissieres, Pierre ; Bicêtre Pediatric Liver Transplant Group ; For the Bicêtre Pediatric Liver Transplant Group</creatorcontrib><description>Background
Infectious complications after pediatric liver transplantation frequently occur and are potentially serious. Data concerning strictly defined bacterial infections and their associated risk factors are lacking.
Methods
For the pediatric liver transplant postoperative period, we analyzed data from the nosocomial infection surveillance (2006‐2015).
Results
A total of 235 bacterial infections in 162 transplantations (47%) occurred, including 32 bacterial pneumonia cases, 104 surgical site infections, 27 urinary tract infections, and 40 bloodstream infections. Sepsis was diagnosed in 127 cases (54%), severe sepsis in 22 (9%) cases, and septic shock in 41 (17%) cases. Thirty patients (9%) died, and septic shock was the leading cause of death. The carrier status of multi‐drug resistant bacteria and a tacrolimus level >20 ng/mL were independent risk factors for surgical site infections and the occurrence of severe sepsis or septic shock. The length of mechanical ventilation was an independent risk factor for pneumonia and surgical site infection.
Conclusion
Bacterial infections in the early postoperative period after pediatric liver transplantation are associated with high morbidity and mortality. Physicians involved in the medical care of these patients should be aware of the specific risk factors, and further development of prevention programs is highly recommended.</description><identifier>ISSN: 1398-2273</identifier><identifier>EISSN: 1399-3062</identifier><identifier>DOI: 10.1111/tid.13208</identifier><identifier>PMID: 31693773</identifier><language>eng</language><publisher>Denmark: Wiley Subscription Services, Inc</publisher><subject>Bacteria ; Bacterial diseases ; Bacterial infections ; children ; Complications ; Drug resistance ; Health risks ; Hospitals ; Life Sciences ; Liver ; Liver transplantation ; Liver transplants ; Mechanical ventilation ; Morbidity ; multi‐resistant bacteria ; Nosocomial infection ; Nosocomial infections ; Patients ; Pediatrics ; Physicians ; Pneumonia ; Postoperative period ; Risk analysis ; Risk factors ; Sepsis ; Septic shock ; Surgical site infections ; Surveillance ; Tacrolimus ; Transplantation ; Transplants & implants ; Urinary tract ; Ventilation</subject><ispartof>Transplant infectious disease, 2020-02, Vol.22 (1), p.e13208-n/a</ispartof><rights>2019 Wiley Periodicals, Inc.</rights><rights>2020 Wiley Periodicals, Inc.</rights><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3878-e0a648f1e6e7c0644d8c58c082dc8ba5779beae5b4a9005373ba10fe37680f9b3</citedby><cites>FETCH-LOGICAL-c3878-e0a648f1e6e7c0644d8c58c082dc8ba5779beae5b4a9005373ba10fe37680f9b3</cites><orcidid>0000-0001-5649-8635 ; 0000-0001-8973-5406 ; 0000-0001-5423-5532 ; 0000-0002-8452-9918</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Ftid.13208$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Ftid.13208$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,780,784,885,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31693773$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://hal.science/hal-02359950$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Dohna Schwake, Christian</creatorcontrib><creatorcontrib>Guiddir, Tamazoust</creatorcontrib><creatorcontrib>Cuzon, Gaelle</creatorcontrib><creatorcontrib>Benissa, Mohamed‐Rida</creatorcontrib><creatorcontrib>Dubois, Cécile</creatorcontrib><creatorcontrib>Miatello, Jordi</creatorcontrib><creatorcontrib>Merchaoui, Zied</creatorcontrib><creatorcontrib>Durand, Philippe</creatorcontrib><creatorcontrib>Tissieres, Pierre</creatorcontrib><creatorcontrib>Bicêtre Pediatric Liver Transplant Group</creatorcontrib><creatorcontrib>For the Bicêtre Pediatric Liver Transplant Group</creatorcontrib><title>Bacterial infections in children after liver transplantation: A single‐center surveillance study of 345 consecutive transplantations</title><title>Transplant infectious disease</title><addtitle>Transpl Infect Dis</addtitle><description>Background
Infectious complications after pediatric liver transplantation frequently occur and are potentially serious. Data concerning strictly defined bacterial infections and their associated risk factors are lacking.
Methods
For the pediatric liver transplant postoperative period, we analyzed data from the nosocomial infection surveillance (2006‐2015).
Results
A total of 235 bacterial infections in 162 transplantations (47%) occurred, including 32 bacterial pneumonia cases, 104 surgical site infections, 27 urinary tract infections, and 40 bloodstream infections. Sepsis was diagnosed in 127 cases (54%), severe sepsis in 22 (9%) cases, and septic shock in 41 (17%) cases. Thirty patients (9%) died, and septic shock was the leading cause of death. The carrier status of multi‐drug resistant bacteria and a tacrolimus level >20 ng/mL were independent risk factors for surgical site infections and the occurrence of severe sepsis or septic shock. The length of mechanical ventilation was an independent risk factor for pneumonia and surgical site infection.
Conclusion
Bacterial infections in the early postoperative period after pediatric liver transplantation are associated with high morbidity and mortality. Physicians involved in the medical care of these patients should be aware of the specific risk factors, and further development of prevention programs is highly recommended.</description><subject>Bacteria</subject><subject>Bacterial diseases</subject><subject>Bacterial infections</subject><subject>children</subject><subject>Complications</subject><subject>Drug resistance</subject><subject>Health risks</subject><subject>Hospitals</subject><subject>Life Sciences</subject><subject>Liver</subject><subject>Liver transplantation</subject><subject>Liver transplants</subject><subject>Mechanical ventilation</subject><subject>Morbidity</subject><subject>multi‐resistant bacteria</subject><subject>Nosocomial infection</subject><subject>Nosocomial infections</subject><subject>Patients</subject><subject>Pediatrics</subject><subject>Physicians</subject><subject>Pneumonia</subject><subject>Postoperative period</subject><subject>Risk analysis</subject><subject>Risk factors</subject><subject>Sepsis</subject><subject>Septic shock</subject><subject>Surgical site infections</subject><subject>Surveillance</subject><subject>Tacrolimus</subject><subject>Transplantation</subject><subject>Transplants & implants</subject><subject>Urinary tract</subject><subject>Ventilation</subject><issn>1398-2273</issn><issn>1399-3062</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp1kc9u1DAQhyMEoqVw4AWQJS5wSDu249jmtpT-k1bqpZwtx5lQV95ksZOt9saJM8_Ik-B02yJVqg_2yP70jUe_onhP4ZDmdTT69pByBupFsU-51iWHmr28q1XJmOR7xZuUbgCo1JV-XexxWmsuJd8vfn-1bsTobSC-79CNfuhTLom79qGN2BPb5XcS_CbvY7R9Wgfbj3YGv5AFSb7_EfDvrz8O-xlMU9ygD5lxSNI4tVsydIRXgrhsRjeN2fRUlN4WrzobEr67Pw-K76cnV8fn5fLy7OJ4sSwdV1KVCLauVEexRumgrqpWOaEcKNY61VghpW7QomgqqwEEl7yxFDrkslbQ6YYfFJ933msbzDr6lY1bM1hvzhdLM98B40JrARua2U87dh2HnxOm0ax8cjiPhsOUDOOUKVBCQEY_PkFvhin2eRIz-5gUsoL_zV0cUorYPf6AgpmDNDlIcxdkZj_cG6dmhe0j-ZBcBo52wK0PuH3eZK4uvu2U_wBzkamC</recordid><startdate>202002</startdate><enddate>202002</enddate><creator>Dohna Schwake, Christian</creator><creator>Guiddir, Tamazoust</creator><creator>Cuzon, Gaelle</creator><creator>Benissa, Mohamed‐Rida</creator><creator>Dubois, Cécile</creator><creator>Miatello, Jordi</creator><creator>Merchaoui, Zied</creator><creator>Durand, Philippe</creator><creator>Tissieres, Pierre</creator><general>Wiley Subscription Services, Inc</general><general>Wiley</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>7U9</scope><scope>8FD</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>P64</scope><scope>7X8</scope><scope>1XC</scope><orcidid>https://orcid.org/0000-0001-5649-8635</orcidid><orcidid>https://orcid.org/0000-0001-8973-5406</orcidid><orcidid>https://orcid.org/0000-0001-5423-5532</orcidid><orcidid>https://orcid.org/0000-0002-8452-9918</orcidid></search><sort><creationdate>202002</creationdate><title>Bacterial infections in children after liver transplantation: A single‐center surveillance study of 345 consecutive transplantations</title><author>Dohna Schwake, Christian ; Guiddir, Tamazoust ; Cuzon, Gaelle ; Benissa, Mohamed‐Rida ; Dubois, Cécile ; Miatello, Jordi ; Merchaoui, Zied ; Durand, Philippe ; Tissieres, Pierre</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3878-e0a648f1e6e7c0644d8c58c082dc8ba5779beae5b4a9005373ba10fe37680f9b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Bacteria</topic><topic>Bacterial diseases</topic><topic>Bacterial infections</topic><topic>children</topic><topic>Complications</topic><topic>Drug resistance</topic><topic>Health risks</topic><topic>Hospitals</topic><topic>Life Sciences</topic><topic>Liver</topic><topic>Liver transplantation</topic><topic>Liver transplants</topic><topic>Mechanical ventilation</topic><topic>Morbidity</topic><topic>multi‐resistant bacteria</topic><topic>Nosocomial infection</topic><topic>Nosocomial infections</topic><topic>Patients</topic><topic>Pediatrics</topic><topic>Physicians</topic><topic>Pneumonia</topic><topic>Postoperative period</topic><topic>Risk analysis</topic><topic>Risk factors</topic><topic>Sepsis</topic><topic>Septic shock</topic><topic>Surgical site infections</topic><topic>Surveillance</topic><topic>Tacrolimus</topic><topic>Transplantation</topic><topic>Transplants & implants</topic><topic>Urinary tract</topic><topic>Ventilation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dohna Schwake, Christian</creatorcontrib><creatorcontrib>Guiddir, Tamazoust</creatorcontrib><creatorcontrib>Cuzon, Gaelle</creatorcontrib><creatorcontrib>Benissa, Mohamed‐Rida</creatorcontrib><creatorcontrib>Dubois, Cécile</creatorcontrib><creatorcontrib>Miatello, Jordi</creatorcontrib><creatorcontrib>Merchaoui, Zied</creatorcontrib><creatorcontrib>Durand, Philippe</creatorcontrib><creatorcontrib>Tissieres, Pierre</creatorcontrib><creatorcontrib>Bicêtre Pediatric Liver Transplant Group</creatorcontrib><creatorcontrib>For the Bicêtre Pediatric Liver Transplant Group</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><collection>Hyper Article en Ligne (HAL)</collection><jtitle>Transplant infectious disease</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dohna Schwake, Christian</au><au>Guiddir, Tamazoust</au><au>Cuzon, Gaelle</au><au>Benissa, Mohamed‐Rida</au><au>Dubois, Cécile</au><au>Miatello, Jordi</au><au>Merchaoui, Zied</au><au>Durand, Philippe</au><au>Tissieres, Pierre</au><aucorp>Bicêtre Pediatric Liver Transplant Group</aucorp><aucorp>For the Bicêtre Pediatric Liver Transplant Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Bacterial infections in children after liver transplantation: A single‐center surveillance study of 345 consecutive transplantations</atitle><jtitle>Transplant infectious disease</jtitle><addtitle>Transpl Infect Dis</addtitle><date>2020-02</date><risdate>2020</risdate><volume>22</volume><issue>1</issue><spage>e13208</spage><epage>n/a</epage><pages>e13208-n/a</pages><issn>1398-2273</issn><eissn>1399-3062</eissn><abstract>Background
Infectious complications after pediatric liver transplantation frequently occur and are potentially serious. Data concerning strictly defined bacterial infections and their associated risk factors are lacking.
Methods
For the pediatric liver transplant postoperative period, we analyzed data from the nosocomial infection surveillance (2006‐2015).
Results
A total of 235 bacterial infections in 162 transplantations (47%) occurred, including 32 bacterial pneumonia cases, 104 surgical site infections, 27 urinary tract infections, and 40 bloodstream infections. Sepsis was diagnosed in 127 cases (54%), severe sepsis in 22 (9%) cases, and septic shock in 41 (17%) cases. Thirty patients (9%) died, and septic shock was the leading cause of death. The carrier status of multi‐drug resistant bacteria and a tacrolimus level >20 ng/mL were independent risk factors for surgical site infections and the occurrence of severe sepsis or septic shock. The length of mechanical ventilation was an independent risk factor for pneumonia and surgical site infection.
Conclusion
Bacterial infections in the early postoperative period after pediatric liver transplantation are associated with high morbidity and mortality. Physicians involved in the medical care of these patients should be aware of the specific risk factors, and further development of prevention programs is highly recommended.</abstract><cop>Denmark</cop><pub>Wiley Subscription Services, Inc</pub><pmid>31693773</pmid><doi>10.1111/tid.13208</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0001-5649-8635</orcidid><orcidid>https://orcid.org/0000-0001-8973-5406</orcidid><orcidid>https://orcid.org/0000-0001-5423-5532</orcidid><orcidid>https://orcid.org/0000-0002-8452-9918</orcidid></addata></record> |
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| source | Access via Wiley Online Library |
| subjects | Bacteria Bacterial diseases Bacterial infections children Complications Drug resistance Health risks Hospitals Life Sciences Liver Liver transplantation Liver transplants Mechanical ventilation Morbidity multi‐resistant bacteria Nosocomial infection Nosocomial infections Patients Pediatrics Physicians Pneumonia Postoperative period Risk analysis Risk factors Sepsis Septic shock Surgical site infections Surveillance Tacrolimus Transplantation Transplants & implants Urinary tract Ventilation |
| title | Bacterial infections in children after liver transplantation: A single‐center surveillance study of 345 consecutive transplantations |
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