|
KMID : 1040320180250020082
|
|
Pediatric Infection & Vaccine
2018 Volume.25 No. 2 p.82 ~ p.90
|
|
|
Bacterial Infections after Liver Transplantation in Children: Single Center Study for 16 Years
|
|
Kim Jae-Choon
Kim Su-Ji
Yun Ki-Wook
Choi Eun-Hwa
Yi Nam-Joon
Suh Kyung-Suk
Lee Kwang-Woong
Lee Hoan-Jong
|
|
|
Abstract
|
|
|
Purpose: Survival after liver transplantation (LT) has improved over the years, but infection is still a major complication. We aimed to identify the characteristics of bacterial infections in pediatric LT recipients.
Methods: This study is a retrospective review of 189 consecutive children undergoing LT between 2000 and 2015 at a single center. In this study, the incidence of infection was determined for the following periods: within 1 month, between 1?5 months, and between 6?12 months. Patients who underwent liver transplants more than once or multiple organ transplants were excluded.
Results: All patients had received postoperative antibiotic for 3 days. Only the maintenance immunosuppression with oral tacrolimus and steroids were performed. As a result, 132 bacterial infections developed in 87 (46.0%) patients (0.70 events per person-year). Bacterial infections occurred most frequently within the first month (n=84, 63.6%) after LT. In the pathogens, Staphylococcus aureus (15.2%), Enterococcus species (15.2%), and Klebsiella species (13.6%) were most common. Regarding the organ infected, bloodstream was most common (n=39, 29.5%), followed by peritoneum (n=28, 21.2%), urinary tract (n=25, 18.9%), and lungs (n=20, 15.2%). We changed prophylactic antibiotics from ampicillin-sulbactam to piperacillin-tazobactam at 2011, October, there were no significant effects in the prevalence of antibiotics resistant bacterial infections. The 1-year mortality was 9.0% (n=17), in which 41.2% (n=7) was attributable to bacterial infection; septicemia (n=4), pneumonia (n=2), and peritonitis (n=1).
Conclusions: The incidence and type of bacterial infectious complications after LT in pediatric patients were similar to those of previous studies. Bacterial complications affecting mortality occur within 6 months after transplantation, so proper prophylaxis and treatment in this period may improve the prognosis of LT.
|
|
|
KEYWORD
|
|
|
Liver transplantation, Child, Bacterial infections, Korea
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
|
|