41440. Risk Factors of Multidrug-resistant Gram-negative Bacteremia in Liver Transplantation Recipients
Session: Poster Abstract Session: Medical Student Poster Session
Friday, October 4, 2013
Room: Yerba Buena Ballrooms
Background: Bacteremia by gram-negative bacilli is one of most frequent infectious complications occurring after liver transplantation (LT). Like as the critically ill patients, the prevalence of multidrug-resistant (MDR) gram-negative bacteremia is recently increasing in the solid organ transplantation recipients. The aim of this study was to investigate risk factors for the occurrence of MDR gram-negative bacteremia, and its impact on mortality in LT recipients.

Methods: A retrospective cohort study was conducted in total 263 patients who received LT between January 2008 and March 2013 in single tertiary-care university-affiliated hospital. Patients were divided into 2 categories; case group (N=30, 11.4%) with MDR gram-negative bacteremia and control group (N=233) without any bacteremia after LT. MDR was defined as the isolates with the resistance in more than 3 antibiotic classes.

Results: 36 episodes of MDR gram-negative bacteremia in 30 patients were caused by 7 Pseudomonas aeruginosa (19.4%), 9 Klebsiella pneumonia (25%), 16 Acinetobacter baumannii (44.4%), 1 Chryseobacterium sp. (2.8%), 1 Serratia marcescens (2.8%), and 2 Escherichia coli (5.6%). Independent risk factor for MDR gram-negative bacteremia was prolonged mechanical ventilation (more than 72hrs) (OR 13.6, 95% CI 5.1-36.1, P<0.001). All-cause in-hospital mortality of patients who experienced MDR gram-negative bacteremia was significantly higher than those who did not experience any bacteremia. (63.3% vs.8.2%, P<0.001).

Conclusion: MDR gram-negative bacteremia frequently occurred with the independent significance among recipients who experienced the prolonged mechanical ventilation after LT. The control measures to prevent MDR gram-negative bacteremia after LT are required due to their high mortality.

MIN Hyung KIM, MD1, Jin Young Ahn, MD2, Je Eun Song2, Heun Choi, MD2, Hea Won Ann, MD3, Jae Kyoung Kim, MD2, Sun Bean Kim, MD2, Su Jin Jeong, MD/PhD2, Nam Su Ku, MD2, Sang Hoon Han, MD2, Jun Yong Choi, staff4, Myoung Soo Kim, MD, PhD5 and June Myung Kim, MD2, (1)Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea, (2)Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, Seoul, South Korea, (3)Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea, (4)Yonsei university college of medicine, Seoul, Korea, Republic of, (5)Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea

Disclosures:

M. H. KIM, None

J. Y. Ahn, None

J. E. Song, None

H. Choi, None

H. W. Ann, None

J. K. Kim, None

S. B. Kim, None

S. J. Jeong, None

N. S. Ku, None

S. H. Han, None

J. Y. Choi, None

M. S. Kim, None

J. M. Kim, None

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