Program Schedule

Enterococcal Infections (EI) in Liver Transplant (LT) Recipients- a 9 year retrospective review

Session: Poster Abstract Session: Transplant Infectious Diseases
Thursday, October 9, 2014
Room: The Pennsylvania Convention Center: IDExpo Hall BC
  • Elbatta.pdf (500.2 kB)
  • Background: Infections after LT cause significant morbidity and can adversely affect the function of the transplanted organ. Enterococcus faecalis and faecium are pathogens increasingly associated with infections after LT. However, there is scant data available regarding the incidence, risk factors and outcomes of EI in LT recipients

    Methods: This is a cohort study aimed at finding the incidence, risk factors and outcome of EI in LT recipients from years 2004 to 2012 at Henry Ford Hospital in  Detroit Michigan. Clinical information including patient demographics, clinical, laboratory, treatment and outcome data was collected. Frequency analysis of all variables using a chi-square test for dichotomous variables and a students' t test for continuous variables was performed. We also performed a logistic regression for risk factors which could contribute to death with EI

    Results: The incidence of Enterococcal infections in this cohort of 892 LT recipients was  18.3 per 100 (163/892) transplant patients. The median duration of development of EI from the date of transplant was 17 days (mean= 104; range= 1-1460). EI most often presented as urinary tract infections (42%), intrabdominal abscesses (27.6%) and bacteremia (19%). E.faecium (67%) was more common as compared to E.faecalis (33%). Vancomycin resistant Enterococci(VRE) was observed in 89/163 (55%) of infections. Among the EI 86.5% were treated for a mean duration of 16 + 19.8 days. Microbiological clearance was achieved in these patients at a mean duration of 4.8 + 7.15 days. A logistic regression revealed previous comorbidities (OR=4.03), long ICU stay (OR=1.02), EI occurring less than 1 year after transplant (OR =1.54), presence of concomitant infections (OR = 3.64) and presence of clinical progression or microbiological persistence of infection (OR = 6.36) predicted death in this cohort

    Conclusion: Enterococcal infections are an important cause for morbidity and mortality in liver transplant recipients. Urinary tract is the most common source followed by intraabdominal infections. VRE contributed to half of the EI in this cohort. Death is this cohort was predicted by clinical  progression, microbiological persistence, previous comorbidities and presence of coexisting infections.

    Mohammad Elbatta1, Priscilla Rupali, M.D1, Hiba Hadid1, Daniela Moreno, MPh1, Mayur Ramesh, MD1, Ramon Del Busto1 and George Alangaden, MD2, (1)Infectious Diseases, Henry Ford Hospital, Detroit, MI, (2)Wayne State University, Detroit, MI


    M. Elbatta, None

    P. Rupali, None

    H. Hadid, None

    D. Moreno, None

    M. Ramesh, None

    R. Del Busto, None

    G. Alangaden, None

    Findings in the abstracts are embargoed until 12:01 a.m. EDT, Oct. 8th with the exception of research findings presented at the IDWeek press conferences.

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