Effect of antibiotic prophylaxis on the risk of surgical site infection in orthotopic liver transplant

Authors

  • Angel Asensio,

    1. Infectious Diseases Unit, Hospital Universitario Puerta de Hierro, Universidad Autónoma de Madrid, Madrid, Spain
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  • Antonio Ramos,

    Corresponding author
    1. Infectious Diseases Unit, Hospital Universitario Puerta de Hierro, Universidad Autónoma de Madrid, Madrid, Spain
    • Infectious Diseases Unit, Hospital Universitario Puerta de Hierro, Universidad Autónoma de Madrid San Martín de Porres 4, 28035 Madrid, Spain
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    • Telephone: 34 913445000 or 34 646 829 554; FAX: 34 913730535

  • Valentin Cuervas-Mons,

    1. Liver Transplantation Unit, Hospital Universitario Puerta de Hierro, Universidad Autónoma de Madrid, Madrid, Spain
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  • Elisa Cordero,

    1. Red de Estudio de la Infección en el Trasplante, (RESITRA)-Grupo de Estudio de la Infección en el Trasplante (GESITRA), Spain
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  • Victor Sánchez-Turrión,

    1. Liver Transplantation Unit, Hospital Universitario Puerta de Hierro, Universidad Autónoma de Madrid, Madrid, Spain
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  • Marino Blanes,

    1. Red de Estudio de la Infección en el Trasplante, (RESITRA)-Grupo de Estudio de la Infección en el Trasplante (GESITRA), Spain
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  • Carlos Cervera,

    1. Red de Estudio de la Infección en el Trasplante, (RESITRA)-Grupo de Estudio de la Infección en el Trasplante (GESITRA), Spain
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  • Joan Gavalda,

    1. Red de Estudio de la Infección en el Trasplante, (RESITRA)-Grupo de Estudio de la Infección en el Trasplante (GESITRA), Spain
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  • Jose M. Aguado,

    1. Red de Estudio de la Infección en el Trasplante, (RESITRA)-Grupo de Estudio de la Infección en el Trasplante (GESITRA), Spain
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  • Julian Torre-Cisneros

    1. Red de Estudio de la Infección en el Trasplante, (RESITRA)-Grupo de Estudio de la Infección en el Trasplante (GESITRA), Spain
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  • See Editorial on Page 747

Abstract

Surgical site infections are common bacterial infections in orthotopic liver transplantation. The purpose of this study was to determine the incidence, timing, location, and risk factors, specifically antibiotic prophylaxis, for surgical site infections. A prospective study was performed that included a population of 1222 consecutive patients (73.0% males) who underwent liver transplantation in Spanish hospitals belonging to the Red de Estudio de la Infección en el Trasplante research network. One hundred seven patients developed surgical site infections. The predominant infection sites were incisional wound (53 episodes) and peritonitis (40 episodes). The timing of the organ/space surgical site infections was slightly delayed in comparison with incisional surgical site infections. Enterococcus spp., Escherichia coli, Staphylococcus aureus, and Acinetobacter baumannii were the predominant pathogens. Choledochojejunal or hepaticojejunal reconstruction (odds ratio, 4.2; 95% confidence interval, 1.6–10.7), previous liver or kidney transplant (odds ratio, 2.6; 95% confidence interval, 1.1–6.3), and more than 4 red blood cell units transfused (odds ratio, 2.0; 95% confidence interval, 1.1–3.4) were independently associated with the development of surgical site infections. Biliary reconstruction by choledochojejunostomy or hepaticojejunostomy increases the risk of surgical site infections. Liver Transpl 14:799–805, 2008. © 2008 AASLD.

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