Risk Factors,pathogenicity,drug Resistance And Survival Analysis Of Early Infection After Liver Transplantation

Purpose: To explore laws of the early after liver transplantation(3 months)infection in patients with risk factors,pathogens distribution and drug resistance analysis and the present status of survival,provide a reference for clinical doctors accurate diagnosis and treatment and infection prevention,finally,improve the postoperative survival rate of liver transplant recipients.Methods: Collected our hospital from February 2014 to February 2016,a total of 118 patients who underwent liver transplantation in patients with clinical data were retrospectively studied,its risk factors using Logistic regression analysis,the final out independent risk factors for infection after liver transplantation;The pathogens of various parts and ways to return specimens for culture and drug sensitive test,the results were statistically described;The Kaplan-Meier method to describe survival rate.Results: Independent risk factors for early infection after liver transplantation for the surgery time ≥600 min(P value = 0.002 OR higher,odds ratio(OR)= 10.339,95%confidence interval(95% CI)= 2.289 ~ 46.707),ICU length OR greater 6 days(P = 0.008,value OR = 0.008,95% CI = 1.618 ~ 26.536),the Child-Pugh class to C(P value =0.020,0 r = 6.600,95% CI = 1.354 ~ 32.167);In included in the study of 118 cases of liver transplant patients,61 cases of infection(51.69%),57 cases,there was no infection(48.31%),a total of 176 strains isolated pathogens.The pathogen strains is one of the most inbile,sputum,secondly,ascites,and the end of the Catheter drainage,blood,deep venous Catheter,midway through the urine,pleural effusion and Peripherally Inserted Central Catheter(PICC),etc.Including of G + bacteria of 82 strains(46.59%),G-bacteria for 52 strains(29.55%),fungus is 32 strains(18.18%),the virus for 10 strains(5.68%).Infection occurs mainly in liver transplant recipients within 1 month after surgery,accounting for about 141 strains(80.11%),especially in postoperative 1 week is most significantly,about 59 strains(33.52%),over time,the detection rate of pathogenic bacteria gradually leveled off;G + bacteria to penicillin,aminoglycoside and large ring lactone class,quinolone,lincosamide,etc all have higher drug resistance rate,especially the enterococcus faecium resistance to the highest.G-bacteria resistance distribution is individualized;Actively follow-up,in patients with liver transplantation postoperative infection of these patients,in 1month,12 months,24 months cumulative survival rates were 96.72%,94.91%,94.91%,and not infected patients were 100%,98.25%,96.49%(P= 0.454).Conclusion: The operation time≥600 min,ICU stay time≥ 6 days,the Child-Pugh class to C are independent risk factors for infection after liver transplantation.Increase the rate of pathogen specimens were postoperatively in patients with liver transplantation and the detection rate,in a timely manner according to the corresponding choose sensitive antibiotic susceptibility results.In the case of a positive and effective anti-infection treatment,establish scientific and perfect,reasonable postoperative follow-up system,provide professional medical guidance for postoperative patients in time,strive to improve the quality of the patient’s survival.