Risk Factors Of Multi-drug Resistant Bacteria Infection After Liver Transplantation

Objective Multi-drug resistant bacteria infection is a clinical complication with extremely high incidence after liver transplantation.The purpose of this study was to analyze the clinical data of patients after liver transplantation to obtain the relevant risk factors for infection with multi-drug resistant bacteria after liver transplantation.Methods Through our medical record system and the China Liver Transplant Registry,we collect clinical information on all patients undergoing liver transplantation in our center from January 2015 to December 2020,and the possible risks of infection with multi-drug resistant bacteria after liver transplantation.Logistic univariate analysis regression analysis was performed on the risk factors,and then the statistically different risk factors were included in the Logistic multivariate regression analysis,and then the independent risk factors related to the infection of multi-drug resistant bacteria after liver transplantation were obtained.Establishing a risk prediction model for infection of multi-drug resistant bacteria after liver transplantation,and on this basis,make ROC curve,and evaluate the effect of this model on predicting the risk of multi-drug resistant bacteria infection after liver transplantation through the area under the ROC curve.Results 1.This project included a total of 135 liver transplant patients who met the inclusion criteria.The main causes of liver transplantation were 56 cases of hepatocellular carcinoma,72 cases of liver cirrhosis,3 cases of cholangiocarcinoma,and 4 cases of other liver diseases.46 cases were infected with multi-drug resistant bacteria after liver transplantation,accounting for 34.07%;2.A total of 31 risk factors that may affect the infection of multi-drug resistant bacteria in recipients after liver transplantation were included.In final,Logistic multivariate regression analysis showed that a total of 4 independent risk factors may affect the infection of multi-drug resistant bacteria after liver transplantation,respectively,age(OR:1.06,95%CI:1.0121.109,P=0.013),gender(OR:3.677,95%CI:1.210-11.175,P=0.022),MELD score(OR:1.079,95%CI:1.033-1.127,P=0.001),length of hospital stay(OR:1.057,95%CI:1.012-1.103,P=0.012);3.The predictive model of multi-drug resistant bacteria infection after liver transplantation is:Logistic(P)=7.529+0.058*age+1.302*gender+0.076*MELD score+0.055*length of hospital stay.The area under the ROC curve is 0.81(95%CI 0.729-0.891),which is better than the invalid model(chance line)(P<0.001).Conclusions The independent risk factors for infection of multi-drug resistant bacteria in recipients after liver transplantation are gender,age,length of hospital stay and MELD score,and the risk prediction model can be used to better predict whether patients would be infected with multi-drug resistant bacteria after liver transplantation.