Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Aug;23(4):e13589.
doi: 10.1111/tid.13589. Epub 2021 Mar 23.

Rates and causative pathogens of surgical site infections attributed to liver transplant procedures and other hepatic, biliary, or pancreatic procedures, 2015-2018

Nora Chea  1 , Mathew R P Sapiano  1   2 , Liang Zhou  1   3 , Lauren Epstein  1 , Alice Guh  1 , Jonathan R Edwards  1 , Katherine Allen-Bridson  1 , Victoria Russo  1   3 , Jennifer Watkins  1   3 , Stephanie M Pouch  4 , Shelley S Magill  1
Affiliations

Rates and causative pathogens of surgical site infections attributed to liver transplant procedures and other hepatic, biliary, or pancreatic procedures, 2015-2018

Nora Chea et al. Transpl Infect Dis. 2021 Aug.

Abstract

Liver transplant recipients are at high risk for surgical site infections (SSIs). Limited data are available on SSI epidemiology following liver transplant procedures (LTPs). We analyzed data on SSIs from 2015 to 2018 reported to CDC's National Healthcare Safety Network to determine rates, pathogen distribution, and antimicrobial resistance after LTPs and other hepatic, biliary, or pancreatic procedures (BILIs). LTP and BILI SSI rates were 5.7% and 5.9%, respectively. The odds of SSI after LTP were lower than after BILI (adjusted odds ratio = 0.70, 95% confidence interval 0.57-0.85). Among LTP SSIs, 43.1% were caused by Enterococcus spp., 17.2% by Candida spp., and 15.0% by coagulase-negative Staphylococcus spp. (CNS). Percentages of SSIs caused by Enterococcus faecium or CNS were higher after LTPs than BILIs, whereas percentages of SSIs caused by Enterobacteriaceae, Enterococcus faecalis, or viridans streptococci were higher after BILIs. Antimicrobial resistance was common in LTP SSI pathogens, including E. faecium (69.4% vancomycin resistant); Escherichia coli (68.8% fluoroquinolone non-susceptible and 44.7% extended spectrum cephalosporin [ESC] non-susceptible); and Klebsiella pneumoniae and K. oxytoca (39.4% fluoroquinolone non-susceptible and 54.5% ESC non-susceptible). National LTP SSI pathogen and resistance data can help prioritize studies to determine effective interventions to prevent SSIs and reduce antimicrobial resistance in liver transplant recipients.

Keywords: drug resistance; liver transplantation; microbial; surgical wound infection.

PubMed Disclaimer

Conflict of interest statement

The authors of this manuscript have no conflicts of interest to disclose.

References

    1. Organ Procurement and Transplantation Network . National Data. https://optn.transplant.hrsa.gov/data/view‐data‐reports/national‐data/#. Accessed May 27, 2020.
    1. Scientific Registry of Transplant Recipients . Transplant Center Search Results. https://www.srtr.org/transplant‐centers/?&organ=liver&recipientType=adul.... Accessed May 27, 2020.
    1. Scientific Registry of Transplant Recipients . OPTN/SRTR 2018 Annual Data Report: Liver. https://srtr.transplant.hrsa.gov/annual_reports/2018/Liver.aspx. Accessed May 28, 2020.
    1. Viehman JA, Clancy CJ, Clarke L, et al. Surgical site infections after liver transplantation: emergence of multidrug‐resistant bacteria and implications for prophylaxis and treatment strategies. Transplantation. 2016;100(10):2107‐2114. - PubMed
    1. Natori Y, Kassar R, Iaboni A, et al. Surgical site infections after liver transplantation: prospective surveillance and evaluation of 250 transplant recipients in Canada. Infect Control Hosp Epidemiol. 2017;38(9):1084‐1090. - PubMed

MeSH terms

Substances