[Infections in the postoperative period of a liver transplant. A comparison of 2 protocols for anti-infectious prophylaxis]

Abstract

We discuss the incidence of infection in 198 liver transplants during the immediate post-surgical period. All of them were treated with protocols with anti-infective prophylaxis, and have been divided in two groups regarding the antibiotic scheme used, in the second of said groups we have included parenteral vancomycin. Global incidence of infection was different for both groups (46.9% in group A and 15.3% in group B) (p < 0.01). We stress that the most frequent germ found in the cultures of the group without vancomycin was Staphylococcus aureus, with a great difference between groups (p < 0.01); global incidence of pneumonias was also different between both groups (p < 0.05). After the introduction of vancomycin in the second group the most frequent found germ was Candida but with a low percentage. Gram-negative germs appear preferably in both groups when hospital stay was over 10 days. It is important to stress that transplanted patients who did not show rejection got significantly lesser infected (p < 0.05) than patients who shown rejection. We think that parenteral prophylaxis with ceftazidime and vancomycin, associated with oral-rhino-gastric decontamination, is useful for the control of early infections in patients with liver transplant.