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Incidence, mortality, and risk factors associated with carbapenem-resistant Acinetobacter baumannii bacteremia within 30 days after liver transplantation

Authors
 Eun-Ki Min  ;  Seung Hyuk Yim  ;  Mun Chae Choi  ;  Jae Geun Lee  ;  Dong Jin Joo  ;  Myoung Soo Kim  ;  Deok-Gie Kim 
Citation
 CLINICAL TRANSPLANTATION, Vol.37(5) : e14956, 2023-05 
Journal Title
CLINICAL TRANSPLANTATION
ISSN
 0902-0063 
Issue Date
2023-05
MeSH
Acinetobacter Infections* / drug therapy ; Acinetobacter Infections* / epidemiology ; Acinetobacter Infections* / etiology ; Acinetobacter baumannii* ; Anti-Bacterial Agents / therapeutic use ; Bacteremia* / drug therapy ; Bacteremia* / epidemiology ; Bacteremia* / etiology ; Carbapenems / therapeutic use ; Humans ; Incidence ; Liver Transplantation* / adverse effects ; Risk Factors
Keywords
Acinetobacter baumannii ; carbapenem resistant ; liver transplantation
Abstract
Carbapenem-resistant Acinetobacter baumannii bacteremia (CRAB-B) is a fatal infectious complication of liver transplantation (LT). This study investigated the incidence, effects, and risk factors associated with CRAB-B during the early post-LT period. Among 1051 eligible LT recipients, 29 patients experienced CRAB-B within 30 days of LT with a cumulative incidence of 2.7%. In the patients with CRAB-B (n = 29) and matched controls (n = 145) by nested-case control design, the cumulative incidence of death on days 5, 10, and 30 from the index date was 58.6%, 65.5%, and 65.5%, and 2.1%, 2.8%, and 4.2%, respectively (p < .001). Pre-transplant MELD (OR 1.11, 95% confidence interval [CI] 1.04-1.19, p = .002), severe encephalopathy (OR 4.62, 95% CI 1.24-18.61, p = .025), donor body mass index (OR .57, 95% CI .41-.75, p < .001), and reoperation (OR 6.40, 95% CI 1.19-36.82, p = .032) were independent risk factors for 30-day CRAB-B. CRAB-B showed extremely high mortality within 30 days after LT, especially within 5 days after its occurrence. Therefore, assessment of risk factors and early detection of CRAB, followed by proper treatment, are necessary to control CRAB-B after LT.
Full Text
https://onlinelibrary.wiley.com/doi/10.1111/ctr.14956
DOI
10.1111/ctr.14956
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Deok Gie(김덕기)
Kim, Myoung Soo(김명수) ORCID logo https://orcid.org/0000-0002-8975-8381
Min, Eun-Ki(민은기)
Lee, Jae Geun(이재근) ORCID logo https://orcid.org/0000-0002-6722-0257
Yim, Seung Hyuk(임승혁) ORCID logo https://orcid.org/0000-0003-2146-3592
Joo, Dong Jin(주동진) ORCID logo https://orcid.org/0000-0001-8405-1531
Choi, Mun Chae(최문채)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/195328
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