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Pseudomonas aeruginosa bacteremia in patients undergoing liver transplantation: An emerging problem

Korvick, JA and Marsh, JW and Starzl, TE and Yu, VL (1991) Pseudomonas aeruginosa bacteremia in patients undergoing liver transplantation: An emerging problem. Surgery, 109 (1). 62 - 68. ISSN 0039-6060

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Abstract

In our institution, Pseudomonas aeruginosa bacteremia appeared to occur with increasing frequency in patients undergoing liver transplantation. We thus conducted a prospective study to define risk factors and outcome in these patients. Over a 19-month period 6% of liver transplants were followed by Pseudomonas bacteremia. The mean age was 46 years (range, 24 to 67 years). The interval between transplantation and onset of bacteremia was 3 to 372 days (mean, 80). The incidence of Pseudomonas bacteremia in liver transplants was three times that of other transplants (heart, lung, kidney). Ninety one percent of infections were nosocomial. Polymicrobial bacteremia occurred in 30% of episodes. The portal of entry was respiratory in 30%, abdominal in 35%, and biliary in 13%. Four patients had recurrent Pseudomonas bacteremia: liver abscess (1), biliary obstruction (2), subhepatic abscess (1). Survival at 14 days was 70%. Survival rates were significantly lower for patients with hypotension, on mechanical ventilators, and increasing severity of illness (p < 0.05). Survival was higher when bacteremia occurred within the first 30 days after transplantation compared to after 30 days. A large number (43.4%) of Pseudomonas bacteremias occurred after transplant surgery or biliary tract manipulation, while the patient was receiving a prophylactic regimen of cefotaxime and ampicillin. P. aeruginosa is an important pathogen in the liver transplant recipient; prevention may be possible for a subgroup of patients with the use of prophylactic antibiotics with activity against P. aeruginosa.


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Korvick, JA
Marsh, JW
Starzl, TEtes11@pitt.eduTES11
Yu, VL
Centers: Other Centers, Institutes, or Units > Thomas E. Starzl Transplantation Institute
Date: 1 January 1991
Date Type: Publication
Journal or Publication Title: Surgery
Volume: 109
Number: 1
Page Range: 62 - 68
Institution: University of Pittsburgh
Refereed: Yes
ISSN: 0039-6060
Other ID: uls-drl:31735062117019, Starzl CV No. 1148
Date Deposited: 08 Apr 2010 17:19
Last Modified: 13 Oct 2017 21:56
URI: http://d-scholarship.pitt.edu/id/eprint/4534

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