Multidrug-resistant bacteria and disease progression in patients with end-stage liver disease and after liver transplantation
Background: Multidrug-resistant (MDR) pathogens represent an emerging challenge in end-stage liver disease and in liver transplant recipients. - Methods: We evaluated the impact of MDR bacteria upon clinical outcomes in patients with end-stage liver disease (n = 777) at the time of enrollment on the...
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| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
13 July 2019
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| In: |
Journal of gastrointestinal and liver diseases
Year: 2019, Volume: 28, Issue: 3, Pages: 303-310 |
| ISSN: | 1842-1121 |
| DOI: | 10.15403/jgld-212 |
| Online Access: | Verlag, Volltext: https://doi.org/10.15403/jgld-212 Verlag: https://www.jgld.ro/jgld/index.php/jgld/article/view/212 
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| Author Notes: | Kilian Friedrich, Jessica Krempl, Shigehiko Schamoni, Theresa Hippchen, Jan Pfeiffenberger, Christian Rupp, Daniel Nils Gotthardt, Philip Houben, Rebecca von Haken, Alexandra Heininger, Thorsten Brenner, Arianeb Mehrabi, Karl-Heinz Weiss, Markus Mieth |
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| 245 | 1 | 0 | |a Multidrug-resistant bacteria and disease progression in patients with end-stage liver disease and after liver transplantation |c Kilian Friedrich, Jessica Krempl, Shigehiko Schamoni, Theresa Hippchen, Jan Pfeiffenberger, Christian Rupp, Daniel Nils Gotthardt, Philip Houben, Rebecca von Haken, Alexandra Heininger, Thorsten Brenner, Arianeb Mehrabi, Karl-Heinz Weiss, Markus Mieth |
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| 520 | |a Background: Multidrug-resistant (MDR) pathogens represent an emerging challenge in end-stage liver disease and in liver transplant recipients. - Methods: We evaluated the impact of MDR bacteria upon clinical outcomes in patients with end-stage liver disease (n = 777) at the time of enrollment on the liver transplant (LTx) waiting list, after first LTx (n = 645), and after second LTx (n = 128). - Results: Colonization/infection with MDR bacteria was present in 72/777 patients on the waiting list, in 98/645 patients at first LTx, and in 46/128 patients at second LTx. While on the LTx waiting list, the time until first hydropic decompensation (p = 0.021), hepatic encephalopathy (p < 0.001) and hepatorenal syndrome (p < 0.001) was reduced in the presence of MDR bacteria, which remained an independent risk factor of poor survival in multivariate analysis (p < 0.001). Following first and second liver transplant, MDR bacteria were associated with an increased risk of infection-related deaths (first LTx: p < 0.001; second LTx: p = 0.037) and reduced actuarial survival (first LTx: p < 0.001; second LTx: p = 0.046). - Conclusions: We showed that MDR pathogens are associated with poor outcomes before, after first and after recurrent LTx. | ||
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