Predicting bacteremia and bacteremic mortality in liver transplant recipients

Singh, N., Paterson, D.L., Gayowski, T., Wagener, M.M. and Marino, I.R. (2000). Predicting bacteremia and bacteremic mortality in liver transplant recipients. In: Liver Transplantation.. Annual Meeting of the American-Society-of-Transplantation, Chicago, IL, U.S.A., (54-61). 15-19 May, 1999. doi:10.1002/lt.500060112


Author Singh, N.
Paterson, D.L.
Gayowski, T.
Wagener, M.M.
Marino, I.R.
Title of paper Predicting bacteremia and bacteremic mortality in liver transplant recipients
Conference name Annual Meeting of the American-Society-of-Transplantation
Conference location Chicago, IL, U.S.A.
Conference dates 15-19 May, 1999
Proceedings title Liver Transplantation.   Check publisher's open access policy
Journal name Liver Transplantation   Check publisher's open access policy
Place of Publication Hoboken. NJ., U.S.A.
Publisher Wiley Interscience
Publication Year 2000
Sub-type Fully published paper
DOI 10.1002/lt.500060112
ISSN 1527-6465
1527-6473
Volume 6
Issue 1
Start page 54
End page 61
Total pages 8
Language eng
Abstract/Summary Predictors of bacteremia and mortality in bacteremic liver transplant recipients were prospectively assessed. One hundred eleven consecutive episodes of fever or infections were documented in 59 patients over a 4-year period. Forty-nine percent (29 of 59 patients) of the patients had bacteremia, 39% (23 of 59 patients) had nonbacteremic infections, and 12% (7 of 59 patients) had fever of noninfectious cause. Primary (catheter-related) bacteremia (31%; 9 of 29 patients), pneumonia (24%; 7 of 29 patients), abdominal and/or biliary infections (14%; 4 of 29 patients), and wound infections (10%; 3 of 29 patients) were the predominant sources of bacteremia. Diabetes mellitus (odds ratio, 6.9; P = .03) and serum albumin level less than 3.0 mg/dL (odds ratio, 0.14; P = .02) were independently significant predictors of bacteremia compared with nonbacteremic infections. Mortality at 14 days was 28% (8 of 29 patients) in those with bacteremia compared with 4% (1 of 23 patients) in those with nonbacteremic infections and 0% (0 of 7) in patients with fever of noninfectious cause (P = .03). Intensive care unit stay at the time of bacteremia (100% v 47%; P = .005), absence of chills (0% v 53%; P = .005), lower temperature at the onset of bacteremia (99.2°F v 101.5°F; P = .009), lower maximum temperature during the course of bacteremia (99.3°F v 102°F, P = .008), greater serum bilirubin level (7.6 v 1.5 mg/dL; P = .024), presence of abnormal blood pressure (80% v 16%; P = .0013), and greater prothrombin time (15.6 v 13.3 seconds; P = .013) were significantly predictive of greater mortality in the bacteremic patients. These data have implications for discerning the likelihood of bacteremia and initiation of empiric antibiotics pending cultures. Lack of febrile response in bacteremic liver transplant recipients portended a poorer outcome. (C) 2000 by the American Association for the Study of Liver Diseases.
Subjects 1103 Clinical Sciences
Keyword Factors Influencing Prognosis
Major Bacterial-infections
Risk-factors
Cytomegalovirus Disease
Receiving Tacrolimus
Etiologic Agents
Fever
Survival
Sepsis
Outcomes
Q-Index Code E1

Document type: Conference Paper
Collection: UQ Centre for Clinical Research Publications
 
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Created: Tue, 07 Sep 2010, 17:12:25 EST