Multidrug-resistant bacteria and disease progression in patients with end-stage liver disease and after liver transplantation

• Verfasst von: Friedrich, Kilian [VerfasserIn]
• Verfasst von: Schamoni, Shigehiko [VerfasserIn]
• Verfasst von: Wenz, Theresa [VerfasserIn]
• Verfasst von: Pfeiffenberger, Jan [VerfasserIn]
• Verfasst von: Rupp, Christian [VerfasserIn]
• Verfasst von: Gotthardt, Daniel [VerfasserIn]
• Verfasst von: Houben, Philipp [VerfasserIn]
• Verfasst von: Haken, Rebecca von [VerfasserIn]
• Verfasst von: Heininger, Alexandra [VerfasserIn]
• Verfasst von: Brenner, Thorsten [VerfasserIn]
• Verfasst von: Mehrabi, Arianeb [VerfasserIn]
• Verfasst von: Weiss, Karl Heinz [VerfasserIn]
• Verfasst von: Mieth, Markus [VerfasserIn]
• Titel: Multidrug-resistant bacteria and disease progression in patients with end-stage liver disease and after liver transplantation
• Verf.angabe: 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
• E-Jahr: 2019
• Jahr: 13 July 2019
• Umfang: 9 S.
• Fussnoten: Gesehen am 04.11.2019
• Titel Quelle: Enthalten in: Journal of gastrointestinal and liver diseases
• Ort Quelle: Cluj-Napoca : Soc., 2006
• Jahr Quelle: 2019
• Band/Heft Quelle: 28(2019), 3, Seite 303-310
• ISSN Quelle: 1842-1121
• DOI: doi:10.15403/jgld-212
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 168088736X

Abstract

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.