Year 2023 / Volume 115 / Number 7
Original
Implementation and impact of an antibiotic control program and multidrug-resistant bacterial colonization in a liver transplant unit

357-361

DOI: 10.17235/reed.2022.8810/2022

Ainhoa Fernández, Clara Díez-Picazo, Carmen Iglesias Sobrino, Celia Trueba Collado, Mario Romero Cristóbal, Fernando Díaz Fontenla, Aránzazu Caballero Marcos, Maricela Valerio, María Olmedo, Teresa Vicente Rangel, Belén Padilla Ortega, Rafael Ramos, José Ángel López Baena, Patricia Muñoz, Rafael Bañares, Magdalena Salcedo,

Abstract
Introduction: infections by multidrug-resistant bacteria are a major cause of morbidity and mortality in transplant patients. Objective: a retrospective single-center study was performed to evaluate the implementation of an Antimicrobial Treatment Optimization Program (PROA) on multidrug-resistant bacteria colonization and infection after liver transplant (LT). Methods: colonization by multidrug-resistant bacteria and infections during the first year after a liver transplant were analyzed in a group of 76 transplanted patients in two stages, before and after PROA (2016-2019). Clinical variables related to infection, readmissions and survival one year after the liver transplant were analyzed. Results: there was good adherence to the PROA. Infection was the most frequent cause for readmission during the first year after the liver transplant. Incidence of infections was similar during both periods (mean of 1.25 and 1.5 episodes of bacterial infection per patient/year, respectively) with 19 bacterial infectious episodes, six by hospital-acquired multidrug-resistant and extensively drug-resistant (MDR-XDR) bacteria in the pre-PROA stage, and 18 bacterial infectious episodes, five by MDR-XDR in the post-PROA stage. A 37 % decrease of post-TH of rectal colonization by MDR-XDR after liver transplant was observed during 2019. Conclusions: epidemiological surveillance policies and antibiotic optimization are key to control the increase of colonization and infection by multidrug-resistant bacteria in liver transplant units. Long-term studies are needed to better evaluate the impact of these programs.
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Fernández A, Díez-Picazo C, Iglesias Sobrino C, Trueba Collado C, Romero Cristóbal M, Díaz Fontenla F, et all. Implementation and impact of an antibiotic control program and multidrug-resistant bacterial colonization in a liver transplant unit. 8810/2022


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Publication history

Received: 22/03/2022

Accepted: 19/04/2022

Online First: 31/05/2022

Published: 06/07/2023

Article Online First time: 70 days

Article editing time: 471 days


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