Enterococcal infections the first year after liver—a prospective cohort study
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Enterococcal infections the first year after liver—a prospective cohort study. / Rasmussen, Daniel B.; Møller, Dina L.; Knudsen, Andreas D.; Rostved, Andreas A.; Knudsen, Jenny D.; Rasmussen, Allan; Nielsen, Susanne D.
In: Microorganisms, Vol. 9, No. 8, 1740, 2021.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Enterococcal infections the first year after liver—a prospective cohort study
AU - Rasmussen, Daniel B.
AU - Møller, Dina L.
AU - Knudsen, Andreas D.
AU - Rostved, Andreas A.
AU - Knudsen, Jenny D.
AU - Rasmussen, Allan
AU - Nielsen, Susanne D.
N1 - Publisher Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2021
Y1 - 2021
N2 - This study aimed to investigate the incidence of enterococcal infections and determine risk factors associated with enterococcal bloodstream infection (BSI) within the first year post-liver transplantation (LTx). We included 321 adult liver transplant recipients transplanted from 2011 to 2019 in a prospective cohort study. Cumulative incidence of enterococcal infections and risk factors associated with BSI were investigated in a competing risk model and time-updated Cox models, respectively. A total of 223 enterococcal infections were identified in 89 recipients. The cumulative incidences of first enterococcal infection and first enterococcal BSI were 28% (95% CI (23–33)) and 11% (CI (7–14)), respectively. Risk factors associated with enterococcal BSI were previous infections in the biliary tract (HR, 33; CI (15–74); p < 0.001), peritoneum (HR, 8.1; CI (3–23); p < 0.001) or surgical site (HR, 5.5; CI (1.4–22); p = 0.02), recipient age (HR per 10 years increase, 1.2; CI (1.03–1.6); p = 0.03), and cold ischemia time (HR per one hour increase, 1.2; CI (1.1–1.3); p < 0.01). Enterococcal infections are highly prevalent the first year post-LTx, and recipients with enterococcal infections in the biliary tract, peritoneum, or surgical site are at increased risk of BSI. These findings may have implications for the choice of empiric antibiotics early post-LTx.
AB - This study aimed to investigate the incidence of enterococcal infections and determine risk factors associated with enterococcal bloodstream infection (BSI) within the first year post-liver transplantation (LTx). We included 321 adult liver transplant recipients transplanted from 2011 to 2019 in a prospective cohort study. Cumulative incidence of enterococcal infections and risk factors associated with BSI were investigated in a competing risk model and time-updated Cox models, respectively. A total of 223 enterococcal infections were identified in 89 recipients. The cumulative incidences of first enterococcal infection and first enterococcal BSI were 28% (95% CI (23–33)) and 11% (CI (7–14)), respectively. Risk factors associated with enterococcal BSI were previous infections in the biliary tract (HR, 33; CI (15–74); p < 0.001), peritoneum (HR, 8.1; CI (3–23); p < 0.001) or surgical site (HR, 5.5; CI (1.4–22); p = 0.02), recipient age (HR per 10 years increase, 1.2; CI (1.03–1.6); p = 0.03), and cold ischemia time (HR per one hour increase, 1.2; CI (1.1–1.3); p < 0.01). Enterococcal infections are highly prevalent the first year post-LTx, and recipients with enterococcal infections in the biliary tract, peritoneum, or surgical site are at increased risk of BSI. These findings may have implications for the choice of empiric antibiotics early post-LTx.
KW - Antibiotic resistance
KW - Bacteremia
KW - Biliary tract infec-tion
KW - Bloodstream infections
KW - Cholangitis
KW - Enterococcal infections
KW - Liver transplantation
U2 - 10.3390/microorganisms9081740
DO - 10.3390/microorganisms9081740
M3 - Journal article
C2 - 34442818
AN - SCOPUS:85112408135
VL - 9
JO - Microorganisms
JF - Microorganisms
SN - 2076-2607
IS - 8
M1 - 1740
ER -
ID: 276850407