Microbiologic Investigation of Patients Before Living-Donor Liver Transplant.

OBJECTIVES

Chronic infections can cause serious complications and create morbidity and mortality for affected patients during immunosuppressive therapy in the posttransplant period. Here, we studied the microbiologic screening results of patients before living-donor liver transplant.

MATERIALS AND

METHODS

The microbiologic screening results of 25 patients during 2015 at National Scientific Research Center (Astana, Kazakhstan) before livingdonor liver transplant were prospectively analyzed. Sputum samples, swabs from throat and nose, and urine samples were collected for quantitative microbiologic examination. Identification of isolates and antibiotic susceptibility testing were performed using the Vitek 2 automated system (bioMérieux, Marcy l'Etoile, France).

RESULTS

Of the patients, 16 (64%) were female and the average age was 46.8 ± 2.2 years. Of 97 clinical samples collected, 80 samples (82.4%) showed bacterial growth. A total of 88 isolates to 15 different species was isolated. The greatest number of bacteria was isolated from throat swabs (35.2%). Of 88 isolates, 70 isolates (79.5%) were gram-positive, with α-hemolysis streptococci being the major isolate (39.7%). Coagulase-negative staphylococci were found in 13.6% of isolates, Staphylococcus aureus in 11.3%, and both Klebsiella pneumoniae and Streptococcus pneumoniae in 10.2%. Results of antibiotic susceptibility testing showed that the resistance rate of Staphylococcus aureus to oxacillin was 10%. About 87.5% of isolates of Klebsiella pneumoniae were resistant to inhibitor-protected penicillin, 85.7% to quinolones, and more than 60% to cephalosporins and aminoglycosides groups of antibiotics.

CONCLUSIONS

Microbiologic monitoring of recipients before living-donor liver transplant showed higher prevalence of opportunistic pathogens. These results suggest establishing quality preoperative preparations with a view to possible improvements in the health status of intended recipients and elimination of factors that could adversely affect the transplant and cause complications during the postoperative period.