Multidrug-resistant bacterial infections in the liver transplant setting.

IF 2.4 3区医学 Q2 SURGERY

Updates in Surgery Pub Date : 2024-11-01 Epub Date: 2024-06-25 DOI:10.1007/s13304-024-01903-6

Alberto Ferrarese, Marco Senzolo, Lolita Sasset, Domenico Bassi, Umberto Cillo, Patrizia Burra

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Abstract

Bacterial infections pose a life-threatening complication in patients with decompensated liver cirrhosis and acute-on-chronic liver failure. An increasing prevalence of infections caused by multidrug-resistant organisms (MDROs) has been observed in these patients, significantly impacting prognosis. A growing body of evidence has identified the most common risk factors for such infections, enabling the development of preventive strategies and therapeutic interventions. MDRO infections may also occur after liver transplantation (most commonly in the early post-operative phase), affecting both graft and patient survival. This review provides an overview of MDRO infections before and after liver transplantation, discussing epidemiological aspects, risk factors, prevention strategies, and novel therapeutic approaches. Furthermore, it examines the implications of MDRO infections in the context of prioritizing liver transplantation for the most severe patients, such as those with acute-on-chronic liver failure.

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肝移植手术中的耐多药细菌感染。

细菌感染是肝硬化失代偿期和急性-慢性肝衰竭患者的一种威胁生命的并发症。在这些患者中，耐多药生物（MDRO）引起的感染发病率越来越高，严重影响了预后。越来越多的证据已经确定了此类感染最常见的风险因素，从而有助于制定预防策略和治疗干预措施。肝移植后也可能发生 MDRO 感染（最常见于术后早期），影响移植物和患者的存活。本综述概述了肝移植前后的 MDRO 感染，讨论了流行病学方面、风险因素、预防策略和新型治疗方法。此外，它还探讨了 MDRO 感染对优先为最严重的患者（如急性-慢性肝功能衰竭患者）进行肝移植的影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Updates in Surgery Medicine-Surgery

CiteScore

4.50

自引率

7.70%

发文量

208

期刊介绍： Updates in Surgery (UPIS) has been founded in 2010 as the official journal of the Italian Society of Surgery. It’s an international, English-language, peer-reviewed journal dedicated to the surgical sciences. Its main goal is to offer a valuable update on the most recent developments of those surgical techniques that are rapidly evolving, forcing the community of surgeons to a rigorous debate and a continuous refinement of standards of care. In this respect position papers on the mostly debated surgical approaches and accreditation criteria have been published and are welcome for the future. Beside its focus on general surgery, the journal draws particular attention to cutting edge topics and emerging surgical fields that are publishing in monothematic issues guest edited by well-known experts. Updates in Surgery has been considering various types of papers: editorials, comprehensive reviews, original studies and technical notes related to specific surgical procedures and techniques on liver, colorectal, gastric, pancreatic, robotic and bariatric surgery.