ArticleMedicine2020
High prevalence of multidrug-resistant gram-negative bacterial infection following pediatric liver transplantation.
Article in Medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 2 of them syntheses that pooled it.
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Who cites it
18 citing papers in PubMed, 2 syntheses or guidelines pooled it, 30 citations in OpenAlex.
- Etiology and management of cholangitis in pediatric liver transplant recipients: a systematic review.Current opinion in organ transplantation · 2026Pooled it
- Global challenges of bacterial infections in organ transplantation: assessment of risk factors and predominant bacterial pathogen profiles threatening liver, kidney, heart, and lung transplant recipients.BMC infectious diseases · 2025Pooled it
- Preoperative NLR and INR, and intraoperative cold ischemia time as predictors of short-term mortality risk in paediatric liver transplantation: a LASSO-cox model study.Annals of medicine · 2026Article
- Piperacillin Population Pharmacokinetics in Plasma and Peritoneal Fluid and Dosing Optimization in Children Undergoing Liver Transplant: An Optimome Study.Clinical pharmacology and therapeutics · 2026Observational
- Multidrug resistant bacterial infection in liver transplant recipients: A Deterrent and obstacle.Pakistan journal of medical sciences · 2026Article
- Antimicrobial Prophylaxis in Solid Organ and Hematopoietic Stem Cell Transplantation: A Survey Among Member Centers of the European Reference Network TransplantChild.Pediatric transplantation · 2026Article
- National registry on characteristics and outcomes of pediatric liver transplantation in a middle-income country.BMC pediatrics · 2026Article
- Clinical characteristics and outcomes of liver transplant recipients with carbapenem resistant klebsiella pneumonia infection.Frontiers in cellular and infection microbiology · 2026Article
- Antimicrobial resistance surveillance of gram-negative bacteria among solid organ transplant recipients, a 4-year retrospective study.Scientific reports · 2025Article
- A Systematic Literature Review to Determine Gaps in Diagnosing Suspected Infection in Solid Organ Transplant Recipients.Open forum infectious diseases · 2025Article
- Incidence, causative organisms, and risk factors of bloodstream infections in pediatric liver transplant patients: a systematic review.Clinical and experimental pediatrics · 2024Article
- Risk factors of early bacterial infection and analysis of bacterial composition, distribution and drug susceptibility after cadaveric liver transplantation.Annals of clinical microbiology and antimicrobials · 2023Article
- A European International Multicentre Survey on the Current Practice of Perioperative Antibiotic Prophylaxis for Paediatric Liver Transplantations.Antibiotics (Basel, Switzerland) · 2023Article
- Risk factors and molecular epidemiology of fecal carriage of carbapenem resistant Enterobacteriaceae in patients with liver disease.Annals of clinical microbiology and antimicrobials · 2023Article
- Role of bacteriophage therapy for resistant infections in transplant recipients.Current opinion in organ transplantation · 2022Review
- Risk factors for antibiotic-resistant bacteria colonisation in children with chronic complex conditions.Scientific reports · 2022Article
- Epidemiology, Risk Factors and Outcome Due to Multidrug Resistant Organisms in Paediatric Liver Transplant Patients in the Era of Antimicrobial Stewardship and Screening.Antibiotics (Basel, Switzerland) · 2022Article
- Carbapenem-resistantFrontiers in public health · 2022Article
Corrections and comments
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Bacterial infection has been identified as one of the most significant complications of liver transplantation (LT). Multidrug-resistant (MDR) gram-negative bacteria (GNB) infection remains problematic issue following LT in the adults. However, data in children are scarce. We aimed to examine the prevalence and associated factors of MDR-GNB infection among pediatric LT recipients.We performed a single-center retrospectively study of 118 children who underwent LT between January 2010 and December 2018. Data on the prevalence, clinical characteristics, types, and sites of MDR-GNB infection within 3 months after LT as well as the treatment outcomes were collected. Multidrug resistance was defined as acquired non-susceptibility to at least 1 agent in 3 or more antibiotic classes.In total, 64 (53.7%) patients developed 96 episodes of culture-proven bacterial infection with 93 GNB isolates. Moreover, there were 58 (62.4%) MDR-GNB isolates, with a predominance of Klebsiella pneumoniae (32.7%), Escherichia coli (31%), and Pseudomonas aeruginosa (10.3%). Interestingly, 10 (17.2%) isolates were determined to be carbapenem-resistant Enterobacteriaceae. The median time to MDR-GNB infection was 9 (interquartile range: 5-33) days. The most common type of infection was intra-abdominal infection (47.9%). In the multivariate analysis, the significant variables associated with post-LT MDR-GNB infection include exposure to third-generation cephalosporins (hazard ratio [HR]: 2.16, P = .023), operative time (hazard ratio [HR] 1.20, P = .009), and length of intensive care unit stay (HR 1.03, P = .049). With a focus on carbapenem-resistant Enterobacteriaceae infection, a pediatric end-stage liver disease score >21 was the only significant 6 variable in the multivariate analysis (HR 11.48, P = .024). The overall 3-month mortality rate was 6.8%.This study has highlighted the high prevalence rate of MDR-GNB infection after pediatric LT. Therefore, caution on the emergence of MDR-GNB infection should be paid in at-risk children. Moreover, knowledge regarding the prevalence of MDR-GNB infection and resistant patterns is essential for guideline development to prevent and minimize the risk of MDR-GNB infection in this group of patients.
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