The Epidemiology and Distribution of Pathogens and Risk Factors for Mortality in Liver Transplant Recipients with Gram Negative Bacteremia

Background: More data on the epidemiology and distribution of pathogens and the risk factors for Mortality in liver transplant recipients with Gram negative bacteremia are needed. Methods: Among a cohort of 228 liver transplant recipients, we identified 35 patients with initial episodes of Gram negative bacteremia after operation. The association between the risk factors and Gram negative bacteremia related mortality was assessed. Results: Forty-seven episodes of Gram negative bacteremia occurred in 15.4% of liver transplant recipients. The mean age for these 35 patients was 46.1 years. Among patients with Gram negative bacteremia, 51.4% had an intra-abdominal/biliary source of infection and Escherichia coli was the most common microorganism. There were 18 deaths with a mortality rate of 51.4%. Multivariate logistic regression showed that the independent risk, factors for mortality are serum albumin level <3.0 mg/dL (odds ratio[OR] = 17.6, 95% confidence interval[CI] = 1.4-224.6, P = 0.027) and septic shock (OR = 37.5;95% CI = 3.6-386.7, P = 0.002). Conclusion: The risk factors significantly associated with increased mortality due to Gram negative bacteremia in liver transplant recipients; are decreased serum albumin level and septic shock.