A 17-year study of bloodstream Escherichia coli infection after liver transplantation: Resistance rate, risk factor and mortality

Objective: To explore the resistance rate, risk factors and mortality of Escherichia coli bloodstream infections (BSI) after liver transplantation. Methods: From January 1993 to May 2010, a retrospective analysis of Escherichia coli in liver transplants were conducted. Results: A total of 88 BSI occurred in 83/695 patients and Escherichia coli (n = 23) was most commonly found. Carbapenem and piperacillin-tazobactam were the most consistentiy active against Escherichia coli while the resistance rate to enterococcus for ciprofloxacin, gentamycin, ampicillin-clavulanic acid was over 60%. Univariate analysis identified the following variables as risk factors for Escherichia coli bacteremia: cholangioenterostomy (P < 0.001) and ductal complications (F < 0.001). Escherichia coli bloodstream infection could increase the mortality at 15 days after bloodstream infection. No significant difference in mortality occurred at 30 days and 1 year after enterococcal bacteremia. Conclusion: Escherichia coli after liver transplantation is resistant to agents but commonly active to carbapenem and piperacillin-tazobactam. The risk factor associated with Escherichia coli bloodstream infections are cholangioenterostomy and ductal complications. Escherichia coli bloodstream infection can increase the mortality at 15 days after bloodstream infection.