Skip to Main content Skip to Navigation
Master Thesis

Épidémiologie et facteurs de risques de bactériémie et de fongémies après transplantation hépatique au CHU Grenoble Alpes

Abstract : Introduction: Bloodstream infections are a major cause of morbidity and mortality among liver transplant recipients. This case-control study aimed to describe epidemiology, risk factors, and to evaluate the impact of those infections. Methods: We retrospectively analyzed the clinicals data of 207 liver transplant recipients, hospitalized in the Grenoble Alpes University-Hospital (France), between the 1st June 1995 and 1st April 2019 (69 cases et 138 controls). Results: The 69 cases presented a total of 151 bacteriemia and 7 fungemia. The median time to onset of the first episode was 48 days. Gram-Positive bacteria were isolated in 44,9% of cases, and Gram-Negative bacteria were isolated in 50,6% of those episodes. Microbiological and clinical epidemiology varied according to the time to onset of bacteriemia and fungemia. During the first Gram-Positive Cocci were predominant (66,7%), in association with a high frequency of catheter’s infections (21,7%). After this first month, Gram-Negative Bacilli were predominant (57,6%), in association with a high frequency of hepatobiliary complications (61,6%). The most frequent complication was the biliary stricture, which occurred at least once in 32.9% of patients. Significant independent risk factors for bacteremia and fungemia were as follows: occurrence of at least one episode of post-transplant bile leakage (OR = 3.86; CI 1.51-9.92), retransplantation (OR 9.62; CI 1.47-62.63). Significant independent protective factors for bacteremia and fungemia were as follows: prothrombin rate > 50% before transplant (OR 0.22; CI 0.08-0.57), non-refractory ascites before transplant (OR 0.22; IC 0.07-0.71). The mean stay in intensive care after transplant was significantly longer in the cases patients (13.6 days) than in the controls patients (9.4 days) (p = 0.0271). The average total stay after transplantation was also significantly longer in cases patients (43 days), than in controls patients (28.1 days) (p = 0.0001). The survival rates of the two groups were not significantly different (p = 0.8708). Conclusion: This study allows us to identify the microbiological and clinical epidemiology, but also the risk factors for bacteremia and fungemia in liver transplant patients. This brings us to a possible change on our local anti-infectious practices.
Document type :
Master Thesis
Complete list of metadatas

Cited literature [32 references]  Display  Hide  Download

https://dumas.ccsd.cnrs.fr/dumas-02986818
Contributor : Jean-Hugues Morneau <>
Submitted on : Tuesday, November 3, 2020 - 12:03:13 PM
Last modification on : Thursday, November 5, 2020 - 4:04:43 PM

File

2020GRAL5145_gerster_theophile...
Files produced by the author(s)

Identifiers

  • HAL Id : dumas-02986818, version 1

Citation

Théophile Gerster. Épidémiologie et facteurs de risques de bactériémie et de fongémies après transplantation hépatique au CHU Grenoble Alpes. Médecine humaine et pathologie. 2020. ⟨dumas-02986818⟩

Share

Metrics

Record views

29

Files downloads

16