Title : Risk factors for bacterial infection in children following liver transplantation in Indonesia: A preliminary study
Abstract:
Objective: Survival rate and quality of life of children with chronic hepatobiliary disease has improved since the development of liver transplantation. Incidence of bacterial infection is 36– 79% at 6 months post-transplantation and mortality of 3.0–10.6% at 3 months post- transplantation. Adequate prevention of bacterial infection will reduce morbidity and mortality and increase survival. This study aimed to determine the risk factors for bacterial infection in children who underwent liver transplantation in Indonesia.
Methods: This retrospective cohort study includes pediatric recipients who underwent liver transplantation in Cipto Mangunkusumo Hospital (CMH) during December 2010 – April 2023 with total sampling method. Subjects were classified into groups with and without bacterial infection.
Results: Prevalence of bacterial infection of the 63 subjects was 84.13%. A majority of the bacterial infection cases were healthcare-associated infections (HAIs), comprising of surgical site infections (29.63%), ventilator-associated pneumonia (14.81%), and catheter-related urinary tract infections (13.58%). Multivariate analysis showed ICU length of stay ≥20 days (RR 1.212; CI 95% 1.028−1.426; p = 0.022) and volume of blood loss during surgery ≥70 mL/kg (RR 1.283; CI 95% 1.009 −1.631; p = 0.042) were risk factors for bacterial infection following liver transplantation. Subgroup analysis presented ICU length of stay ≥20 days increased risk of multi- drug resistance bacterial infection by 2.479 times (CI 95% 1.185 – 5.187; p = 0.016).
Conclusion: Bacterial infection prevalence at six-months post-liver transplantation of children in CMH was 84.13% with ICU length of stay ≥20 days and volume of blood loss during surgery ≥70 mL/kg as risk factors. Further studies with better design and larger samples are needed.
