Abstract:

Objective  To systematically assess the risk factors of multi-drug resistant organisms (MDROs) infection after liver transplantation and provide evidences for preventing and controlling the infection. Methods We searched the PubMed, OVID, Cochrane Database, Google scholar, CBMdisc, CNKI (literature published before December, 2013 was retrieved), and Internet to collect  prospective and retrospective studies at home and abroad on risk factors of MDROs infection after liver transplantation. Literature was screened and data were extracted by two reviewers according to inclusion and exclusion criteria. The quality of studies was evaluated according to Newcastle-Ottawa Scale evaluation standard and Meta analysis was performed by STATA 12 software. Results  A total of 5 cohort studies and 1 case-control study were included. The results of Meta analysis showed that hepatic encephalopathy Ⅱ-Ⅳ, drug-resistant bacteria colonization and application of antibacterial drugs before transplantation, hematodialysis, complications after transplantation (renal dysfunction and biliary complication), ICU staying time and prolonging endotracheal tube time (72 h), and reoperation were risk factors of MDROs infection after liver transplantation. Conclusion  Besides enhancing hand hygiene and management and application of clinical antibiotics, further improving the monitoring of patients during the perioperative period, shortening ICU stay time, removing the endotracheal tube as early as possible, and reducing the incidence of postoperative complications should be performed in order to reduce MDROs infection after liver transplantation.

Key words: liver transplantation, multi-drug resistant, infection, risk factors, Meta analysis, systematic evaluation